The eyes are the windows of the soul, as the saying goes, but maybe it should be
said that the skin is. Here we take a good look at acne and some other common skin
conditions especially prevalent in teens.
Acne – act now
Anxiety and anger brought on by severe acne (cystic acne) have recently been recognised.
Acne or any other skin condition is not attractive and will affect the emotional
development of a person. It makes itself known on the face, neck, shoulders and
back. It's normal to feel stared at and vulnerable, and timely treatment from a
doctor is extremely important.
What is acne?
Acne is the medical word used to describe anything from the occasional blemish,
through to comedomes (the technical term for pimples), blackheads, whiteheads, even
large cysts and painful swellings. Acne largely afflicts teenagers and occurs when
the hormones (androgens) are seeking a new balance during puberty.
Looking for a cause
Acne is caused by a blockage to the opening of the oil glands in the skin. These
glands are called sebaceous (sweat) glands and normally provide an oily substance
called sebum, which is required to keep the skin healthy. Sometimes there is an
inherited abnormality and a tendency for the glands to block. The blockage will
take on a dark pigmentation. This is a blackhead and is visible. The blockage will
be invisible at times and the collection of sebum under the skin appears as a small
white lump or whitehead.
If the blockage is really tenacious, the build up of sebum can cause the gland to
rupture under the skin. This is when you get the inflamed, red appearance, which
can often be painful. Sometimes the blockage is deeper again, causing quite large
cysts below the skin, which appear as flesh-coloured lumps. This is when scarring
and disfigurement are more likely to occur because they heal by damaging the tissues.
The myths
There are many myths surrounding acne. A big one is that it's caused by junk food,
eating chocolate or dirty skin. Acne is a skin disease and should be treated as
one. Acne is also not an allergic disease and there is no medical evidence to suggest
this.
Most people with acne learn that changing your diet does not get rid of acne and
doctors who treat acne have long since learnt that dietary factors have almost no
role in the development of acne. Having said that, it's still important to observe
a healthy diet. Nevertheless, occasional indiscretions will not cause further acne
lesions to develop.
There is another myth that acne is a hormonal disease and that treatment of hormones
will treat acne in every case. There's no doubt that acne is influenced by hormones,
but treatment needs to be tailored to the individual by the doctor. Another old
wives' tale is that acne is an infection. It is not infectious and cannot be spread
to other people. Picking on sufferers' cleanliness is an example of how people
can be cruel to those with acne. Acne is not caused by lack of cleanliness and in
fact excessive cleaning and scrubbing can make it worse.
David, now 33, suffered severe acne all through puberty. "At the time, I always
felt on the outside. Girls would look at me and my face as if I was dirty," he says.
David now has his own very successful company working in computers. He is the first
one to admit, however, that acne is what drove him to computers - to hide. He did
not have to talk to anyone. Computers led him to success and eventually a very normal
and loving relationship. Acne made him feel alienated and deeply depressed at times.
The pressure to be perfect physically during teenage years made it an extremely
painful time for David.
"Even though I have pockmarks and scars, the deepest scars are on the inside. I
found growing up with bad skin really hard work. I wouldn't wish it on anyone."
Let the sun shine?
No. There's a belief that sunshine is beneficial in the treatment of acne but dermatologists
have confirmed that sunlight and ultraviolet light have no beneficial effect in
the treatment of acne. In fact, sunlight and ultraviolet light will cause premature
ageing and skin cancer - so should never be recommended as a treatment for acne.
People with acne should be assessed early on by competent medical practitioners
and in cases of severe acne, dermatologists. There are of course many factors that
should be considered, and an acne treatment programme should be tailored for the
individual, taking into account the type and the extent of the acne. Some medications
can make it worse. For example the overuse of oily cosmetics can aggravate acne.
Most widely used treatments are:
The treatment
Benzoyl peroxide - this is the simple treatment. It is available over the counter.
Scrubs, creams and degreasing agents - also available are soaps and solutions containing
salicylic acid that cause gentle peeling.
Antibiotics - these can be either applied to the skin or, in resistant cases, taken
orally.
Severe Acne
The pain, disfigurement and emotional distress caused by severe cystic acne should
not be underestimated.
A medication known as Isotretinoin (Roaccutane) has been released on the Australian
market. It is a form of vitamin A and it has a specific action on the acne cysts.
It's taken orally and sufferers have noticed a significant improvement within the
first few months of treatment. Victims of severe acne have called it a miracle drug.
In a small percentage of cases a partial re-occurrence has been noted. In Australia,
Roaccutane is available as a pharmaceutical benefit under the National Health Scheme
but it must be prescribed by a dermatologist. There are always downsides to any
cure, although with Roaccutane they are not too severe.
- The skin may become dry and itchy and develop dermatitis.
- The lips may become cracked and sore.
- The eyes and nose may develop irritation and discomfort.
All of these side effects can be controlled by using moisturising creams and other
medications recommended by dermatologists. There are some fantastic products out
there on the market, such as Neutrogena, Blistex or good old Sorbolene, try a few
to see what works for you.
Facing facts
Unfortunately it seems the more severe cases of acne appear to be inherited, and
there are often other family members who suffer from similar severe acne. If one
of your parents had acne, chances are you may also get it.
With care and support, early treatment will save low self-esteem and depression
developing.
Other common skin conditions
Eczema
We still do not know the exact cause of eczema. It accounts for a large proportion
of skin disease. Sufferers experience patches of dry red skin, often dotted with
tiny blisters. These patches might feel intensely hot and itchy and when scratched
the blisters burst to leave an open wound that is prone to infection. Many cases
are known as 'atopic', which means there is a family or individual history of
allergic disorders. Early treatment is essential.
Contact dermatitis
This is when your skin is inflamed or irritated by an external cause. There are
two kinds: irritant and allergic. Some irritants are household detergents, acid,
alkalis and over-exposure to water. Some of us are allergic to preservatives, dyes,
fragrances, rubber and nickel jewellery. Contact dermatitis is also caused by constantly
rubbing an area.
Dandruff
Dandruff can be a horrible experience and socially destructive. As with acne, it's
not caused by lack of cleanliness. The secretions from the glands of the scalp dry
up, form white flakes and peel away. There are excellent shampoos available over
the counter that will control the excess production and flaking off of dead skin.
Sun safe
Australia has UV radiation in abundance and this is the main cause of skin cancer.
The bad news is that it is a serious disease and life-threatening. The good news
is that the incidence of skin cancer is beginning to fall. Australians are starting
to protect their skin. Sunscreen, hats and general sun protection are becoming habitual.
This is a very good thing. Sun protection needs to become a ritual from a young
age. Of all environmental factors, the sun causes the most damage. Eighty per cent
of the signs of premature ageing are because of sun exposure. You should do what
you can to prevent further damage from occurring. Before you leave the house in
the morning you should apply factor 30 and re-apply every five hours.
