Acne vulgaris is a skin condition which commonly starts during puberty and is characterised by red painful spots (papules), sometimes filled with pus (pustules) as well as comedones (blackheads i.e. open pores and whiteheads i.e. close pores) and occasionally cysts (firm swellings under the skin). Sometimes acne persists into the early twenties or even further into adulthood if left untreated.
This condition typically affects the face, neck, back and chest as these areas of the body have higher numbers of sebaceous glands which produce an oily substance to lubricate the skin.
It is important to treat acne as at early stage as leaving it untreated may risk leaving long term scarring. Some of the treatment options commonly used are listed below.
Whilst there is no cure for acne, treatments tend to be quite effective. Your medical practitioner will assess the severity of your acne to determine the most effective and safe treatment.
This may include the following:
Topical (cream or gel) treatments - these are applied to the skin, typically once a day and consist of antimicrobials, benzylperoxide and topical retinoids. They can be effective alone for mild to moderate acne or in combination with tablet treatments for moderate-to-severe acne.
Oral antibiotics - these are tablets taken by mouth which are effective against a bacteria which contribute to acne called p.acnes. They may also have an anti-inflammatory effect. The most common group of antibiotics used are tetracyclines (e.g. lymecycline, doxycycline, oxytetracycline). These are often prescribed in primary care alongside a topical treatment for moderate to severe acne in the first instance.
Oral retinoids - for acne not responding to the above measures or if your acne is severe are you are at risk of further long term scarring, you may be suitable for this treatment. This is known as isotretinoin which is the generic name, but many people have heard of "Roaccutane" which is a brand name for this medication. Whilst there have been many media scares about the effect on mood, this is unusual and in most cases your mood will improve as your acne improves. If you have had a history of low mood, you may need to be monitored by a psychiatrist during your treatment. Minor side effects are common and include dry lips, muscle aches, headaches and sometimes nose bleeds. You will also need fasting blood test monitoring of the fat levels in your blood (particularly one called triglycerides) as this can rise during treatment but is fully reversible. A small rise is not concerning, but the clinician needs to ensure it remains within a reasonable limit. Liver function is also monitored but rarely affected; you should however aim not to drink alcohol during treatment or limit this as far as possible. Treatment with oral retinoids tends to be very effective and the treatment episode is typically around 6 months depending on the dose you take and the response to treatment. In most cases, your acne will completely clear by the end of the treatment course and will hopefully remain in remission therefore. Very occasionally, patients require a second course of treatment.
Blue light therapy - whilst not commonly used by clinical practitioners, blue light therapy may be beneficial for acne in some patients. This uses a blue light wavelength (405-420 nm) which is thought to have an antimicrobial effect, thereby treatment the propionobacterium acnes which can contribute to the condition.
Typically 2 sessions per week over a 4 week period are required. This can be used with a photosensitiser such as ALA or as a standalone treatment which can be purchased online. Do however be careful if you are considering this form of treatment that you choose a product which has undergone rigorous testing.
Diet is thought to have relatively little effect on the development or severity of acne and is therefore a common myth.
Whilst oil secreted from sebaceous glands plays a role in the development of acne, the "oilyness" or greasiness of food you eat does not have an affect on the amount of oil secreted from these glands and therefore does not contribute.
Changing your diet is therefore unlikely to have any significant impact on controlling your acne.