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Worried about your spots? You are not alone. 15 per cent of adolescents
in Britain have acne (British Association of Dermatologists, August,
2000).
There is no doubt that acne (spots, zits, pimples, plooks) is one
of the biggest pains about growing up. But it isn't only teenagers
who wake up in the morning having to face this troublesome condition.
For an increasing number of people acne continues to be a problem
in their twenties, thirties and even forties. Most of us have problems
with spots at some stage in our lives.
However, there are many effective treatments for acne. No matter how
bad you think your skin is, try to be patient. There will be a treatment
for you.
What causes acne?
Increased production of hormones during adolescence (11-16 years)
causes the sebaceous or oil glands under the skin to enlarge and produce
excess sebum (oils that lubricate the skin). Usually this oil is released
through openings in the skin's surface (pores). But if the path to
the surface is blocked bacteria grows in the trapped oil and enlarges
the gland.
The bacteria convert the oil into fatty acids, which leaks into skin
tissues, causing swelling. The largest oil glands occur on the face
(especially in the T-zone of forehead nose and chin), neck, chest
and upper back. Acne is not caused by a lack of cleanliness or a bad
diet.
The more easily your pores become blocked the worse your spots will
be. Acne is a genetic condition inherited from your parents, so talk
to them. They know what it's like.
TREATMENT
Creams/gels
Commercially available creams such as Clearasil or Oxy10 can help
mild acne.
In more persistent cases try Panoxyl 5 or 10 or Retina-a Gel, which
are available from chemists without prescription.
Creams and gels for medium/severe acne contain Benzoyl Peroxide to
dry out spots and/or Salicylic Acid to unblock pores. (Benzoyl Peroxide
can cause redness or irritation so try a small amount first. It can
also bleach bedclothes and clothing.)
For the most severe cases try Isotrexin Gel - only available on prescription.
This contains the antibiotic Erythromycin and very small doses of
the most powerful acne treatment Isotretinoin (see below). With this
cream you must avoid prolonged exposure to the sun.
Antibiotics
In more persistent cases your doctor may prescribe six-month courses
of antibiotics. The most effective one is Minocycline. Other available
antibiotics are Tetracycline and more rarely Erythromycin, which the
body finds more difficult to absorb. Six month courses of antibiotics
should clear up most cases of acne.
Remember: It is extremely important not to stay on antibiotics for
long periods at a time (a year or more). Your body may become resistant
to them, which could affect treatment of other illnesses. If your
acne recurs, even after two or three courses, your doctor may suggest
Isotretinoin (or Roaccutane).
Isotretinoin
This can only be prescribed by a dermatologist (skin specialist) at
your local hospital, but appointments are often booked up for at least
one year in advance, so get in early. This drug is neither a hormone
nor an antibiotic, but is related to vitamin A. Extremely effective,
the drug is taken daily for three to four months. Only 5 per cent
of people usually need a second dose. However, Isotretinoin has certain
side effects. It can damage an unborn baby. Women must use an effective
contraceptive throughout treatment and for one month before and after.
Pregnancy tests must also be taken throughout.
In the early stages of treatment your spots can get considerably worse,
before they start to improve. To combat this try starting on a very
low dose. If you have any doubts ask your dermatologist.
Other side effects include:
- dryness/irritation of skin
- muscle soreness
- increased sensitivity to sunlight (use an effective sun-block)
Less common side effects include:
- increased blood lipids (hypertryglycerideamia). Blood should be
screened regularly to check for this
- drug-induced hepatitis - alcohol should be discontinued if the
disorder occurs
- Recent American studies have suggested there may be a link between
Isotretinoin and depression, which in a few rare cases may have
prompted suicidal ideas. This is very rare. But if you are prone
to depression tell your dermatologist before starting the course
and he/she will advise you.
Combating acne day-to-day
Wash you face twice daily with a gentle soap or liquid cleanser.
Some people prefer to use T-tree oil (available from chemists) Do
not wash your face more than twice daily. This may do more harm than
good
Diet
Some nutritionists suggest:
- avoiding dairy products
- drinking lots of water
- eating high degrees of fibre
- using digestive aids which stimulate liver function ie dandelion
and burdock, which may be able to cure acne without other medical
treatment. (Tammy Alex, lecturer in Nutrition, Yale University,
Lecturer in Nutrition, see Vegetarian Times, August 1998).
While diet may certainly have an effect and in some cases has vastly
improved the condition it seems unlikely that it can have as much
of an effect as a wide range of medical treatments. However, with
natural remedies there are no side effects. Why not try natural remedies
along side medical treatment, but first check it is safe to do so
with your pharmacist or doctor.
Remember, for the vast majority of people there will be a cure. Don't
give up!
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