About spots and acne

What is acne?

Acne vulgaris is a skin condition resulting from inflamed or infected oil (or sebaceous) glands in the skin. Our skin is covered in thousands of tiny pores, which connect to the sebaceous glands under the surface. Each gland is linked to the pores via small ducts called follicles, and a small hair grows out of the follicle through the skin. An oily liquid called sebum is produced by the sebaceous glands, helping to keep your skin supple. Certain hormonal changes can cause both the overproduction of sebum and /or an overgrowth of the epidermis (top layer of skin cells) triggering infection from bacteria which feed off the sebum and the result is a spot or pimple.

What causes acne?

Dermatologists believe the main cause of acne is from the skin's response to hormone levels and the effect this has on a normally harmless bacteria resident in the oil glands. The main hormones to blame are androgens (male hormones) such as testosterone which increase during adolescence. Such hormonal disturbances cause the sebaceous gland to produce more sebum and the epidermal cells to thicken, obstructing this flow. Excessive oil production also triggers the bacteria P. acnes to release enzymes to digest the surplus skin oil stimulating intense inflammation that bursts the hair follicle. A lesion then forms on the skin’s surface as a whitehead.

How common is acne and who is affected?

Acne is very common. Around 80% of 11-30 year-olds1 will get acne at some point and it affects people of all races and ages. Although most common in adolescents and young adults, hormone changes during pregnancy, prior to menstruation and as a response to stress or emotional upheaval can trigger an acne outbreak.

What does acne look like?

Acne pimples

Acne pimples can range from tiny painless whiteheads to large painful red cysts filled with sebum and pus. They tend to appear on the face, back, chest, shoulder or neck and sometimes the groin when follicles get blocked and infected. We have described the different types of spots and acne below, to help you identify which type you may have, understand what your doctor or pharmacist is referring to and to help decide how to treat it best.

Blackheads

When the pore of the sebaceous gland fills with sebum and shed skin cells, the secretions can react with air and form a black-coloured plug, hence a blackhead. Careful squeezing can remove the blackhead and let the spot drain, but clean hands and minimal pressure are advised to prevent infection or scarring and if in doubt, don’t touch!

Whiteheads

Certain sebaceous glands have such a tiny opening so air cannot reach the sebum and don’t become blackheads but remain as whiteheads. Unfortunately these are more likely to become red and inflamed, due to infection from bacteria which harmlessly populate the skin’s surface.

Papules

These small bumps are usually pink and visible on the skin’s surface.

Pustules

These spots are clearly visible on the surface of the skin and tend to be red at the base and have visible pus at the top.

Nodules

These are large, solid pimples which are clearly visible and often embedded deeper in the skin and as a result can be rather painful and can cause scarring.

Cysts

Cysts are larger and more inflamed than pimples or bumps, and are clearly visible on the skin’s surface. They are filled with pus and can be quite painful. This type of acne may pit and scar the skin, so it’s very important to treat it effectively.

Top tips for acne care

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