Acne

Acne is very common; around 80% of people between the ages of 11 and 30 will be affected at some time. It occurs most frequently in puberty but it can persist into or even develop in adulthood, where approximately 5% of women and 1% of men over the age of 25 have acne. Most people have acne on and off for several years until their symptoms start to improve as they get older1.

Acne is often triggered by hormonal changes, especially in teenagers going through puberty and in women during their monthly hormonal cycle. The symptoms occur when the grease-producing glands (sebaceous glands) stimulated by these hormonal changes, produce abnormally high levels of sebum. This, in turn, causes narrowing or blocking of the pores (leading to whiteheads and blackheads) and allows normally benign bacteria to multiply, gather in the closed pores and cause inflammation, swelling and pus.

The redness of the spots (papules) is due to inflammation. If the pores rupture, the bacteria are released onto the skin surface as yellow-headed spots (pustules) containing a mixture of bacteria and inflammatory cells (pus). In more severe acne, this can produce hard, painful spots (called nodules and cysts) and these can result in scarring.

The impact of acne should not be underestimated. It is now recognised that people living with acne can experience social, psychological and emotional problems similar to people with long-term illnesses such as asthma, epilepsy or arthritis2.

Acne can run in families, but this does not necessarily mean that all children of parents with acne will develop the condition. There are a number of myths about acne that should be dispelled. Acne is NOT contagious and cannot be ‘caught’ from another person. It is NOT caused by poor hygiene or over-eating of junk foods.

Acne treatment with topical and in some cases oral therapies is very important as the fewer breakouts a person has, the less likely the chance of scarring. Picking and squeezing of spots should be avoided, and gentle skin-care regimens should be followed3. Whilst there is no actual cure for acne, it does usually improve over time and eventually disappears (although this can take several years).

 

Pharmaceutical (i.e. non-surgical) acne treatments that may be recommended by a pharmacist or prescribed by a GP in the UK are described in the table below.

Acne treatment options
 
   
Treatment   Pros   Cons  
Topical treatments – gel or cream to unblock pores and kill bacteria      
Benzoyl peroxide      
Benzoyl peroxide kills bacteria, reduces inflammation and helps unplug blocked pores  
  • Available in pharmacies
  • Effective in treating mild acne
 
  • Can stain clothes or bed sheets
  • Can make skin more sensitive to sunlight and cause mild burning, itchiness and redness of skin
 
Vitamin A gel or cream      
Gels or creams known as topical (rub-on) retinoids are derived from vitamin A. They unblock pores, and reduce production of skin oil (sebum)  
  • Effective at clearing whiteheads, blackheads and smaller spots  
  • Not suitable in pregnancy
  • Possible side effects include increased sensitivity of skin to sunlight, and mild irritation and stinging of the skin
 
Antibiotic gel or cream      
Topical (rub-on) antibiotics are used to kill bacteria  
  • Effective in treating inflamed spots
  • Causes less irritation to the skin than other anti-acne creams or gels
 
  • May be less effective on blackheads and whiteheads
  • Can only be used for up to eight weeks because of the risk of antibiotic resistance
 
Azelaic acid gel or cream      
Azelaic acid unblocks pores and kills bacteria  
  • Effective for mild acne in people who have troublesome side effects with other treatments
  • Does not make skin sensitive to sunlight
 
  • Month before symptoms improve
  • Can cause mild burning, stinging, dryness and itchiness of the skin
 
Medication      
Antibiotic medicines      
Taken by mouth, these kill bacteria and are usually used in combination with a gel or cream  
  • Effective in treating mild to severe acne  
  • Takes six weeks for symptoms to improve
  • Makes contraceptive pill less effective, so alternative contraception should be used
  • Can only be used for six months because of the risk of antibiotic resistance
  • Can make skin more sensitive to sunlight, and can cause nausea, vomiting, diarrhoea and mild stomach pains
 
Co-cyprindiol      
A hormonal treatment that can be used in women when hormonal conditions, such as polycystic ovary syndrome, are thought to be causing acne  
  • Effective in treating severe acne that does not respond to antibiotics  
  • Carries a very small risk of causing blood clots and breast cancer later in life
  • Not suitable if you're pregnant or breastfeeding
  • Side effects include bleeding between periods, headaches, sore breasts, mood changes, loss of interest in sex, weight gain or weight loss
 
Isotretinoin      
Isotretinoin, taken as capsules or tablets, is derived from vitamin A. It works in the same way as retinoid gel or cream but is more powerful
  • Effective in treating severe acne
  • Can only be prescribed by a dermatologist, not by a GP
  • High risk of causing serious birth defects in pregnant women, so reliable contraception must be used
  • Can cause inflammation and dryness of lips, nosebleeds, headaches, inflammation of the eyelids or eyes, skin rashes, muscle, joint and bone pain, blood in urine
  • Causes a person to bruise and bleed more easily

 

SEQuaderma Acne Prone Skin does not have the side effects associated with prescribed acne treatments. It works quickly, and significant improvements in acne have been seen after just 1 week’s treatment (although it may take longer to work for some people). In addition, the sebum reduction effect of SEQuaderma means that recurrences may be reduced and other topical and oral treatments needed less. It can also help patients currently on prescription medication to care for their skin better as SEQuaderma can be used in conjunction with drugs. Please check our life changing stories.

1http://www.nhs.uk/Conditions/Acne/Pages/Introduction.aspx [Accessed 15 July 2015].

2 All Party Parliamentary Group on Skin. The psychological and social impact of skin diseases on people’s lives. London 2013. Available from: http://www.appgs.co.uk/publication/view/the-psychological-and-social-impact-of-skin-diseases-on-peoples-lives-final-report-2013/ [Accessed 19 May 2015].

3https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/acne-scars/tips-for-preventing [Accessed 11 June 2015].