What is it about ?
Acne vulgaris, or more simply acne, is the medical term for pimples typical of adolescence. Normal skin retains its suppleness and is protected against dehydration thanks to sebum. Sebum is a kind of oil produced by the sebaceous glands in the skin and secreted by the pores of the skin. Acne develops when these pores become blocked and sebum builds up, forming blackheads (comedones). Often the problem is accompanied by bacterial superinfection.
The condition usually begins at puberty, under the influence of hormonal changes typical of adolescence. In some, it is limited to a few buttons; in others, acne is a very widespread skin condition, which can be accompanied by psychological problems. Some may still suffer from it in adulthood.
Some forms of acne are caused by external factors: they are usually substances that clog the sebaceous gland, such as certain cosmetic products. An existing acne can also worsen by so-called mechanical factors (pressure and friction). Finally, certain medications, such as cortisone, can cause acne to appear or worsen.
Acne is not the result of eating fatty foods or consuming chocolate. It is not an infectious disease either, so it is not contagious at all. There is also no link between acne and hygiene, sweating, smoking, tension or stress.
What is its frequency?
According to some experts, up to 9 in 10 people have had acne at some time in their life. The condition appears mainly between the ages of 15 and 24, and affects women more often than men. Acne appears earlier and earlier, as puberty begins earlier and earlier. Most often, acne heals spontaneously around the age of 25. The condition lasts longer in a small percentage of people. It is estimated that around 1 in 5 women have adult female acne.
How to recognize it?
Pimples appear on the face, back, shoulders or chest. The characteristic signs of acne are blackheads (comedones). A small white ball then forms on the sebaceous gland, which can then turn black. If the sebaceous gland is inflamed, a red pimple (papule) appears, often surmounted by a yellow head (pustule) at the end of the course. This head can burst and heal, leaving a scar.
How is the diagnosis made?
The doctor will examine your skin to see if you have blackheads and pimples, and to assess any scars and discolorations they have left. He will also ask you how you are handling the situation emotionally.
What can you do ?
Touch your skin as little as possible. Wash it off with lukewarm water, then dab it with a towel to dry it (without rubbing). Avoid washing, rubbing and massaging it excessively at all costs; it irritates the skin and does not solve the problem. Avoid puncturing or scratching the pimples; you may cause new pimples and scars to appear. Only blackheads can possibly be pierced delicately, with the side of the fingers (and not the nails, therefore). You can also use a blackhead remover. This one looks like a teaspoon with a hole in the middle. Wash your skin with lukewarm water before removing blackheads.
Preferably avoid makeup products. They contain certain products that can promote the development of acne. If you still decide to put on makeup, opt for water-based cosmetics that are certified non-comedogenic. Some milks and hair gels can also make acne worse.
The sun has no beneficial effect against acne. It can reduce inflammation for a while, but acne often comes back more pronounced afterwards. The solarium is therefore not recommended.
Avoid medications, such as cortisone, which can trigger an acne breakout.
What can your doctor do?
Medicines for external use
Local treatment is usually sufficient to treat a mild acne with only blackheads.
Wash your skin daily with soap and water or an antibacterial solution.
Then apply a thin layer of tretinoin-based cream, adapalene-based gel, or even benzoyl peroxide (3-10%) cream or gel. These agents sort of exfoliate the skin, which facilitates the evacuation of sebum and prevents the formation of blackheads. In addition, benzoyl peroxide to a small extent slows down the proliferation of bacteria.
At first, these drugs can cause irritation. So be sure to use them in low concentration and rinse them with water after a few hours. They will become better and better tolerated by your skin over time.
Tretinoin cannot be used during pregnancy or breastfeeding.
Benzoyl peroxide bleaches hair and hair, textiles (clothing) and metals (glasses and jewelry). So be careful and use a towel to protect your clothes.
Avoid intensive exposure to sunlight and ultraviolet (UV) rays (solarium).
If there is no improvement with one drug, it is possible to combine two or more. A combination of drugs is the first choice automatically in the event ofmild to moderate acne.
Drugs for oral use
These drugs are offered
- if you do not get enough results after 2 to 3 months of local treatment;
- in case of’severe acne.
It could be an antibiotic. These drugs should be taken for several months. Tablets are of course likely to cause more side effects than creams. They can thus cause gastrointestinal disturbances and they can increase the sensitivity of the skin to the sun (photosensitization). These medicines can be taken at the same time as local treatment.
THE’isotretinoin is another possible drug, which slows down the production of sebum. This medicine contains a substance related to vitamin A. It is a very effective remedy for severe forms of acne, which do not respond sufficiently to other treatments. This medication is only available on prescription. The most common side effect associated with isotretinoin is dryness of the lips, nasal mucosa, eyes and skin. Sometimes the levels of enzymes in the liver and fat in the blood increase during treatment. It is therefore necessary to do regular blood tests. If you are pregnant, you absolutely cannot use isotretinoin. Indeed, it can cause serious malformations in children. The doctor will check that you are not pregnant before you start treatment. In addition, during and for up to a month after stopping this medication, women should take additional measures to prevent pregnancy. The doctor will carefully assess the advantages and disadvantages of this treatment. In severe forms of acne and for the treatment of scars, he will therefore refer you to the dermatologist.
In women, the doctor may also prescribe a hormonal treatment. A simple contraceptive pill (containing estrogen and progestins) often produces a marked improvement.
Want to know more?
- Tretinoin (+ clindamycin) for the skin – CBIP – Belgian Center for Pharmacotherapeutic Information
- Adapalene for the skin – CBIP – Belgian Center for Pharmacotherapeutic Information
- Benzoyl peroxide for the skin – CBIP – Belgian Pharmacotherapeutic Information Center
- Isotretinoin – CBIP – Belgian Center for Pharmacotherapeutic Information
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