Acne

What do you need to know about acne?

Acne isn't just a skin disease, it's a disease of the pilosebaceous follicle, a structure that includes the hair and the sebaceous gland. The sebaceous gland is responsible for the production of sebum, a mixture of lipids, which is essential for protecting the skin from external aggressions and ensuring its suppleness. Acne is affected by two main factors, hormones and bacteria:

• Hormones cause too much sebum to be produced or mean it becomes too thick, while the cells of the follicle multiply. Hyperseborrhea (too much sebum) and hyperkeratinization (too many cells) lead to clogged pores and the appearance of the first acne flare-ups. Acne is hormone-dependent, which explains why it is very common in adolescence. In adulthood, factors such as pregnancy, menstruation, the pill or menopause disrupt the hormonal balance and cause an increase in acne.
• A bacteria called Cutibacterium acnes, which occurs naturally on everyone's skin, also plays a major role in the development of acne. These bacteria are altered by the influence of hormones and changes in sebum, leading to the appearance of acne lesions.

Other common causes of acne include family history, comedogenic cosmetic products, certain medications and stress.

What are the different types of acne?

Depending on the significance of the various foregoing factors, acne can take several forms:

• "Retentional" acne is characterized by shiny skin, dilated pores, blackheads (open comedones) and whiteheads (closed comedones or microcysts).
• "Inflammatory" acne involves the presence of red spots, which appear as papules, pustules or even nodules, depending on the depth of the spots within the skin.
• Nodular or nodulocystic acne, also called acne conglobata, is a chronic and severe form of acne, marked by numerous lesions, especially nodules, and with a high risk of scarring.
• Acne fulminans is the most serious form of acne but fortunately the rarest. It is the only acute form of the disease, characterized by severe cutaneous and extra-cutaneous signs, and requires emergency hospitalization. OR VISUAL
• Acne flare-ups also affect a wide range of people:

• Juvenile acne, i.e. adolescent and pre-adolescent acne, is the most common form of the condition; about 80% of young people are affected.
• Acne in adult women, which affects about 20% of women, is concentrated on the lower part of the face and is most often caused by physiological or pathological hormonal disturbances.
• Acne in adult men tends to affect the back most often, but can also occur on the face and can be difficult to deal with on a daily basis.
• Infant acne starts between 0 and 3 months; it often disappears after a few months, leaving no scars, and should not alarm parents!

What are the treatments for acne?

It is important to consult a general practitioner or a dermatologist (i.e. a skin specialist), if you have acne. As acne is a chronic disease, the various treatments available are usually envisaged over several months or years. A medicinal treatment may be prescribed to improve the skin's condition and limit the worsening of acne. Depending on the type of acne, its severity and other criteria (duration, age, etc.), a local, oral or combined treatment will be indicated. Other options such as laser treatments may be recommended by your dermatologist.

Some treatments may sometimes weaken the skin, leading to dryness, redness, discomfort, etc. These side-effects can be counterbalanced by appropriate hydrating dermo-cosmetic skin care products. Anti-acne dermo-cosmetic treatments can be prescribed by your doctor and recommended by your pharmacist. They include creams, masks, lotions, corrective sticks, and so on.

To get rid of your acne and limit the risk of scarring, you must be patient, comply with your prescription and follow the advice of your health care professionals.

What can you do about acne on a daily basis?

What should you do if you develop acne? It's important to adopt the right habits from the very first spot flare-ups:

• Avoid touching your spots to prevent superinfections and scars.
• Use mild cleansing products specially formulated for acne-prone skin.
• Rinse and dry after a workout.
• Apply makeup with suitable products that are labelled "non-comedogenic".
• Use alcohol-free shaving and aftershave products.
• Be careful not to expose yourself to the sun without adequate protection. The sun is a false friend to acne: although it causes acne to disappear during exposure, spots are sure to reappear later once you are out of the sun!
• As far as diet is concerned, there is no need to restrict what you eat or eliminate any particular food. Contrary to popular belief, cold meats and chocolate do not cause acne flare-ups! Until we know more about other foods, particularly dairy and sugary products, the key is to follow a balanced diet.