Skin Conditions

An interview with Dr Anne O’Neill
Dermatologist, Sydney

Acne

A photograph of someone with acne

What is acne?

This is a very common skin condition, particularly in teenagers and young adults. Acne is where blackheads and whiteheads appear on the forehead, nose, chin, and sometimes the chest and back. If the acne is severe then there will be inflammation and pimples (or zits), and in the most severe cases, cysts and scars.

What causes acne?

This is caused by hair follicles in the skin becoming clogged or plugged (medical word is comedones). This plugging happens during excess sebum production in puberty (sebum is our natural skin oil). This sebum then mixes with skin cells and plugs the follicle. The plug can then be infected with a bacterium called Propionibacterium acnes (P. acnes) and become known as a blackhead or whitehead. This follicle can then rupture and become inflamed, commonly known as a pimple.

What are blackheads, white heads, pimples etc?

A blackhead is an open comedone where it partially opens to the skin surface and turns black due to the oil reacting with the oxygen in the air (not dirt). A whitehead is a closed comedone that stays below the skin’s surface. Pimples develop when the blackheads and whiteheads become infected and inflamed. Pimples either appear as red lumps (papules) or yellow heads (pustules).

What are popular misconceptions?

Dirt

  • Acne is not caused by dirty skin, in fact acne is often made worse by overwashing.

Diet

  • Greasy food and chocolate do not cause acne.

Cosmetics

  • Most moisturisers or toners do not cause acne.

What’s some good advice?

  1. Use a gentle non-soap skin cleanser (eg Cetaphil® Gentle Skin Cleanser)
  2. Wash gently twice a day to remove the sebum
  3. Gently pat the skin dry
  4. Don’t scrub, pick or squeeze the skin
  5. Avoid harsh preparations that may be irritating (eg face washes such as Phisohex, chlorhexidine, salicylic acid)
  6. Use a light moisturiser that won’t clog the pores (eg Cetaphil® Moisturising Lotion), only if required

What is a suitable gentle skin cleanser?

Cetaphil® Gentle Skin Cleanser is a good soap-substitute for people with acne. It is non-drying, with less irritation than many other cleansers. It does so without foaming and lathering. Cetaphil® Moisturising Lotion and Cream are ideal for those with particularly dry sensitive skin that need more moisturisation. The Cetaphil® Gentle Cleansing Bar is also available for those who prefer a bar.

How is acne treated?

The cornerstone of treatment is a topical preparation. The best over the counter product in the pharmacy is benzoyl peroxide (eg Benzac® AC). This works by rapidly killing the bacteria on the surface of the skin and deep within the follicle. Improvement with acne therapy is not immediate and will usually take 8 weeks, so patience and regular use of treatment is very important. The continued use of benzoyl peroxide with prescription medication can help prevent the bacteria (P. acnes) becoming resistant.

When should I see my GP or a dermatologist?

If the acne has not improved after 8 weeks or the acne is severe then see your GP for a prescription only medication (eg a topical retinoid in combination with a topical or oral antibiotic).

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