Acne, or acne in the technical language, is a chronic inflammatory skin disease, and the pimples occur when you get inflamed sebaceous glands. Acne usually occurs on the face, chest or back because it is in these areas that most sebaceous glands are present. In the most severe cases, medical treatment is needed to get rid of the ailments.
The sebaceous glands produce sebum that lubricates the hair strands and our skin. If they produce more sebum than usual, or become clogged, they will become inflamed and acne will form.
Acne is a very common condition, and the vast majority of us will suffer from acne to a greater or lesser degree during our lifetime. This is actually one of the most common skin diseases in Norway.
Especially in the teens and early twenties, many will experience a lot of acne. About 85% of all people in the age group 12-24 are affected by acne. The reason for this is that it is at this age the sebaceous glands produce the most sebum.
The causes of acne
As mentioned, acne is caused by inflamed sebaceous glands. There are mainly two reasons why a sebaceous gland becomes inflamed. One is the overproduction of tallow. You will be able to see this as black or white blackheads on the face, especially over the nose.
The sebum is broken down by bacteria in the skin. In the process, the bacteria secrete waste products that cause the sebaceous glands to become inflamed.
It is important to point out that pimples are not caused by poor hygiene.
The production of sebum is particularly affected by the hormones in the body and women can get pimples from contraceptives, menstruation and pregnancy, among other things. Stress can also be a cause.
The male sex hormones also affect sebum production and are a common contributor to acne, especially in boys during puberty.
The second reason that sebaceous glands can become inflamed is if the pores become clogged. This can be done by using make-up or certain skin creams. Acne patients should therefore avoid using oils (coconut oil / lanolin), greasy creams and dyes (especially the red ones) in hair and cosmetic products. Instead, water-based creams should be used.
Mechanical acne can occur with the use of tight jewelry, bra straps and the like. In addition, high sweat production after, for example, physical exercise can irritate the acne areas. Then just wash with lukewarm water. Heat and high humidity can also aggravate acne.
Should acne be treated?
In many cases, acne disappears on its own after a short time. This is especially true of isolated pimples. These are therefore rarely necessary to treat.
If, on the other hand, you are bothered by a larger amount of acne, or that the acne persists over time, treatment may be necessary.
First, such acne can be bothersome and embarrassing. Particularly severe acne can also have severe and long-lasting psychological effects with an increased risk of social isolation, unemployment, anxiety, absenteeism from school and depression. Acne can also be seen in adulthood, most often in women. With successful treatment of acne, significant improvement in self-esteem and quality of life can be demonstrated at the same time.
Second, there is a high risk of developing permanent scarring, especially with long-term acne. Studies have shown that up to 55% with pimples on the face later developed visible scars. There are different types of acne tissue, some of which contain increased levels of collagen, but most often collagen loss is seen. Known risk factors for scar tissue formation are positive family history, facial acne and the severity of acne.
Treatment of acne depends on a number of factors:
- Your age
- If you have other diseases
- If you have signs of scarring
- Are you pregnant?
- Do you have light-sensitive skin?
- If you have mild, moderate or severe acne
Treatment from a dermatologist via messaging service
Our dermatologists treat many of their patients based on the patient's description and sharp images of the problem area. Maybe your skin problems can also be solved so easily.
How to treat acne
When treating acne, you have many options, but it is desirable that treatment is started as soon as possible to improve the quality of life and reduce the risk of scarring. Many people have good help from various creams or cleansers that can be bought in regular stores, or without a prescription at the pharmacy.
An example of such a cream is Basiron gel, which contains the active substance benzoyl peroxide. The substance opens blocked pores and reduces the amount of bacteria that cause pimples.
If you suffer from acne, you should wash your face with water and a soap with the right pH value once or twice a day. The correct pH value is around 6,5.
To prevent it, it is important to be careful about which products you use on your face.
It is also important to avoid pinching pimples, although it can be tempting. If you squeeze them, you can get scars and in addition, more inflammation can occur in the area.
If self-treatment does not help, it may be necessary to use prescription drugs. If this becomes necessary, your dermatologist will prescribe the medication you are going to use, as well as make a treatment plan for you.
Medications used in the treatment of acne
If the acne is severe and needs to be treated with prescription drugs, it is possible to use either creams or tablets in the treatment.
Be aware that the medication for topical use can cause redness and some burning during treatment. The drugs have different strengths, and the skin reacts differently to the different treatments. Therefore, with some medications, a habituation period will be necessary.
The redness and burning will usually subside after a few days or a few weeks, depending on how sensitive your skin is. Most people have little discomfort associated with this.
The creams for local use can be divided into three groups:
Retinoids: Ointments, creams and gels in this group contain active ingredients made from vitamin A acid. They work against acne by exfoliating the outer layer of the skin, which dissolves blackheads, kills bacteria and prevents new clogging.
Azelaic acid: Azelaic acid is anti-inflammatory and has a proven effect on the bacteria that cause acne. In addition, the acid can reduce redness and swelling. Can also lighten acne scars because the acid inhibits the process that leads to pigmentation in the skin.
Antibiotic cream: Antibiotic creams contain antibiotics to kill bacteria associated with inflammation and pus. The creams are applied directly to exposed areas.
Treatment in the form of tablets can also be divided into three groups:
Birth control pills: For some women, it may be appropriate to start on, or switch to, birth control pills that contain both estrogen and progestin and that may therefore have an effect on acne. This is especially relevant if you also want to use contraception. This treatment can be combined with treatment with creams.
Antibiotics: A tablet treatment with antibiotics is usually used only if you do not see the effect of local remedies, and the acne can be classified as moderate or severe. They reduce the amount of bacteria and prevent inflammation of the sebaceous glands.
Retinoids in tablet form: Isotretinoin is a retinoid in tablet form. Such tablets must be prescribed by a dermatologist and used in the treatment of severe acne. It requires follow-up with a dermatologist during treatment and can cause serious side effects. Among them liver damage or fetal damage. Such tablet treatment should therefore not be used by pregnant women, and effective contraception must be used throughout the treatment. If you wear contact lenses or have a tendency to depression, it is important to inform your dermatologist before starting treatment.
Video consultation with a dermatologist
If you want to talk to one of our dermatologists on video, you can reserve an appointment here. Our dermatologists can treat all skin diseases and ailments as well as prescribe medicines if necessary for the treatment.
It is worth mentioning that the development of antibiotic resistance is a concern in the medical world. Antibiotic resistance can develop both with insufficient and incorrect dosage of antibiotics. Recent international research emphasizes the need to limit antibiotic consumption. To reduce the risk of antibiotic resistance, the addition of the substance benzoyl peroxide is often recommended when long-term antibiotic treatment is required.
What treatment is appropriate for your type of acne?
Acne is classified according to the severity, mild, moderate and severe. Depending on the type of acne you have, there may be different treatment methods that are relevant. Regardless of whether you start with local and / or tablet treatment, combination treatment with several active ingredients is always recommended.
If you have mild acne, this means that you have blackheads and superficial acne. Such acne will in many cases go away on its own.
It is described as mild because it is not inflammatory. Inflammatory means that the immune system works in high gear and sends constant signals that the acne must be fought. This leads to more and more inflammation.
Mild acne can still be bothersome, and you can use over-the-counter remedies to treat it.
Use face wash and creams for oily skin. These products are often lightweight and prevent pores from clogging.
If this does not help, you can ask for agents with benzoyl peroxide at the pharmacy. These are over-the-counter remedies, but benzoyl peroxide opens clogged pores and reduces the amount of bacteria. It can also help to use a cream with vitamin A acid.
Such treatment can cause the skin to become red and a mild burning at first, but this usually resolves within a few weeks.
Moderate acne is characterized by an inflammatory response. There are often several red swellings and pimples filled with pain. The swellings are called papules and the pimples are called pustules.
Papules are red swellings or nodules in the skin and occur due to inflammation. It can feel tender or painful to touch papules. Pustules are characterized by the fact that there is a limited area filled with plaster. Plaster is produced by infections and is a white or yellowish, slightly thick liquid.
Initially, you can try to treat moderate acne yourself. Get a facial cleanser with a pH value around 6,5 and use light creams without perfume.
You can also try using a cream with benzoyl peroxide.
If you do not see any improvement after 6-8 weeks, you should contact your dermatologist for guidance. This is also important to prevent scarring. Your dermatologist can help you figure out what will be the right treatment and will give you a treatment plan. Your doctor will prescribe the medication you need.
Severe acne is the most severe form of acne you can have. With severe acne, you not only have common pimples, but larger nodules and cysts form under the skin. These can become inflamed and then they are filled with plaster, sebum and bacteria.
All acne can cause scarring, but when you get such nodules and cysts, the risk increases that the acne will leave scars. The reasons are that the nodules and cysts can crack and damage the skin in the surrounding area.
Due to the severity of such acne, this type of acne should always be treated by a dermatologist. Current treatment methods are antibiotics in tablet treatment, use of Isotretinoin, cortisone tablets or injections.
The dermatologist assesses what is beneficial in each individual case.
Please be patient
No matter what form of treatment is used, you have to be patient. It may take several weeks for the effect to appear, sometimes several months. Therefore, it is important to complete the entire treatment as described by your doctor. This way you can also prevent new acne breakouts.