Understanding the issue
Understanding the issue
The medical term for acne is acne vulgaris – ‘vulgaris’ meaning ‘common’. According to the NHS, about 80 per cent of people aged 11-30 will be affected by acne to some extent.
Acne is most common between the ages of 14-17 in girls, and 16-19 in boys – around the time when the hormonal changes of puberty peak. In general, symptoms tend to improve as the person gets older and usually disappear when they reach their mid-20s. However, for some people, acne remains an issue into adult life – about 5 per cent of women and 1 per cent of men over the age of 25 have acne.
In adults, roughly 80 per cent of acne cases occur in women. There is some evidence that acne runs in families. For instance, it has been suggested that if both parents suffered from acne, their child is more likely to develop acne at an earlier age and their symptoms may be more severe. Research also suggests that if one or both parents had adult acne, their child is more likely to suffer from adult acne too.
Examining acne
Acne is associated with puberty and is caused by the skin’s reaction to hormonal changes. During puberty, levels of the hormone testosterone increase. As a result, the sebaceous glands in the skin are stimulated to produce higher levels of sebum, which is why teenagers often suffer from oily skin and greasy hair.
Changing hormone levels in adults have also been linked to acne symptoms – such as just before a woman’s period or during the early stages of pregnancy. Women with polycystic ovary syndrome (PCOS) may also suffer from acne.
In addition, bacteria (Propionibacterium acnes) which normally occur harmlessly on the skin’s surface, thrive in this excess oil and multiply. If the bacteria grow inside a clogged skin pore, that pore can become red, swollen and inflamed.
Acne most commonly develops on the face, with almost all sufferers affected by facial acne. In addition, about half of sufferers develop lesions on their back and about 15 per cent get them on their chest.
There are various types of acne lesions. Non-inflammatory types include:
- Blackheads: these develop when pores become clogged with sebum and dead skin cells to form ‘comedones’. If the entrance to the pore remains open, the blockage may be visible and appear dark, hence the term ‘blackhead’
- Whiteheads: ‘closed comedones’ arise when the pore becomes clogged, but the pore opening is closed. This causes them to be slightly raised and have a white or skin-coloured appearance.
Other types of acne lesions are inflammatory:
- Papules: small, raised bumps that appear red and sore to the touch
- Pustules (pimples): similar to papules, but with a white or yellow pus-filled centre
- Nodules: large, painful and often solid lesions that are lodged deep within the skin
- Cysts: the most severe type of acne lesion. They are large, pus-filled bumps that look similar to boils and can cause permanent scarring.
Busting myths
One of the most important things pharmacy teams can do to help acne sufferers is to dispel common myths. These can affect how people view their condition and how they choose to treat it:
- Acne is not caused by poor diet, poor hygiene or sweating
- Acne is not contagious
- Squeezing blackheads and pimples won’t improve acne. In fact, this can irritate the skin, make symptoms worse and may lead to scarring
- Acne is not seasonal – it is a year-round condition
- Acne is not just suffered by people with oily skin – people with dry skin can get acne too
- Toothpaste does contain antibacterial ingredients, but it should not be used on spots as it also contains substances that can irritate and damage the skin.
