Understanding acne


Acne is a very common skin condition that most of us will experience at some point in our lives. It causes spots and bumps on the skin - most commonly on the face, back and chest.

Types of spots

The following are the main types of spots caused by acne:

Blackheads – these are small darkened bumps caused by pores that are clogged with a mix of dead skin cells and oil

Whiteheads – these are similar to blackheads, but are closed off, so they won’t empty when squeezed

Papules – small spots that are red and may feel tender or sore

Pustules – similar to papules, but these have a white or yellow centre which is filled with pus.

Nodules – large and painful red bumps

Cysts – large lumps filled with pus which look like boils. This is the most severe type of spots caused by acne

Types of acne

Acne is classified as:

• Mild – mostly whiteheads and blackheads, with a few papules or pustules

• Moderate – more widespread whiteheads and blackheads, with many papules and pustules

• Severe – lots of large, painful papules, pustules, nodules or cysts. You may also have some scarring

What causes acne?

Our skin produces a substance called sebum, which keeps the skin lubricated. Acne is caused when the skin produces too much sebum, blocking the skin's pores. This causes blackheads or whiteheads.

The normally harmless bacteria that naturally live on the skin can then invade the blocked pores, causing an infection and leading to papules pustules, nodules or cysts.

Acne and hormones

Hormone changes at puberty and during the menstrual cycle or pregnancy can affect the amount of sebum our skin produces which can lead to acne.

Women generally experience more changes in their hormone levels, which may be why 80% of adult acne cases affect females.

Acne runs in families, so if your parents had acne as teenagers, you're more likely to get it too.

Acne and polycystic ovary syndrome (PCOS)

For some women, acne is a symptom of a condition called polycystic ovary syndrome (PCOS), which affects the working of your ovaries. You should see your Doctor, if you have acne and any of the following:

• Irregular periods (or no periods at all)

• Excess facial or body hair

• Weight gain

• Thinning hair or hair loss on your head

Acne and makeup

Some people find acne can be triggered by using cosmetics. This is less common than it used to be, as most cosmetics are now tested to make sure they are non-comedogenic (this means they won't block pores).

Acne and smoking

Smoking can contribute to the development of acne in older people. If you're ready to quit smoking, there's lots of help and support available. You can see your pharmacist or Doctor for advice.

Acne associated with medicines

Some medicines have been associated with acne flare-ups. These include steroid medicines, lithium (used to treat bipolar disorder and depression) and some anti-epileptic medicines. 

If you've been prescribed any of these medicines it's very important that you don't stop taking them unless your doctor tells you to stop, even if you believe they might be causing you to have acne. You can see your Doctor for advice on managing your acne and a review of your medication.

Beliefs about acne – tackled

Acne is common, but this doesn't mean you have to simply live with it. Talk to your pharmacist or Doctor for advice. There's no evidence that acne is caused by poor diet, dirty skin or inadequate hygiene. 

Acne is not infectious and can't be passed on to other people.  It's very tempting to pick or squeeze at spots, and many people believe this is the best way to help them heal. However, doing so can drive the infection deeper into your skin and cause long-term scarring. 

You may have heard that sunlight, or using a sunbed, can help manage acne, but there's no evidence this is true. In fact, a number of medicines used to treat acne can make your skin more sensitive to light. So, exposure can lead to skin damage and can increase your risk of developing skin cancer in later life. Make sure you read the information leaflet which comes with your medicine to check if your medicine can make your skin more sensitive to light. If it does, then you should avoid exposure to strong sunlight, as well as other sources of UV, such as sunbeds.

Next steps 

• Don't pick or squeeze spots. It can drive infection deeper into the skin and lead to scarring

• If you have mild acne, you can talk to your pharmacist for advice

• If you have moderate or severe acne, you should see your Doctor