Acne, also known as acne vulgaris, is a common chronic inflammatory skin condition that occurs when hair follicles become clogged with oil and dead skin cells. Acne is one of the most common skin conditions in the United Kingdom and leads to around 3.5 million visits to primary care every year.
The prevalence of acne is:
85% in those between 12-24 years of age
8% in those between 25-34 years of age
3% in those 35-44 years of age
Most people will find that they have acne coming on and off for many years before their symptoms improve as they become older. In some cases, acne can continue into adult life.
WHAT AREAS ARE AFFECTED BY ACNE?
The most common areas affected by acne are the face, back and chest. Nearly everyone with acne will experience spots on their face, whilst around half will experience it on their back and only around 15% will experience acne on their chest.
WHAT ARE THE SYMPTOMS OF ACNE?
Acne causes spots, oily skin and skin that may be painful or hot to touch. It can present with whiteheads and blackheads and may lead to complications such as widespread inflammation and scarring. There are difference types of spots caused by acne, which include:
Blackheads
Whiteheads
Papules
Pustules
Nodules
Cysts
What are blackheads?
Blackheads typically present with small black or yellowish bumps on the skin. Blackheads are not filled with dirt, but due to the inner lining of the hair follicle it produces a black colour.
What are whiteheads?
Whiteheads have a similar appearance to blackheads, however they will not empty when squeezed and may be firmer.
What are papules?
Papules are small red bumps on the skin, which may feel tender or sore.
What are pustules?
Pustules are similar to papules, however due to a build-up of pus they have a white tip in the centre.
What are nodules?
Nodules are large hard lumps that form and build up beneath the skins surface and they can be painful.
What are cysts?
Cysts are large lumps filled with pus and look similar to boils. They are the most severe type of spot caused by acne and may cause permanent scarring.
WHAT ARE THE CAUSES OF ACNE?
Acne is caused when hair follicles become blocked. Hair follicles can become blocked when sebaceous glands next to the hair follicles product too much sebum. Sebaceous glands normally produce an oily substance known as sebum, which aims to lubricate the hair and skin to stop it from drying. However, in acne, these glands may produce too much sebum which can mix with dead skin cells and block the hair follicle. If the blocked follicle is close to the skins surface, it can bulge outwards and form a whitehead. Whereas if the blocked follicle opens towards the skin, then it can create a blackhead. In some cases, normally harmless bacteria on the skin can infect the blocked follicles and this can cause papules, pustules, nodules or cysts.
One of the most common causes of acne is hormonal changes during puberty. This is as certain hormones can cause glands next to hair follicles to produce larger amounts of oils such as sebum. This can change the activity of skin bacterium called P. acnes. P. acnes is usually harmless, but the change in activity can cause it to become more aggressive and causes inflammation and pus. Certain hormones also thicken the inner lining of the hair follicle, which can block the pores and contribute to acne. Certain hormones that can affect the glands include testosterone or hormonal changes that occur during periods or pregnancy or other conditions such as polycystic ovary syndrome.
Acne can also be related to your family history and currently there is no clear link between diet, poor hygiene or sexual activity caused acne. Although certain cosmetic products, medications (e.g., steroids, lithium, antiepileptics), smoking or items of clothing can contribute and cause flare-ups of acne.