They’re only a teenage problem, right ? Caused by too much chocolate ? Frequent washing cures them ? No long term effects ? Worse in UK ? Few sufferers visit their doctor ?
NO for all of the above !


• Acne vulgaris – the “ proper “ name for pimples – commonly affects teenagers in UK, Philippines and worldwide. Half have symptoms as young adults and even by the age of 40, pimples may affect 1% of men / 5 % of women. Genes do affect skin type – oily skins are more prone ( but don’t burn so easily in sunlight ).



• The link between chocolate ( or other foods, especially dairy products ) is not strong, but for individuals it’s worth trying change of diet if certain items seem to make pimples worse. Similarly it’s one more reason to quit smoking.


• Dirt itself does not cause acne, and too frequent washing may worsen it, by dehydrating the skin. Modest sun exposure may help – excessive exposure not only dehydrates, but also risks skin ageing and cancers.



• As with other conditions, good general health helps – including exercise, avoiding constipation, and adequate sleep.


• Acne DOES result in many doctor visits in the UK, and MAY cause scarring ( both physical and anxiety / depression ).



• What is it ? Inflammation involving “ pilosebaceous units “ ( hair and related “ oily “ glands ). This is related to androgens ( “ male “ hormones, actually produced in both sexes ). Acne may also be a side effect of drugs.



• Too many cells and too much “ sebum “ ( oil ) result in “ comedone “ ( blackhead and whitehead formation ). These are NOT dirt but oxidised melanin, cells, and sebum ! A bug is also involved ( Propionibacterium acnes ). Inflammation may cause small lumps, cysts and scarring – made worse by squeezing !!



• Mild acne – usually affecting the face – can be managed by twice daily washing and a moisturiser.


• For mild – moderate acne, “ topical “ agents applied to the skin may be helpful. Retinoids ( vitamin A derivatives ) are increasingly recommended, perhaps with antibiotic or benzoyl peroxide – but only on doctor’s advice. They are expensive ! Because of antibiotic resistance such courses should be limited to less than 3 months’ duration. Various “ over-the-counter “ agents may be bought – take pharmacist’s advice, and check the constituents !



• “ Systemic “ treatment ( by mouth ) may be needed for severe acne. Hormone agents may be combined oral contraceptives, or anti-androgens. Antibiotics may also be helpful – but on medical advice and usually limited to 3 months. The first line treatment for severe acne is now “ Isotretinoin “ - it may take several months and must be on medical advice ( possible serious side effects ).



• Unfortunately cost is an issue, especially in the Philippines, with many online sites selling acne medications. The only available article worth recommending, in my opinion, is :-

http://www.nhs.uk/Conditions/Acne/Pa...roduction.aspx