What causes acne?
Types of acne
Other Problems Caused by Acne
Myths About Acne
How acne is traditionally treated
The ARC solution to acne

What is acne?

'Acne as a disease is so common as to be considered a normal rite of passage. Yet acne is a devastating disease striking most adolescents at their most vulnerable time when their life long self esteem and sense of identity is being developed.' Goodman, G. (2006)

Acne is a common skin condition that affects 85% - 100% of people at some point in their lives.

79% - 95% of the adolescent population are affected (mostly males). It can be caused by a hormone imbalance which is why teenagers are more commonly affected.

40% - 54% of men and women over 25 years are affected whilst middle aged clinical acne affects 12% of women and 3% of men.

What causes acne?

There are three main causes of acne: excess sebum, hormones and inflammation. Excess sebum being trapped in the hair follicle is the most common cause of acne. Acne affects the hair follicles and also the sebaceous glands in the skin, which secrete an oily substance called sebum. Sebum becomes trapped in the glands and in hair follicles and this results in an inflammation. An acne spot is simply trapped oil and skin cells in pores in the skin. Inflammation of the hair follicle and the sebaceous glands can affect the skin in the same way.

An increase in the hormone Androgen is another cause of acne and why it is most common in adolescents. During puberty, adolescents are experiencing numerous changes to their hormone levels and this can trigger the appearance of acne.

Other causes of acne can be drug related, i.e. through the use of steroids, lithium, antiepileptics and iodides.

Types of acne

The most common type of acne is Acne Vulgaris and this can range from mild through to moderate and severe. Acne Vulgaris mild/moderate is diagnosed through the appearance of whiteheads, blackheads, papules and pustules.

Whiteheads can appear as small white spots or be barely visible on the surface of the skin. They occur through trapped bacteria and sebum which stays below the skin.
A Blackhead occurs when the pore opens to the surface, and the sebum, which contains the skin pigment melanin, oxidizes and turns a brown/black colour. Blackheads can last for a long time because the contents very slowly drain to the surface.
A papule is an inflamed pore and occurs when white blood cells rush into a break in the follicular wall. It appears as a small red bump on the skin’s surface.
Pustules are formed several days later when white blood cells make their way to the surface of the skin. This is what people usually refer to as a 'pimple' or 'spot'.

Acne Vulgaris severeis diagnosed through the appearance of nodules and cysts -

A Nodule is when a follicle breaks along the bottom, total collapse can occur, causing a large, inflamed bump that can be sore to the touch.
Sometimes a severe inflammatory reaction can result in very large pus filled lesions referred to as Cysts.

Far more severe forms of acne exist such as: Acne Conglobata; Acne Fulminans; Gram-Negative Folliculitis; and Pyoderma Faciale. These different forms are characterised by more extreme cysts and nodules; conjoined lesions and other symptoms such as fever and arthritis. These forms of acne need immediate medical intervention. The Advanced Rejuvenation Clinic cannot treat these forms of acne.

Myths About Acne

There are various myths surrounding the cause and appearance of acne.

The most common is hygiene. Commonly a school-ground taunt, acne is not caused by poor hygiene. Lesions must be kept clean and it is important not to touch the affected area in order not to spread bacteria, but excessive cleaning can in actual fact exacerbate acne by inflaming the area.
Poor diet is another wrongly cited cause of acne. Based on various research there is currently no strong evidence to suggest this is true.
It is common thought that sun exposure can improve the appearance of acne by drying out the lesions. There is no convincing evidence of this and clinicians would argue against it for the reasons of increased melanoma and photosensitivity caused by acne treatments.

How acne is traditionally treated

There are various prescribed treatments depending on the severity of acne. For mild to moderate acne vulgaris treatments can include:

Topical Retinoids – derivatives of vitamin A
Topical antimicrobials such as benzoyl peroxide and clindamycin – theses can have adverse effects including erythema, peeling, dryness and burning.
Hormonal therapy – for women only, certain oral contraception can control the causes of acne.

For more moderate to severe acne vulgaris the following treatments can be used:

Isotretinoin – a metabolite of Vitamin A it can cause dry lips, skin and eyes with more severe reactions being headache/ backache, depression and foetal malufunctions.
Oral antibiotics – adverse effects can include gastric problems; fungal problems; ulceration and vertigo. It is common to build up a resistance to the medication therefore long-term use must be avoided.
It is common to receive a mixture of treatments when dealing with acne to avoid the adverse effects and resistance. These treatments can have a success rate of 30%-80% on inflammatory acne in 12 weeks however maintenance courses of treatments required. None of the above prescribed treatments can help post-acne scarring or skin conditions caused as a result of acne treatments.

The ARC solution to acne