Acne facts and fixes

Preventing their child from being bullied, using drugs, or developing an eating disorder are important concerns for parents, but few realise that acne, a common problem for teenagers, can be just as debilitating and can cause embarrassment, anxiety, social isolation and other, more serious problems.

Dr JS van Heerden, a dermatologist from Menlo Park, explains that acne can have a devastating effect on self-image, saying that it “ranks as one of the diseases with the highest morbidity and effect on self-esteem, with huge psychological consequences.” Depression and suicide have also been seen as a result of acne in some studies. So what exactly is acne and how can it be treated?

Acne, simply put, comes down to excess skin oil, or sebum. At puberty, the sudden increase in sex hormone levels, especially testosterone, stimulates the production of sebum, and since most of the sebaceous glands can be found on the face, neck and trunk, this is where it appears most severely.

The excess sebum blocks the pores, leading to bacterial growth and inflammation, which is what we see on our face as a pimple. Dr Van Heerden says that it is entirely normal to develop acne, and anyone from the age of 10 to 60 can suffer from it.

He also clears up some common misconceptions about acne and what causes it. Eating fatty foods like burgers or chocolate will not make your skin worse, “food contributes very little to acne,” he says, and the same is true for sweat.

Skin cleansing, especially with astringents/exfoliants (anything with harsh chemicals or a rough texture, like a scrub), will not help to get rid of acne. These can actually make the problem worse by irritating your skin and making it more inflamed.

He adds that hypoallergenic beauty products prevent allergic reactions, not acne. He does, however, advise acne sufferers to use oil-free products.

The contraceptive pill is a possible approach to treating acne. Its usage is, however, a controversial issue and the pros and cons need to be considered before making a decision.

The pill carries warnings of increased risk for heart attack, stroke, and blood clots, especially if there is a family history. But it has been scientifically proven to reduce the severity of acne. Androgens (a group of hormones including testosterone) stimulate the skin to produce sebum.

The pill reduces or blocks the effect of these androgens, which means your skin produces less sebum, resulting in fewer pores being blocked and less of the bacteria and inflammation that cause acne.

So what should an acne sufferer do? “It is a fallacy that you can actually prevent acne,” Dr Van Heerden emphasises. But his top five tips for getting rid of it and preventing scarring are:

– Follow a suitable skin routine

– Use an acne agent that reduces the build-up and clogging of pores

– Seek proper medical treatment if the grade of acne is severe or if there is a family history of acne, regardless of age

– Refrain from picking acne

– Avoid unproven remedies.

The primary goal in managing acne is to prevent scarring. He explains that certain patterns of acne usually lead to scarring, but picking at it also worsens the chances of ending up with scars.

Treatment with drugs like Roaccutane (also known as Oratane/Acnetane) can reduce the risk of scarring and there are also several safe and effective treatments to treat scarring, including skin peels, laser and surgery. Each case needs to be evaluated individually.