Chapter 4

### Acne

##### What is acne?

Acne is inflammation of the sebaceous (oil) glands of the skin, causing an outbreak of pimples (zits). At first these glands become blocked (blackheads and whiteheads) and then inflammation can lead to red bumps (papules), yellowheads (pustules) and even deep, tender cysts.

Acne is a common disorder of adolescence. It appears usually on the face, but can extend onto the neck, arms, chest and back.

##### What is the cause?

Acne is related to the increase in the levels of male hormones during puberty in both sexes. Although the increase in hormone levels is normal, some people seem more sensitive to it.

Bacteria on the skin grow in the blocked gland and release fatty acids, which are irritating and set up inflammation.

##### Who gets it?

Most young men aged 13 to 18 will get acne. It is worse in males aged 18 to 19. It is slightly less common in girls, although they get it at a younger age; for them it is worse around 14 years and around period time.

##### When will it settle down?

It usually settles by the age of 20, but may continue longer in severe cases.

• It is not usually affected by diet.

• It is not infectious from one person to another.

• Ordinary chemicals (including chlorine in swimming pools) do not make it worse.

• Blackheads are not dirt, and will not dissolve in hot, soapy water.

• It may flare up with excessive stress such as at exam time or with relationship problems.

##### A word to parents

Your son or daughter hates acne and finds it embarrassing. It is not due to the way the skin is washed or what is eaten—it just happens.

It will not help if you are overanxious and nag your child; give support and encouragement instead, especially in following your doctor's instructions.

##### What is the treatment?

This varies according to the severity and persistence of the problem and the person's skin type. Severe cases require specialist referral.

Diet

Some people may find certain foods such as lollies, chocolate or milk aggravate their acne, but the scientific evidence is poor and special diets are not advised. However, have a sensible, nutritious low-glycaemic-index (GI) diet.

Soap and washing

Cleaning the skin does help. Special soaps are unhelpful. Use a low-irritant soap or mild skin cleansing agent and wash gently 2 to 3 times a day—do not scrub.

Cosmetics

Avoid oily or creamy cosmetics ...

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