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Acne pil revision 2007 edited by dmitchell



PATIENT INFORMATION LEAFLET

ACNE

This leaflet has been written to help you understand more about acne-what it
is, what causes it, what can be done about it and where you can find out more
about it.
What is acne?
Acne is a very common skin condition characterised by comedones
(blackheads and whiteheads) and pus-filled spots (pustules). It usually starts
at puberty and varies in severity from a few spots on the face, back and chest,
which most adolescents will have at some time, to a more serious problem
that may be embarrassing, sap self-confidence and cause scarring. For the
majority it tends to resolve by the late teens or early twenties but can persist
for longer in some people. Acne can develop for the first time in people in their
late twenties or even the thirties. It occasionally occurs in young children.
What causes acne?
The sebaceous (oil-producing) glands of people who get acne are particularly
sensitive to normal blood levels of a hormone called testosterone, which is
present in both men and women. This causes the glands to produce an
excess of oil. At the same time, the dead skin cells lining the pores are not
shed properly and clog up the follicles. These two effects result in a build-up
of oil producing blackheads (where a darkened plug of oil is visible) and
whiteheads.
The acne bacterium (known as Propionibacterium acnes) lives on everyone’s
skin, usually causing no problems, but, in those prone to acne, the build up of
oil creates an ideal environment in which these bacteria can multiply. This
triggers inflammation and the formation of red or pus-filled spots.
Is acne hereditary?
Acne can run in families, but this does not necessarily mean that if your
parents had acne you will get it too.
Tel: 020 7383 0266 Fax: 020 7388 5263 e-mail: admin@bad.org.uk What does acne look like and what does it feel like?
The typical appearance of acne is a mixture of the following: an oily skin,
blackheads and whiteheads, red spots and yellow pus-filled pimples, and
scars. Occasionally, large, tender spots or cysts may develop which can
either eventually burst and discharge their contents or may heal up without
bursting
How is acne diagnosed?
Acne is easily recognised by the appearance of the spots and by their
distribution on the face, neck, chest or back. However there are several
varieties of acne and your doctor will be able to tell you which type you have
after examining your skin. The most common type is “acne vulgaris”.
Can acne be cured?
At present there is no ‘cure’ for acne, although the available treatments can
be very effective in preventing the formation of new spots and scarring.
How can acne be treated?
If you have acne but have had no success with over-the –counter products
then it is probably time for you to visit your doctor. In general, most treatments
take two to four months to produce their maximum effect.
Acne treatments fall into the following categories:
- Those that are applied directly to the skin (topical treatments) - Oral antibiotics (tablets taken by mouth). - Oral contraceptive pills (O.C.P.) - Isotretinoin
Topical treatments
These are usually the first choice for those with mild to moderate acne. They
should be applied to the entire affected area of the skin and not just to
individual spots. Sometimes they can cause irritation of the skin, but reducing
the frequency of application, at least temporarily, can help to overcome this
problem. There is a variety of active anti-acne agents such as benzoyl
peroxide, antibiotics (erythromycin, tetracycline and clindamycin), retinoids
(such as tretinoin, isotretinoin and adapalene), azelaic acid and nicotinamide.
Oral antibiotic treatment
Your doctor may recommend a course of antibiotic tablets that should be
taken in combination with suitable topical treatment.
Antibiotics need to be taken for a minimum of two months, and are usually
continued until there is no further improvement. Some should not be taken at
the same time as food, so read the instructions carefully.

Oral contraceptive treatments

Tel: 020 7383 0266 Fax: 020 7388 5263 e-mail: admin@bad.org.uk Some types of oral contraceptive pills help women who have acne. The most
effective contain a hormone blocker (for example cyproterone), which reduces
the amount of oil the skin produces. It usually takes three to four months for
the benefits to show.
Isotretinoin

This powerful treatment has the potential to cause a number of serious side
effects and can be prescribed only by a dermatologist. Isotretinoin can harm
an unborn child. Women will be asked to enrol in a pregnancy prevention
programme and need to have a negative pregnancy test prior to starting
treatment. Pregnancy tests will be repeated every month during treatment and
five weeks after completing the course of treatment. Effective contraception
must be used whilst on treatment, and for four weeks afterwards.
There are concerns that isotretinoin may cause depression and suicidal
feelings. Details about any personal and family history of mental illness should
be discussed with your own doctor and dermatologist prior to considering
treatment with isotretinoin.
Most courses of isotretinoin last for four months during which time the skin
may become red and dry. Often, acne becomes a little worse before
improvement occurs.
It should be emphasised that many thousands of people have benefited from
treatment with isotretinoin without serious side effects.

Other treatments
There have been developments in the use of light and laser therapy for
inflammatory acne but these forms of treatment are yet to be fully evaluated.
Laser resurfacing of facial skin to reduce scarring is an established technique
requiring the skills of an experienced laser surgeon.
What can I do?

• Try not to pick or squeeze your spots as this usually aggravates them • However your acne affects you it is important to take action to control it as soon as it appears. This helps to avoid permanent scarring and reduces embarrassment. If your acne is mild it is worth trying over the counter preparations in the first instance. Your pharmacist will advise you. • Expect to use your treatments for at least two months before you see much improvement. Make sure that you understand how to use them correctly so you get the maximum benefit. Tel: 020 7383 0266 Fax: 020 7388 5263 e-mail: admin@bad.org.uk • Some topical treatments may dry or irritate the skin when you start using them. An oil-free moisturiser should help, but you may also have to cut down on the frequency with which you apply the treatments. • Wear oil-free, water-based make-up and choose products that are labelled as being ‘non-comedogenic’ (should not cause blackheads or whiteheads) or non-acnegenic (should not cause acne). Remove them at night with mild soap or a gentle cleanser and water. Scrubbing too hard can irritate the skin and make your acne worse. • There is little evidence that any foods cause acne but it may be sensible for you to avoid foods that you think make your acne worse.
Where can I get more information?
www.aad.org/pampheltsacnepamp.html
www.skincarephysicians.com/acnenet/
(Whilst every effort has been made to ensure that the information given
in this leaflet is accurate, not every treatment will be suitable or effective
for every person. Your own doctor will be able to advise in greater
detail.)

PRODUCED MAY 2007
Tel: 020 7383 0266 Fax: 020 7388 5263 e-mail: admin@bad.org.uk

Source: http://www.giggshillsurgery.co.uk/ipod/docs/ACNE.pdf

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