Acne

What is it?
Blockage and inflammation of the hair follicle and oil gland, causing blackheads, whiteheads, and small and large red bumps and cysts.

What causes it?
Many factors are involved, including:
genetics
hormones
bacteria
certain medications and skincare products

What treatments are available?
Topical treatments: topical retinoids, benzoyl peroxide, hydroxy acids, azelaic acid, niacinamide and topical antibiotics
Physical treatments:comedone extraction, chemical peels, corticosteroid injections, blue light therapy
Oral medications: antibiotics, spironolactone or the contraceptive pill (females), isotretinoin

Acne is a condition well-known to all of us, and it’s a myth that it only affects teenagers. These days, there are loads of good treatment options, including many that are available without a prescription. 

What is acne?

Acne is a common condition, which results from blockage and inflammation of the hair follicle and its associated oil gland. This leads to open comedones (blackheads), closed comedones (whiteheads), inflammatory papules (red bumps), pustules, nodules and cysts (larger red bumps and deep ‘blind’ pimples). It’s most common on sites of the body where the oil glands are the largest and most active, such as the face, neck, chest and back. 

What causes it?

Acne is caused by a combination of factors, including genetics, hormones, bacteria and external factors such as certain medications, some skincare products, and humidity. A diet high in dairy products and high glycemic foods may increase the risk of acne. 

Is acne really caused by being ‘unclean’ or eating too much chocolate?

Yes, and no. Not removing greasy skincare products from your skin can cause pimples, but in most cases acne isn’t really to do with not cleansing properly. There’s some evidence that a diet high in dairy foods and high glycemic foods (such as sugary foods and drinks, white bread and white rice), may be linked to acne. 

How can I treat acne?

Topical treatments include topical retinoids, benzoyl peroxide, alpha and beta hydroxy acids, azelaic acid, niacinamide and topical antibiotics. Physical treatments such as comedone extraction, chemical peels, intralesional corticosteroid injections for cysts, blue light therapy and Kleresca may help. For more severe acne, oral antibiotics, spironolactone or the oral contraceptive pill for females, or isotretinoin may be required. Treatment depends on the kind of acne you have, the location, and its severity. 

What non-prescription products are helpful for acne?

Salicylic acid, alpha hydroxy acids such as glycolic and lactic acid, azelaic acid, benzoyl peroxide, niacinamide and retinoids are all available over the counter in a variety of strengths and forms including cleansers, serums, spot treatments, peels and creams. These products can all potentially dry and irritate the skin, so it’s important to try one at a time, to start gradually, and to use moisturiser alongside them. Some can also increase sun sensitivity, so sunscreen is crucial!

References
Aghasi M, Golzarand M, Shab-Bidar S, Aminianfar A, Omidian M, Taheri F. Dairy intake and acne development: A meta-analysis of observational studies. Clin Nutr. 2019 Jun;38(3):1067-1075.

Kraft J, Freiman A. Management of acne. CMAJ. 2011;183(7):E430-E435.

Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Postepy Dermatol Alergol. 2016;33(2):81-86. 

Pei S, Inamadar AC, Adya KA, Tsoukas MM. Light-based therapies in acne treatment. Indian Dermatol Online J. 2015;6(3):145-157.

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ABOUT THE AUTHOR

Dr-Julia-Rhodes

Spotlight on Skin was created by award-winning Melbourne-based dermatologist, Dr Julia Rhodes.

Julia knows first-hand how overwhelming the skincare world can be, and that’s with over 10 years of experience practicing dermatology. Given that even she gets overwhelmed, she appreciates how hard it can be for those of you without a scientific background to make sense of all the information available, and choose products that are right for your skin…