Acne is an extremely common condition that mainly affects teenagers but is not uncommon in adults. All acne is hormonal but there is often a genetic or hereditary predisposition to more severe forms of acne.

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Most teenagers will develop acne.  Some teenagers will develop it in a mild form for a short period of time and unfortunately, some teenagers may develop a more severe form of acne for a longer period of time. This more severe form of acne, called Nodulocystic Acne, may produce permanent scarring if left untreated and it may persist into adult life. All acne is imminently treatable and nobody should end up with permanent scars.

 

Treatment

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I generally recommend a gentle cleansing of the skin and one should avoid using scrubs and toners as this often irritates the skin.

 

Depending upon the type of acne, one would often use topical benzyl benzoate (Benzac-AC Gel®) as a spot treatment to the infected areas and a topical retinoid such as Differin Gel® at night for blackheads and whiteheads.

 

Hormonal treatments include the contraceptive pill such as Yasmin® and Yaz® but the best hormonal treatment is Diane-35® which contains estrogen as well as a drug called cyproterone acetate which is an anti-androgen i.e. it blocks the male hormone testosterone.

 

If the acne is inflamed, I prescribe oral antibiotics are the tetracyclines such as Tetralysal®. This is one of the newer tetracycline antibiotics which is safer with fewer side effects. These tetracycline antibiotics will often reduce the infection and inflammation of the skin but should not be used for long period of times.

 

Isotretinoin (Roaccutane®) is a drug that is derived from Vitamin A and is the only drug that can put acne into remission i.e. if the drug is prescribed to the patient at the correct dosage for the correct length of time there is an approximate 85% chance of the acne going into remission permanently. There is however an approximate 15% chance of a relapse. The isotretinoin reduces the oil production, it makes the top layer of the skin less sticky and it has got an anti-inflammatory action. It is a powerful drug and it needs to be given under strict supervision, preferably by a Dermatologist. The side effects include dryness of the lips, sensitivity to the sun and very rarely, the isotretinoin may push up the cholesterol in the bloodstream and affect the liver. A woman must not fall pregnant while she is on the isotretinoin and for 30 days afterwards. If she should fall pregnant while she is on the isotretinoin, there is a chance of producing an abnormal child.

 

Blood tests need to be performed before the patient is placed on isotretinoin and the patient needs to be monitored closely while on the medication. It is an extremely effective drug and it is safe if given under supervision by an experienced Dermatologist.