What is acne?

Acne is a common skin condition caused by clogged hair follicles beneath the skin. Sebum (an oil that prevents the skin from drying out) and dead skin cells tend to clog pores which cause lesions known as pimples or zits. The outbreaks usually show up on the face, but they can also show up on a person’s back, chest and shoulders.

What are the types of acne?

Acne causes several types of lesions or pimples. Doctors refer to enlarged or clogged hair follicles as comedones.

Types of acne include:

• Whiteheads -  clogged hair follicles that form a white bump and remain beneath the skin.
• Blackheads - clogged follicles that open when they reach the skin’s surface causing black discolouration due to exposure to the air and not from dirt.
• Papules - lesions that are inflamed and can be tender to the touch. They typically appear as small, pink bumps on the skin.
• Pustules or pimples - pus-filled lesions that are white or yellow and may be red at the base.
• Nodules - large, bothersome, solid lesions that are buried deep in the skin.
• Cystic acne - also known as severe nodular acne, these lesions are deep, painful and pus-filled.

What causes acne?

Acne is a hormonal condition caused mainly by androgen hormones. It typically becomes active during a person’s teenage and young adult years. Sensitivity to these hormones, surface skin bacteria, fatty acids in oil glands and other factors can cause acne.

Acne can be caused by or exacerbated by the following:

• Picking at an acne scar
• Tight clothing, and headgear like hats and sports helmets
• Changes in hormone levels around a woman's period cycle
• Stress, which can raise the hormone cortisol
• Certain types of medications
• Genetics
• Pollution in the air and specific weather conditions, particularly high humidity
• Personal care products such as heavy lotions, creams or hair pomades and waxes that cause the skin to be oily or greasy.

What are the symptoms of acne?

The most common areas to experience breakouts are:

• Face and neck
• Chest
• Shoulders
• Back
• Shoulders

Those with acne might also experience:

• Scarring or skin discolouration, including dark spots (hyperpigmentation) and redness
• Swelling and inflammation
• Pain and tenderness when touched or not

What are the treatments for acne?

The purpose of acne treatment is to aid in the healing of existing lesions, prevent the formation of new lesions and prevent scarring. Some of the factors that lead to acne such as an abnormal clumping of cells in the follicles, high levels of sebum, bacteria and inflammation can be stopped with medication. Your doctor may suggest prescription or over-the-counter medications that can be taken orally or applied topically.

Topical medications (medication applied to the outer layer of the skin) include:

• Antibiotics, usually used with other topical medications.
• Vitamin A-derived retinoids, used to treat lesions and reduce inflammation. Additionally, they can aid in scarring and acne prevention.
• Benzoyl peroxide, which may reduce sebum production and kill bacteria.
• Salicylic acid that breaks down whiteheads and blackheads, and helps reduce cell shedding from hair follicles.

There are numerous types of topical medications, including pads, gels, lotions, creams and soaps. Topical medications may result in adverse effects such as redness, irritation, or burning of the skin for some individuals. It is best to consult your dermatologist if you are experiencing any side effects.

Oral medications include:

• Antibiotics, to slow or stop the growth of bacteria and reduce inflammation. Other topical therapies are usually prescribed alongside antibiotics by your doctor. This is usually for moderate to severe acne, such as severe nodular acne (also called cystic acne).
• Retinoids, that help treat acne by opening pores and working their way through the bloodstream. This makes it possible for other treatments like antibiotics to get into the follicles and treat the acne.
• Corticosteroids, that aid in reducing inflammation of severe acne, including severe nodular acne. The medication may be injected directly into the affected areas of your skin after consulting your skin doctor.

Some people may require additional treatments for severe acne that does not respond to oral or topical medications, such as:

• Laser and light therapies
• Chemical peels are applied by a skin doctor to the skin on a superficial level
• Surgical procedures that aid in the treatment and repair of scars

The treatment of the skin requires a gentle touch. Our dermatologists at SKINCENTRIC located in Bukit Tinggi Medical Centre (BTMC) have many years of treating various types of skin conditions. They can give you a detailed explanation of your skin condition and what treatments suit you best.