Acne - A Complete Guide

Acne affects approximately 650 million people, or about 9.4% of the population, as of 2010. Niven & Joshua's Complete Guide to acne helps you understand the science, causes and treatment options.

Acne - A Complete Guide
Introduction

Niven & Joshua take great pleasure in introducing our guide to acne. We will guide you through an introduction, causes, treatments and best practice, including product recommendations. Our aim is to help educate, allowing an informed decision to be made. Most of all, we want to help with this troublesome skin condition.

Acne vulgaris (cystic acne or acne) is a condition which affects many people - approximately 650 million people, or about 9.4% of the population, as of 2010 (Source: T. Vos - 15/12/12, Lancet). Acne can cause spots to develop on the skin, usually on the face, back and chest. Acne is most common amongst 12-25 year olds, with more male sufferers than female. It is estimated that 3 in 10 teenagers have moderate to severe acne (Source: Dr Tim Kenny © EMIS) but it can affect anyone, at any age. Almost 90% of people during their teenage years are affected due to changing hormones during puberty, this often continues into adulthood (Source: Annelise L. Dawson 08/05, BMJ).

Normal Skin

Normal skin has correctly working sebaceous glands, which make oil (sebum) to keep skin optimally hydrated. Pores on the skin's surface allow the secretion of sebum. An overactivity of the sebaceous glands can make acne worse, and leave an oily or greasy residue.

Mild to Moderate Acne

In mild to moderate acne, pores become blocked or plugged - often caused by thicker skin and dead skin cells. The result is small skin spots known as comedones, or blackheads and whiteheads. As sebum collects underneath the blockage, pimples or pauples (inflamed, red, tender bumps with no head) can occur.

Moderate to Severe Acne

In moderate to severe acne, trapped sebum becomes an ideal feed for bacteria to flourish - specifically the P. acnes germ. As a reaction to this bacteria, inflammation occurs. The result is red skin and large pus filled spots known as pustules (inflamed, red and with a white or yellow centre). Pustules can develop further and form nodules (large, hard bumps under the skin's surface) or cysts (similar to nodules but pus-filled) - both of which can be treated by a Dermatologist with a cortisone (steroid) shot.

Acne Graphic

Images from acne.org

Affects

These spots and aforementioned variations will eventually heal, given time. However, during their lifecycle which can be several months they are unsightly and can cause low self esteem, depression, dark spots on the skin and in severe cases permanent scars (Source: American Academy of Dermatology).

At this point we would like to mention that there are potential other causes of acne, not just overactive sebaceous glands and pore blockages. These include and are not limited to: polycystic ovary syndrome, genetics, hormones and diet. Therefore, we would always advise consulting your GP and or Dermatologist prior to commencing any treatment.

Your body and its immune system will do their best to fight off acne related issues but you can help yourself and avoid the following, which can make acne worse. Common to popular belief acne is not caused by unhygienic practices, nor stress, it is not a skin infection and can't be cured by drinking more water than is recommended per day. There is no evidence sunbeds (tanning beds) can cure acne, and yes, proper treatment will help if not put acne into complete remission.

Avoid
  • Thick and or greasy makeup.
  • Picking or squeezing acne spots - it will only increase inflammation and scarring.
  • Sweating heavily.
  • Tight, warm clothes which cause unnecessary sweating.
  • Certain medication - check with your GP or Dermatologist.
  • Anabolic steroids.
  • Some research suggests diets high in sugar and milk products may make acne worse.
GP and or Dermatologist Treatments

Your GP and or Dermatologist will be able to prescribe topical treatments for acne, these include lotions and creams such as benzoyl peroxide to kill bacteria, reduce inflammation and unblock pores. Other treatments include pore unblocking retinoids (Accutane), topical antibiotics, light/ laser therapy and azelaic acid. Your GP and or Dermatoligist may chose to prescript oral treatments such as tetracycline-based antibiotics (oxytetracycline, tetracycline, doxycycline, lymecycline and minocycline) or isotretinoin tablets. The latter does have well documented side affects.

Treatment can take anywhere up to 4 months (sometimes longer) but many, after discovering which treatment or combination, works for them will see results in 4-6 weeks. You may wish to maintain treatment particularly through your late teens or early twenties to prevent flare ups. Should you choose to stop using medication after successful treatment, any return of acne can be reassessed and retreated.

Best Practice

In addition to GP and or Dermatologist treatments, Niven & Joshua have a selection of anti-acne skin care products designed to assist with your plight. Each product has undergone rigorous testing by the manufacturer and complies with local skin care body regulations. Our stand out brand for acne treatment is Murad, created by Dr Howard Murad - a board-certified dermatologist, pharmacist and Associate Clinical Professor of Medicine at UCLA. Murad has a range of unique products which any acne sufferer will appreciate.

  • Wash a normal amount; morning and night using lukewarm water. The Burt's Bees Anti-Blemish Purifying Daily Cleanser £9.99/ 145ml will remove blemish causing surface bacteria, reduce redness and calm inflammation but not over-dry the skin, which can lead to increased sebum production.
     
  • Use non-comedogenic and or oil-free skin care products. Burt's Bees Anti-Blemish Clarifying Toner keeps skin free of excess oil and impurities by helping to regulate oil production. Burt's Bees Anti-Blemish Daily Moisturising Lotion £14.99/ 55g is lightweight and oil-free.
     
  • Avoid abrasive soaps, astringents and facial scrubs/ exfoliators. Burt's Bees Anti-Blemish Spot Treatment £9.99/ 7.5ml reduces the appearance of blemishes and soothes any irritation. Extracts of Tea Tree, Calendula, Yarrow and Parsley help care for troubled skin and reduce redness while Borgae Extract promotes healthy and smooth looking skin.
     
  • Do not scrub 'away' blackheads, they are not black with dirt but skin pigmentation. Instead, use Baxter of California Clarifying Clay Mask  £18/ 120ml with its natural clay-based formula that absorbs impurities as it deep cleans and reduces blemish breakouts.
     
  • For sizeable and or noticeable isolated spots, we recommend the Burt's Bees Herbal Blemish Stick £9.99/ 7.5ml - a fast acting formula to banish blemishes and speed up the healing process.
     
  • Finally, you may wish to conceal any spots, redness and or inflammation - a great option is Recipe for Men Concealer £17/ 2.8ml, available in Light and Medium  infused with vitamins it expertly covers and hides imperfections. Along similar lines is Myego Matifiant £18/ 10g available in Light and Medium , which can be used to cover the entire face with an oil absorbing formula - it will also cover and hide minor imperfections. Optionally, a Dermatologist may opt to give anyone with a large and unpleasant spot a cortisone (steroid) shot, which will clear a spot almost over night - this is a last resort, and normally reserved for nodules or cysts (see paragraph 4 above).
Conclusion

There is a lot of information to take in when it comes to acne, but hopefully the above has given you the tools of understanding, to learn and the products to treat this most common of conditions. As before, we would always advise you consult your GP and or Dermatologist before undertaking any kind of treatment or using a new acne treatment product. Remember, acne is treatable - there is light at the end of the tunnel, and you're not alone! Send Niven & Joshua a Confidential email if you have any questions or concerns and we and or our resident grooming expert will be able to assist.

Main image © tearoad - Fotolia.com