How does it happen?

Acne occurs when pores in the skin (follicles) get blocked with oil (sebum) which normally drains to the skin surface. Bacteria begin to grow on this blocked sebum.

  1. White heads :
    White heads are formed when the trapped sebum and bacteria stay below the skin. They may show up as tiny white spots on the skin.
  2. Black heads
    Bacteria and sebum trapped within the hair follicle opens on to the surface. As this contains melanin (the skin pigment) it oxidizes and turns black.

White heads and black heads can heal gradually. However, if you pick on it, touch it regularly or scratch it, then these can rupture and inflammatory acne can occur.  These can leave a mark.

  • Papule: This occurs due to a break in follicle wall. White blood cells rush to this damaged site and there is inflammation.
  • Pustule: This occurs some days later when the white blood cells make its way to the surface of the skin slowly. This is what is commonly known as the ‘pimple’.

Where does acne appear most?

Lesions can be isolated and single or scattered and discrete. They occur mostly on

  • Face
  • Upper back
  • Chest
  • Arms
  • Neck
  • Family history of acne
  • Hormonal activity – common close to menses, during puberty
  • Sebaceous gland activity
  • Micro-organisms
  • Medication containing Lithium, Barbiturates, androgens
  • Pressure on the skin by leaving the face on hands
  • Stress

Acne is common during adolescence, as there is increased sex hormones which causes follicular glands to get larger and make more sebum..

It is seen among more than 85% of adolescents.

These lesions may disappear by itself without any medications but, if there is severe acne which affects your self esteem please see a doctor.

  • Chocolates and fatty foods increase acne
    It has been shown that the high glycaemic index of certain foods containing simple carbohydrates eg. sugar, cakes etc. increases acne. However, there is no proven relationship with acne and chocolates.
  • Dirt or not washing the face causes acne
    Pimples are not caused by dirt. Frequent washing may irritate pores and cause them to be blocked. You should wash the face gently with your bare hands and wash only twice a day.
  • Masturbation or sexual intercourse causes acne
    No, these activities do not cause acne.
  • Stress increases acne
    Stress may have an effect on your hormones and this can exacerbate acne.
  • Topical antibiotics
    Eg. Clindamycin, Erythromycin. These should be applied at day time.
  • Benzoyl Peroxide gels (2% or 5%)
  • Topical Retinoids (Vitamin A)
    May need to apply for 2-5 months. Apply at night. Increase the dose immediately.
  • Oral Tetracycline – for severe cases
  • Oral contraceptive pills (for women) – for severe cases