• Dr Kalli Nikolaidou
  • Highly Qualified Doctor
  • Dermatology Expert
  • Harley Street Location
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EXPERT CARE, SUPERIOR RESULTS

Acne

Give a solution to your acne prone skin

Make breakouts a thing of the past.

Acne can be helped with

Acne is a common skin condition which affects most people at some point. It is very common in teenagers and younger adults. About 80% of people aged between 11 to 30 are affected by acne. It causes oily skin, spots and sometimes skin that’s painful or hot to touch.
Acne most commonly develops on the face (affects almost everyone with acne); back (affects more than half of people with acne; chest (affects about 15% of people with acne)
There are 6 main types of spots caused by acne:

  • Blackheads – small yellowish or black bumps that develop on the skin; whilst they are not filled with dirt, they are black due to the fact that the inner lining of the hair follicle produces pigmentation (colouring)
  • Whiteheads – similar appearance to blackheads, but won’t empty when squeezed and may be firmer
  • Papules – small red bumps that may feel sore or tender
  • Pustules – similar look to papules, but have a white tip in the centre which is caused by a build-up of pus
  • Nodules – large and hard lumps that build up beneath the surface of the skin and may be painful
  • Cysts – this is the most severe type of spots which are caused by acne; they’re large pus-filled lumps that look similar to boils and carry the greatest risk of leading to permanent scarring
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Causes of Acne

Acne is caused when small holes in the skin, known as hair follicles, become blocked.
Sebaceous glands are tiny glands which are found near the surface of your skin. The glands are attached to hair follicles, these being small holes in your skin from which an individual hair grows out. The sebaceous glands lubricate the skin and the hair to stop it from drying out. They perform this action by producing an oily substance called sebum.

When it comes to acne, the glands begin to produce too much sebum. This excess sebum mixes with dead skin cells and the two substances form a plug in the follicle. If this plugged follicle is near the surface of the skin, it bulges outwards, thus creating a white head. Alternatively, the plugged follicle can be open to the skin, in this case creating a blackhead. Usually harmless bacteria that exists on the skin can then contaminate and infect the plugged follicles, resulting in papules, pustules, nodules or cysts.

Acne is most commonly linked to changes in the hormone levels during puberty but it can start at any age.
Particular hormones such as testosterone cause the grease-producing glands which are next to hair follicles in the skin to produce larger amounts of oil (known as abnormal sebum).
This abnormal sebum modifies the activity of a normally harmless skin bacterium called P. acnes, which becomes more aggressive and thus causes inflammation and pus.
The hormones also thicken the inner lining of the hair follicle, which causes blockage of the pores (opening of the hair follicles). Please note that cleaning the skin doesn’t help in removing this blockage.

Other possible causes are:

  • Acne is known to run in the family. If both your father and mother had acne, it’s likely that you’ll also have it.
  • Hormonal changes, like those that occur during the menstrual cycle or pregnancy may also lead to episodes of acne in women.
  • Polycystic ovary syndrome is another cause – a common condition that may cause acne, weight gain and also the formation of small cysts inside the ovary.

There’s no evidence associated with the idea that diet, poor hygiene or sexual activity play a role in acne.

Other possible triggers of an acne flare-up include:

  • Some cosmetic products – however, this is less common as the majority of products are now tested, so they don’t cause spots (non-comedogenic)
  • Certain medications – such as lithium (used to treat depression and bipolar disorder), steroid medications, and some anti-epileptic drugs (used to treat epilepsy)
  • Regularly wearing items that place a certain pressure on an affected area of skin, such as a backpack or a headband
  • Smoking – which can contribute to acne in older people
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Prevention of Acne

These self-help techniques may be useful:

  • Don’t wash the affected areas of skin more than twice a day as frequent washing can irritate the skin and in consequence make symptoms worse.
  • Wash the affected area with a either a mild soap or cleanser and lukewarm water. Cold or very hot water can make acne worse.
  • Don’t try to squeeze spots or “clean out” blackheads. This can make them worse and it can cause permanent scarring.
  • Avoid using too much make-up and cosmetics. Try using water-based products which are described as non-comedogenic (this mens the product used is less likely to block the pores in your skin).
  • Completely remove make-up before going to sleep.
  • If dry skin is a problem, use a water-based, fragrance-free emollient.
  • Regular exercise can’t improve your acne. On the other hand, it can boost your mood and improve your self-esteem. Once you finish exercising, shower as soon as possible as sweat can irritate your acne.
  • Wash your hair regularly and also try to avoid letting your hair fall across your face. Although acne cannot be cured, with treatment it can be controlled. It’s a good idea to speak to your pharmacist for advice if you develop mild acne. Several lotions, creams and gels for treating spots are available for you to buy from pharmacies. Products which are containing a low concentration of benzoyl peroxide may also be recommended, but be careful, as they can bleach clothing. If your acne is severe or appears on your back and chest, you may need to treat it with stronger creams or antibiotics that are only available on prescription.
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Symptoms of Acne

Your doctor can diagnose acne by looking at your skin. This will involve examining your face, back or chest for the different types of a spot, such as blackheads or sore, red nodules. Depending on how severe your acne is, it will determine where you should go for treatment and what treatment would be best suitable for you. The severity of acne is often categorised as:

  • Mild – mostly blackheads and whiteheads, with a few pustules and papules
  • Moderate – more widespread blackheads and whiteheads, with many papules and pustules
  • Severe – lots of large, painful pustules, papules, nodules or cysts; you might also have some scarring

Treatment

Prescription medications that can be used to treat acne include topical preparations, oral antibiotics,  the combined oral contraceptive pill and systemic treatments. If you have severe acne, your doctor can refer you to a dermatology specialist. For example, if you have a large number of papules and pustules on your back and chest, as well as your face, painful nodules, scarring, or are at risk of scarring, a combination of antibiotic tablets and topical treatments is usually the first option in treating severe acne. If this doesn’t work, a medication called isotretinoin may be prescribed to you. Hormonal therapies or the combined oral contraceptive pill can also be an effective solution for women who have acne. But the progestogen-only pill or contraceptive implant can in some cases make acne worse. Many of these treatments may take between 2 to 3 months before they start to work. Therefore, it is essential to be patient and persist with the recommended treatment, even if you can’t see an immediate effect. Dr Nikolaidou is an expert in dermatology and in acne treatment and she will guide you on the most appropriate treatment for you.

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