What is acne

Acne is a skin condition that affects most people at some time during their lives. It often (but not always) occurs during the teenage years, although it can affect children and older people as well. It causes spots to develop on the skin, usually on the face, back and chest. It can last for many months and sometimes years if left untreated.

What are the symptoms?

People with acne can develop several different types of spots and in some cases will also develop some scars.

  • Blackheads (open comedones): small black or yellowish papules where dilated follilcular outlets are filled with keratin.
  • Whiteheads (closed comedones): have a similar appearance to blackheads but they have no visible follicular opening and have a white-coloured centre.
  • Papules: inflammatory lesions that appear as small red bumps that may feel tender or irritated.
  • Pustules: similar to papules but they have a white centre filled with pus (whitish-yellow substance containing dead cells, produced in response to bacterial infection).
  • Nodules: deeper, larger inflammatory lesions that appear as hard lumps that build up under the skin’s surface
  • Cysts: large, pus-filled lumps that have a similar appearance to boils. These are the most serious type of skin lesion caused by acne and have the greatest risk of causing permanent scarring
Blackheads

Blackheads
Whiteheads

Whiteheads
Pauples

Pauples
Pustules

Pustules
Nodules

Nodules
Cysts

Cysts

What is the impact?

If you have acne, you are far from being alone as it affects more than three-quarters (80%) of 11 to 30-year-olds.

Acne affects people of all ethnic groups.

Some people with acne find they just have an occasional spot that quickly clears up. But a lot of people have repeated flare-ups for several years before their symptoms improve as they get older.

For a few people – around one in twenty women and one in every hundred men over 25, acne can continue into adulthood.

Acne can be very distressing. Having acne can have a negative effect on people’s quality of life and self-esteem, affecting social activities and how people feel about themselves, just as much as health conditions that would be considered more ‘serious’, such as asthma and diabetes.

The good news is that effective treatments are available and treating acne can dramatically improve quality of life.

One person who has suffered from the effects of acne says….

‘I was totally shocked to develop acne when I was 40 years old! For no apparent reason I just started to develop acne breakouts on my cheeks and forehead. The acne just got worse and worse and it became a nightmare.

I’d never had bad skin as a teenager and even when I was pregnant my skin didn’t change. So you can imagine how horrified I was when my skin broke out like this. I was completely paranoid about it – I stopped looking people in the face thinking they were just looking at this face full of awful spots. It had a huge impact on my life and I was desperate for help. I visited my GP and he prescribed a treatment that thankfully worked for me.’

How severe is your acne?

Anyone with acne – however mild - can find their spots distressing, but doctors classify the symptoms as mild, moderate or severe:

Mild: blackheads and/or whiteheads, usually only on the face with a few inflamed red spots

Moderate: spots (papules and pustules), blackheads and whiteheads that may extend to the shoulders and back as well as affecting the face

Severe: Many inflamed spots and/or nodules and cysts (hard lumps, some containing pus) as well as spots, which may spread extensively.

This classification can be important in determining what type of treatment is most appropriate for each individual.

What are the different types of acne?

Acne vulgaris is the most common form of acne. Acne vulgaris lesions include blackheads, whiteheads, papules, pustules, nodules and cysts.

Acne conglobata is the most severe type of acne vulgaris, with large lesions and widespread blackheads. It occurs on the face, chest, back, and elsewhere, and can cause severe scarring. It is more common in males, usually between the ages of 18 to 30 years.

Pyoderma Faciale (Rosacea Fulminans): This type of severe facial acne affects only females, usually between the ages of 20 to 40 years old. Symptoms include large painful nodules, pustules, and sores, all of which may scar. It begins abruptly, and may occur in a woman who has never had acne before. It is confined to the face, and usually does not last longer than one year, but can but can cause major distress in that time.