Acne is a common skin condition affecting up to 80% of teenagers. It is primarily caused by hormonal factors although personal hygiene, certain drugs and even other diseases can contribute to acne. Although it is so common, there are still many misconceptions surrounding this skin disease. Similarly, there are many myths about the treatment of acne. Acne should be treated by a medical doctor, preferably a dermatologist, and there is no cure for acne.
What is Acne?
In terms of teen acne, or acne vulgaris, the first signs of a skin problem starts around the time of puberty. This is often marked by menarche, the start of menstruation in young girls. In young boys, it may coincide with body hair growth, particularly the pubic hair and/or facial hair. The fluctuating hormones associated with puberty acts on the skin, causing the oil gland (sebaceous gland) to produce more oil (sebum). This is the reason that many teens have oily skin.
The oil gland empties the oil into a duct that leads to the skin through a pore. This duct also contains a hair shaft. Sometimes these ducts get blocked with the oil and causes inflammation of the skin at that area. If it gets infected with bacteria, the simple papule (pimple) will become a large pustular pimple, which teens sometimes call a zit.
While teens are more likely to suffer with acne, it may continue into adulthood. In fact, most teens who suffer with acne may find that it will only settle in the early 20s. In some cases this persists right till the 30s, especially if there is a hormonal disorder. When acne starts in adulthood, it could be a sign of a hormonal disorder – particularly gynaecological disorders in women, like polycystic ovary syndrome (PCOS) or other hormonal causes also associated with infertility. The hormonal changes associated with pregnancy is also the reason that acne is seen during this stage.
Back & Chest Acne
While the face is most often affected, acne can also occur on other areas, particularly, the chest, back and/or shoulders. Back acne, sometimes called bacne or backne, affects most teens along with pimples on the face. The treatment for acne on the back, shoulders and chest is the same as that of the face and requires a combination of oral and topical medication.
Pinching or Squeezing Pimples
Most teens, and even adults, pinch or squeeze a pimple, believing that this will resolve the condition. In fact pinching a zit will actually aggravate your condition further. A pimple is usually visible for 7 to 10 days, depending on the size, after which it resolves, leaves a small spot or mark that fades within 3 months.
Squeezing a pimple will reduce its size within 24 to 48 hours but leaves a scar that will stay for a lifetime. It is therefore not advisable to ever squeeze or pinch a pimple, especially a pustular pimple. These larger ‘zits’ are small cyst-like structures under the skin and any exudate that may erupt when pinching the pimple is only a small amount of the pus. The remainder of the pus, spreads along the deeper skin surface and causes pimples in and around the same area again.
Pinching or squeezing a pimple also makes the skin more prone to infections. At times, a pimple may burst on its own, or when gently washing and this cannot be avoided. This rupture which is not caused by severe trauma through pinching and squeezing, will often not scar. Certain ‘spot’ creams and gel may help dry out a pimple within 4 days and will prevent scarring and skin infections.
Make Up, Skin Creams and Acne
Any application that blocks the pores of the skin can contribute to acne, especially if you have oily skin. Using make up, like foundation or powder, or cosmetic skin creams are the biggest contributing factors to acne caused by skin applications. Foundation is often used to hide acne scars or even small pimples but these applications will aggravate the condition further. Attempting to treat the acne scars with oily creams or skin oils, like vitamin tissue oils, will also aggravate the condition if acne is not first treated and settled.
Treating & Managing Acne
Acne needs to be treated for 2 to 6 months and most 10 day acne ‘cures’ are just a marketing ploy. The approach should involve both a good skin care program and medical treatment.
In cases of hormonal causes of acne in women, your doctor may prescribe an oral contraceptive for up to 6 months. By regulating the hormones and stabilizing the menstrual cycle, the acne will often settle. Antibiotics may be required for cases of infected acne but this will only offer short term relief. Drying agents, like medicated face washes, cleansers and gels, are useful for reducing the oiliness of the skin and minimising any blockage of the pores.
One of the best acne drugs on the market is isotretinoin, marketed under the brand name Roaccutane in South Africa. This drug has received much media attention due to the danger associated with its use. Recently, the American brand of this drug, Accutane, was withdrawn from the U.S. market after the release of studies suggesting that it may contribute to inflammatory bowel disease. However generic versions are still available in the United States. Roaccutane is still available in South Africa and has to be prescribed by a medical doctor.
Simple nutritional approaches to acne have also proven to be helpful with studies indicating that using at least 45mg of zinc for up to 6 weeks will drastically reduce pustular acne. Other myths surrounding the link between certain foods and acne are loosely based on individual reports and some ‘urban legends’. Acne should be treated by a skin specialist (dermatologist) in order to find the most appropriate treatment for your individual case.