Acne (pimples) is a common chronic skin disease involving blockage of the hair follicles. The blockage leads to the formation of comedones that can be open (blackheads/whiteheads) or closed — appearing as small non-painful bumps under the skin. When the blocked pore becomes inflamed or infected, it forms red papules (small tender red bumps) or pustules (red bumps with pus). At its worst, acne can form large cystic or nodular lesions.
Acne can affect anyone, especially those with relatives who have had acne. The majority of people affected are adolescents but any age group can be affected. It can also persist into, begin in, or worsen in adulthood — the latter is called adult-onset acne.
Acne usually affects the face but the back, arms, chest and other parts of the body can be involved.
The cause of acne is largely genetic, but several factors can make it worse: sex hormones (which surge during puberty), medical conditions like polycystic ovaries, psychological stress, environmental factors like high humidity, certain cosmetics, and dietary factors such as high glycaemic-index foods, dairy, caffeine and chocolate.
The best route to treatment is your dermatologist. Severity is graded, and dermatologists treat each grade differently. Treatments include topical retinoids, benzoyl peroxide, the combination of retinoids and benzoyl peroxide, topical antibiotics, salicylic acid and zinc preparations. In severe acne, oral antibiotics or oral retinoids may be added. We will recommend skincare and sunscreen, and may add chemical peels or other cosmetic procedures.
Both treated and untreated acne can lead to scarring. Untreated acne tends to leave more permanent scars that may need surgical or invasive treatments. In milder cases or acne treated early, dark-skinned patients often get flat dark marks/spots and fair-skinned patients get reddish spots — depigmenting agents and sunscreen can help. Indented scars may be improved with Dermapen treatments or deeper chemical peels.