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    Types of acne and its causes

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      Acne is a common skin condition, particularly among teenagers, but as many as 95% of us will experience some kind of acne between the ages of 11 and 30. People are likely to experience the symptoms of acne on and off over several years before the condition improves, however, some people experience acne well into later life. 

      The condition occurs when your hair follicles become clogged up with oil and dead skin cells. Acne often causes spots, oily skin and in some cases the skin can become painful and hot to touch. The appearance of acne is usually characterised by a mixture of whiteheads and blackheads (known as comedones) and also some pus-filled spots (known as pustules). 

      The most common places to experience acne are the face, neck, back and chest.

      Face acne - most people who experience acne would have some acne on the face, typically across the cheeks and forehead 

      Causes of acne

      As previously mentioned acne is caused by the hair follicles becoming blocked. The glands attached to the hair follicles, called the sebaceous glands, produce an oil called sebum to keep the skin and hair hydrated. If you have acne the glands begin to produce too much sebum, causing the follicles to get blocked. 

      When these follicles are close to the surface of the skin, the blockage bulges out causing whiteheads so often seen in acne. If the follicles are open to the skin you will end up with a black head. But what causes this buildup of sebum and acne to develop?

      Testosterone

      It is thought that acne in teenagers is caused by increasing levels of testosterone during puberty. Sebaceous glands seem to produce more sebum when there are increased levels of testosterone in the body, so this is likely to cause this blockage of the pores. 

      Female hormonal changes

      Women are more susceptible to adult acne than men and this is likely to be caused by the changes in hormone levels due to periods, pregnancy or conditions such as polycystic ovary syndrome. 

      Genetics

      It has been found that if your parents have acne, you are likely to have acne as well. Studies have shown that acne in your teenage years is more likely if both your parents had acne. The same goes for adult acne - if one of your parents have or had this, you also have a higher chance of developing adult acne. 

      Stress

      While stress doesn’t necessarily cause acne, if you are acne prone, stress may worsen the condition. 

      Greasy or oily substances

      If your skin regularly comes into contact with oily cosmetics or with grease in a work area, such as a kitchen with fat fryers, you might find this causes acne or makes your condition worse. 

      Other causes of acne

      Other things that are thought to cause an acne flare-up include certain cosmetic products, medications such as steroids, regular use of a headband, mask or backpack, and smoking. 

      Considering acne treatment?

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      Types of acne

      There are a variety of different types of spots that people experience with acne. Some people may have a mixture of these spots, while others may only be affected by whiteheads for example. 

      Blackheads

      As we’ve discussed, blocked follicles that are at the skin’s surface will become blackheads. They get their colour because oxygen in the air reacts with the pigment in the oil causing the blockage to turn black. 

      Whiteheads

      Whiteheads are often mistaken for pustules, but there is actually no pus or swelling. Whiteheads develop when there are blocked follicles beneath the skin’s surface and the opening of the hair follicle is forced to close around the blockage. 

      Papules and pustules

      When bacteria multiply within a blocked follicle and oil and dead skin cells begin to build up, there is a chance the follicle wall will tear open. When the wall tears, white blood cells rush to fight off the bacteria causing the inflammation. These white blood cells then cluster and form a pocket of pus, known as a papule. 

      Pustules are formed when the papule rises to the surface and this is why they are sometimes mistakenly called whiteheads. 

      Nodules and cysts

      Nodules and cysts are common terms for the largest papules and pustules. Nodules are large hard bumps that grow beneath the skin and can be quite painful. 

      Cysts are often the most severe form of spot caused by acne. They can sometimes be confused for boils, as they look very similar. Cysts are the most likely to cause permanent scarring. Find out more about acne scars and treatments. 

      Acne treatment

      There are a variety of different options available if you experience acne. If you have mild to moderate acne you might be able to get over the counter treatment, such as gels and creams, from your local pharmacy. Find out more about how to get rid of your own acne. 

      If your acne is affecting you or it is moderate to severe, you could go see your GP. 

      Moderate acne treatment

      If you experience moderate acne, a GP, or one of our online clinicians may prescribe you topical retinoids, topical antibiotics, azelaic acid, oral antibiotics or for some women, the combined contraceptive pill, such as Dianette, is an option. 

      Moderate to severe acne treatment

      If you are experiencing moderate to severe acne, a clinician may opt for a combination of topical and oral combination. This could be a combination of a topical gel with oral antibiotics, or for some women, the combined contraceptive pill.

      Our online acne clinic

      Our LloydsPharmacy Online Doctor acne clinic boasts a wide range of treatment plans, so that our clinicians can tailor treatment to you and your acne. The service is easy to use and involves a free consultation which includes the opportunity to upload photos of your acne. These alongside the answers to the consultation questions will be reviewed by our clinicians, who will then decide, if suitable, what treatment option might be best, depending on your preference, medical history and the severity of your acne. 

      Sources
      https://www.nhs.uk/conditions/acne/treatment/
      https://www.nhs.uk/conditions/acne/causes/
      https://www.nhs.uk/conditions/acne/
      http://www.acnesupport.org.uk/acne-types/
      https://www.bad.org.uk/shared/get-file.ashx?id=65&itemtype=document
      https://patient.info/skin-conditions/acne-leaflet
      https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047

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