Acne includes mild to severe outbreaks of blackheads, pimples (zits) and cysts on the skin. Hormones associated with puberty are one trigger for teenage acne but adult acne, particularly among women, is also increasing. Acne treatments include a range of medications and cleansers can also help. Reducing stress and a low GI diet may help some people.
Acne is a medical skin problem that usually begins in the early teenage years and can last until the 30s and even 40s. It consists of mild to severe outbreaks of pimples and cysts – mainly on the face, back, arms and chest.
Cysts are lumps under the skin that have pus and other tissue in them, but do not come to a head like pimples do. They can cause scarring, blotchy, uneven skin colour and pitting.
Unfortunately, acne hits people at a time when they most want to look their best. Acne can make teenagers feel embarrassed and bad about themselves. There are treatments that can help if acne is causing distress. If you are concerned about skin problems or skin care, you should talk to your doctor or pharmacist for information about possible treatments.
Hormones and genetics
At the start of puberty, a lot of hormones are released into the body. One of these hormones is testosterone. Both boys and girls have testosterone and other related hormones called androgens, but boys have more of them. Androgens affect oil glands in the skin of the face, neck, back, shoulders and chest. They make the glands grow bigger and produce more oil (sebum).
Bacteria on the skin and blocked pores result in blackheads, pimples and cysts. A teenager is more likely to get acne if one of their parents had it during adolescence, but even in the same family, some people may get worse acne than others.
Girls tend to get it at a younger age than boys and it can become worse or ‘break out’ at certain times of a girl’s menstrual cycle, such as just before a period and they also tend to have ongoing acne, even into their 30s or 40s. Boys often have more outbreaks than girls, and they often seem to get more severe acne – worse pimples and more cysts.
Suggestions to manage acne include:
- Cleansing – cleansers specifically developed for acne-prone skin can help. Try washing the affected areas twice per day. Don’t overdo it. Too much cleansing can cause other skin problems, such as dryness or skin irritations. Try to keep hair clean and off the face and neck, as oil from the hair can make acne worse.
- Make-up – choose water-based, oil-free products where possible to avoid worsening acne by clogging the pores with oils or powder. Make-up should be thoroughly removed before going to bed.
- Don’t squeeze – picking and squeezing pimples can make it worse and lead to scarring.
- Stress – this can trigger an outbreak of pimples as it causes the release of hormones that can make oil glands release more oil onto the skin. This is why pimples seem to magically appear on stressful days, such as at the time of an exam or special date. While stress may be difficult to control, at least you know that the outbreak is due to stress, not a sign that the treatments do not work.
- Diet – there is now more evidence that a low-GI diet may help some people with acne. Many people think that lollies or chocolate cause pimples. Research has not shown any strong link with these foods, but if you notice that eating certain foods causes pimples for you, try avoiding them.
Treatment for acne – non prescription
Some acne treatments can be bought over the counter at chemists or supermarkets. These work by cleaning the skin and drying up excess oil. Mild irritation can occur with such treatments. If this happens, take a short break from treatment and restart after a few days. If the irritation is excessive, stop the medication and speak to your doctor about an alternative.
It is a good idea to talk to the pharmacist before you buy a product to find out which treatment might be the most useful for you. A cleanser for acne-prone skin may be all that is needed for mild acne. Don’t rely on advertisements or the advice of friends.
Treatment for acne – professional
If your acne is not improving with over-the-counter treatments or if you have more severe forms of acne, you will need to see your doctor. They can prescribe medication after assessing your acne. The may also refer you to a dermatologist. Medications can lead to huge improvements in how the skin looks and can reduce the number of new pimples.
Medical treatments are topical or oral and can include:
- Retinoids, which unblock pores of existing acne and prevent new blockages from developing
- Antibiotics to kill bacteria and reduce inflammation
- Hormonal agents, such as the contraceptive pill, to reduce the amount of androgen in the body and therefore oil secretion.
Where to get help
- Your doctor
- Dermatologist (see your GP for a referral)
Things to remember
- Acne is a medical problem that causes mild to severe outbreaks of blackheads, pimples and cysts.
- The triggers for acne include some of the hormones associated with puberty and stress.
- Self-help strategies include cleansing the affected areas, using water-based make up and resisting the urge to squeeze or pick at spots.
- See your doctor or pharmacist for information about possible treatments.
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This page has been produced in consultation with and approved by:
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Australian College of Dermatologists
Last reviewed: October 2012
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