Lifestyle Choices

It is difficult to understand why one person may have bad acne covering most of the back or chest but none on the face whilst another individual may have severe facial acne but little elsewhere. We presume that it is only the sebaceous glands and follicles in the affected areas that are responding to the hormone changes in the blood. Whichever area is affected, the changes are of larger papules and pustules which last longer and some of them may leave small scars. Blackheads will almost certainly be seen as well and they can be very extensive. When a flare-up occurs it may be very uncomfortable and an occasional cyst may appear.

Severe acne

Almost everyone will have known or at least seen someone with really nasty acne. They then expect their own acne will end up the same way but this is most unlikely. Roughly one in fifty acne sufferers has the severe form. It is often more extensive and the spots are deeper, more inflamed and last longer. Cysts may be quite a problem. Despite these changes the amount of scar formation can be minimal, but of course there are certainly people with pronounced scarring. It is for these people in particular that the most powerful modern drugs are reserved in order to treat the disease before more damage appears in the skin.

Skin Treatment

Everyone would like a quick cure for acne but it is not possible. At first you may feel that you are not getting better but it is important to persevere with any treatment. One of the commonest reasons for failure of a medicine is stopping it too quickly: this applies to both skin preparations and those taken by mouth. Not every cream will suit everyone and some trial and error may be necessary. Most acne treatments come with instructions in the packing box and it is always worth reading them. They will tell you how often to apply it, how large an area of skin to cover, how long to keep going with it, whether you should soon go on to a higher strength and lastly, what sort of side effects to watch out for.

People with mild acne may not need any treatment at all but if they do it will always be a skin preparation. Those with moderate or severe disease can quite often manage with skin (topical) preparations alone, but failing this will need to take a medicine by mouth (oral treatment).

Mild acne

Over the counter

It is worth asking the pharmacist about the product you have seen advertised to check whether it really does have an active ingredient, which could help your acne, rather than ingredients which just make your skin feel better.

Killing bacteria

Bacteria are not the most important cause of acne but there is usually some benefit from reducing their numbers. Agents such as hydroxyquinolone (found in Quinoderm cream and Valderma), chlorhexidine (Quinoderm face wash, Triac, Cepton), triclosan (Clearasil medicated, Oxyclean), will all do the job.

Blackhead removal

Removing blackheads is a useful approach, not only because they are ugly but because they also block the follicles and lead to some of the other changes of acne. Blackheads can be removed in three ways. First of all they can be removed by a blackhead extractor (comedone extractor) but these days such extractors are not used very much because the other methods are better. Clean finger nails should only be used if the blackhead is very nearly ready to drop out anyway.

The second method is by using abrasives which act rather like sand paper. Another approach is the use of agents which soften the horny layer and this action helps to loosen blackheads. Salicylic acid is used for this, normally at a concentration of two per cent. Benzoyl peroxide not only loosens blackheads but helps to kill bacteria as well. It is the most widely used agent for this purpose and is found in preparations such as Oxy-10, Topex, Acnidazil, Ultra Clearasil, Acnegel, Panoxyl, Benzagel.

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