Acne

What is Acne?

Acne is a very common skin condition which occurs when hair follicles become clogged with dead skin cells and oil from the skin called sebum. This plug usually gets infected by bacteria known as Propionibacterium acnes and this creates the spots though the severity of an outbreak depends on the strain of bacteria.

There are six main types of outbreak which fall under the umbrella term, ‘Acne’. They are:

• blackheads - known as open comedones, these are follicles with a wider opening which are plugged with sebum (oil) and dead skin cells. A chemical reaction between this material and oxygen results in this build up turning black in colour.
• whiteheads - known as closed comedones, these spots are filled with the same material as a blackhead but the opening in the skin is microscopic and since oxygen cannot get into it reminds white.
• papules - these are small bumps which are often red and painful to touch
• pustules - they have a similar look to papules but with a white centre caused by a pus build-up
• nodules - felt as painful hard lumps under the skin
• cysts - large lumps filled with pus and most likely to leave a scar.

How effective are Acne treatments?

Medications reduce oil production, speed up skin cell turnover, fight infection from bacteria, reduce inflammation and reduce scarring.

You will be recommended an acne treatment based on a number of factors including your age, the severity and/or type of acne you have and what you are happy to try. For example, some treatments require you to wash your face and/or apply a gel or cream twice a day which may be considered too much of a commitment to someone who lives a very busy lifestyle. Medication which comes in the form of an antibiotic can affect gut health and this may not be the best choice for certain patients either. These types of concerns can be discussed with your doctor so you can find the most effective treatment for your situation.

In terms of the length of time it takes to see changes to your skin, it can depend on the severity of your acne and where you are in your skin’s shedding cycle when you begin the treatment. Some treatments will show results from one week whereas others may take six to eight weeks.

Is it safe to use Acne treatments?

All products on the market and available from your doctor and/or chemist, both on prescription or over-the-counter, are considered to be safe but the side effects of these products can differ from person to person based on a number of factors including medical issues you already suffer from, medication you take and your age amongst others.

There are a number of active ingredients in different acne treatments and each one could have a slightly different reaction in the patient using them. In some people, an ingredient which is perfectly safe and causes no side effects or else very minimal effects could cause a severe reaction in someone else due to allergies.

As such, it is highly recommended you discuss your acne concerns with your GP or Click Pharmacy pharmacist or doctor before trying any products, either over the counter or on prescription.

What different Acne treatments are available?

There is a range of acne treatments on offer including topical creams and gels, oral tablets including antibiotics as well as certain therapies such as chemical peels and black or white head extraction.

Depending on the type of acne you have and the severity of it you may wish to start with a milder, topical treatment and progress on to using oral medications if necessary. You can also mix both oral and topical together in more extreme cases but this will be discussed with your Click Pharmacy doctor prior to use.

The most commonly used ingredients in topical treatments are:

• retinoids
• antibiotics
• salicylic acid and azelaic acid
• dapsone

The most common oral medications are:

• antibiotics
• combined oral contraceptives
• anti-androgen agents
• isotretinoin

Does an Acne treatment work immediately?

Different acne treatments will work in a variety of ways and though some may appear to work more quickly they all get to work right away.

Certain gels and creams which are placed directly on the affected area will work immediately and will help you see changes within a week or two in some cases. When antibiotics are being used to treat more severe cases, either orally or topically, it may appear to be taking longer to work and can even look as though it is getting worse before it gets better. The reason for this is that the formulation is working deep within the skin to stop the acne forming at its source by helping to dry out the excess oil and destroy the bacteria within the hair follicles which are causing the acne. As this begins to work, the acne will start to clear and your skin will be able to return to its natural tone and texture.

Can I buy the Acne treatment online?

You can purchase many acne treatments online rather than booking an appointment with your GP by using Click Pharmacy. You will be prompted to fill in a short medical questionnaire which will give our doctors the relevant information to assess which treatment will be most beneficial for you.

From there you will be given a prescription and rather than going to your local chemist, we will send your medication to you directly.

What are the side effects of Acne treatments?

From the strength of the medication you are using to the method of treatment, the side effects of acne treatments can depend on a number of factors.

Most side effects are mild and temporary and ease as your body learns to tolerate the medication. When using topical medications these can include redness, irritation or a mild stinging to the affected area but if your skin burns or peels then tell your doctor as soon as possible.

The side effects of oral medications can vary and include nausea and an upset stomach as well as dizziness and lightheadedness.

If you find you experience very severe reactions from either type of treatment such as issues with your breathing or swelling to the tongue, lips or throat, then get medical help right away and stop using the treatment.

If using birth control when taking an antibiotic it is recommended you use a secondary form of protection as it can affect how well it works. Certain drugs used to treat acne can also have very dangerous side effects when pregnant; so if you are pregnant or become pregnant whilst using them, speak to a doctor right away to discuss your options.

What Causes Acne?

Whenever the skin pores are blocked, it leads to acne spots on your face or body. However, acne triggers tend to vary from person to person, and various of them exist. For instance:

Hormonal Acne

Fluctuations in hormone levels can significantly affect acne. This is because hormone levels directly influence how much oil the skin secretes. Due to this, hormonal acne and breakouts are associated with changes in hormone levels during puberty. As a result, teenagers tend to experience symptoms on the forehead, face, and jaw.

Cystic Acne

Cystic acne is one of the most severe forms of acne. When the normal bacteria on the skin combine with the excessive sebum and dead skin cells and end up trapped in a pore, it leads to cystic acne. This type of acne typically occurs in painful, red, and inflamed cysts on the skin. Not only this, but it can result in scarring if the breakouts are severe enough.

Medication Induced Acne

There are a few medicines out there that can cause acne as a side effect. In particular, medications that fluctuate or modify naturally occurring hormone levels in the body are the primary reason behind such acne. Such drugs include corticosteroids, testosterone, and lithium.

Make-up Products

Oil-based make-up products can further aggravate acne. It can especially worsen if the products are not removed properly. Therefore, it is better to use oil-free and non-comedogenic products. In addition, try double cleansing before bed.

What are the symptoms of Acne?

The initial symptoms of acne are spots that leave a mark and oily skin. In most cases, acne occurs on the face, neck or back. Few people experience acne on their chest and buttocks. There are about six main types of spots that are caused by acne. These spots are:

Blackheads: Blackheads appear as small bumps on the skin. They may appear as black or yellow. This discolouration is due to blockage of hair follicles and is believed by most.

Whiteheads: Whiteheads are very similar to blackheads. But, they are quite firm in appearance, and the heads do not e out if they are squeezed.

Papules: These are red bumps that can feel extremely tender to the touch.

Pustules: Similar to papules, these have a white centre which is a build-up of puss.

Nodules: These are large, hard and painful lumps that occur beneath the surface of the skin.

Cysts: These are large pus-filled protrusions which are extremely painful. These types of spots carry the greatest risk of permanent scarring.

How is Acne diagnosed?

In most cases, a professional diagnosis of acne is not necessary. However, if the symptoms are excessive, painful or complicated, it is best to get an expert's advice.

Acne of any sort can cause emotional and physical distress. If you are experiencing such stress, reaching out to a professional is important, as it can take a toll on your mental health. If your acne presents with cysts or deep nodules, it is also advised to consult a doctor. Taking action right away is crucial. Otherwise, you may experience scarring that takes a while to fade.

An acne diagnosis typically consists of a simple visual examination. First, your GP will inspect the affected areas, such as the face, chest and back, to identify the different types of spots. With the help of this examination, your GP will judge how severe your acne is. Grades can classify the severity of acne:

• Mild acne – Grade 1: Blackheads and whiteheads. Maybe even a few pustules or papules.
• Moderate acne – Grade 2: A lot of pustules and papules.
• Moderate to severe acne – Grade 3: A lot of pustules and papules on the face, back and chest.
• Severe acne – Grade 4: A lot of pustules and nodules. They may be large and painful.

You should see your doctor if you're a woman and have suddenly developed acne as an adult. You may have to undergo an ultrasound or blood test, especially if your symptoms suggest a hormonal imbalance. The most common reason behind such imbalance is PCOS.

What can make acne worse?

The following can worsen your acne:

• Squeezing and picking at the acne spots
• Not washing your face and body immediately after exercising
• Over-cleansing the skin and stripping it of its protective natural oils
• Presence of chemicals, grease and dampness in your working environment
• Having irregular menstrual periods
• Side effects of certain medicines
• Not wearing SPF
• Using pore-clogging make-up products
• Touching your face
• Dirty hair touching your face

How can I prevent my acne from scarring?

To prevent acne scarring, use pimple patches. Such patches help people avoid pop, pick or squeeze spots, which mainly cause scarring. It is better to prevent such things instead of looking for cures for such spots later on. You can use retinol, vitamin C or Azelaic acid to help the face and reduce the appearance of acne scars. Some scars will fade eventually on their own.

Should I squeeze my spots?

Absolutely not. Avoid squeezing, touching or picking on your spots or acne. This can spread harmful bacteria and cause more breakouts on the skin. Additionally, squeezing the pimple can lead to acne scars which are a hassle to get rid of.

Can eating certain foods, like chocolate, give you acne?

Maybe. It is vital to note that there is insufficient data to support such claims. However, there are also not enough studies to suggest otherwise. In fact, a piece of mounting evidence indicates that a lower GI diet can benefit acne.

Instead of avoiding foods blindly, keeping a list of foods that trigger your acne and avoiding them in the future is better. Of course, this is a trial and error process. However, everyone has different skin and body so triggers may vary. So, it is best to figure out the worst foods for your body and avoid them.

Which acne treatment is right for me?

If over-the-counter acne treatments do not work for you, contact your GP. They will prescribe suitable treatments that will be significantly stronger. Unfortunately, they will only be available with a prescription. You can obtain prescriptions for such medications through our website, too. You will be required to fill out a survey, though. The completed survey will be assessed by one of our on-site specialists, who will help determine whether you need assistance with the medication. Once approved, you will be issued the prescription.