A Doctors View on Acne…

Acne…please help!

Acne…the bane of many teenagers’ existence, most young adolescents experience some form of skin breakout between the ages of 12 and 19 (sometimes a bit longer for an unfortunate few).

As a GP, I often get patients (along with their parents!) coming in to ask me if there is anything that can be done medically to improve their skin. And the answer is yes!

First, let’s clear a little confusion about what acne is and why it occurs.

What is acne? Acne is an inflammatory skin disorder involving blockage of hair follicles, infection by particular bacteria, and inflammation. This results in the large unsightly pimples over specific parts of the face. These are usually where there are the most sebaceous glands.

 Acne vulgaris

Acne vulgaris

What causes acne? It is thought that acne is caused by a number of different factors.

  • Genetics – if you had bad acne as a teenager, your child may also experience acne as well
  • Hormones- which is why acne flares up the worst during adolescence
  • Bacterial infection on the skin
  • Blockage of the hair follicles- which can be caused by heavy cosmetics

What can I do to prevent or treat my acne naturally? Lifestyle measures to improve acne include:

  • Avoiding heavy cosmetics
  • Making sure you clean or change your make-up brushes and sponges on a regular basis
  • Avoiding touching the face- as your fingers often contain bacteria
  • Maintain a healthy diet- some people find excessive sugar, “junk” foods and dairy can worsen their skin
  • Using a regular cleanser- however, contrary to popular belief, excessive scrubbing can actually make acne worse due to skin irritation and further inflammation. Cleansers that contain salicylic acid, glycolic acid, or benzoyl peroxide are best for acne-prone skin as these can help clear blockages. In particular, benzoyl peroxide is good for treating the bacteria that causes acne.

I’ve tried all of that and nothing’s working! Then the best next step is to come see your local GP or family doctor to discuss the possibility of medical treatment. The medical treatment that I suggest to treat acne is as follow:

  • Topical antibiotic (Clindatech) or anti-acne gel such as andapalene (Differin) or benzoyl peroxide. Some gels come with these combined, such as Duac gel. This is a gel that is applied to the face every evening after cleansing.
  • If that doesn’t work, we can add an oral antibiotic, such as low dose Doxycycline. This acts as both as an antibiotic against acne forming bacteria as well as an anti-inflammatory. It can take several months of taking this tablet before you start to see the benefits. It is at a low dose, so the risk of side effects is quite low, but you should discuss this with your GP or local doctor.
  • In young women, sometimes we skip the first two steps and go straight to trying the pill, or the combined oral contraceptive pill. This is especially useful in young women with a condition known as polycystic ovarian syndrome, which can also present with irregular periods and excessive hair growth. Not all women can take the pill, so you should discuss this with your family doctor.
  • If those don’t work, usually I will refer patients to see a dermatologist to consider either laser therapy or a stronger medication known as Isotretinoin (Roaccutane). This medication has side effects and also cannot be given in pregnancy. It can only be prescribed by a dermatologist.

What should I do when I have a break out? The number one thing you shouldn’t do is scratch it or pop it! That can cause worsening inflammation and irritation, and sometimes leave scars. It is better to use an ice pack, or natural remedies such as tea tree oil which is a natural antiseptic, to try and reduce the inflammation. If you must pop it, it is best to do it when the pimple is “ripe” (with white showing), with clean hands, and to clean the pimple with antiseptic solution afterwards. You can try using over-the-counter spot treatments, although I can’t verify which one is the best. Some may work for your skin, others may not.

So as you can see, there are a number of things you can do to treat your acne. In general, most acne does improve with time as those adolescent hormones settle down, so for most people, don’t worry, it does get better!

If you would like to see me to discuss you or your child’s acne, then you can find me at MyHealth Medical Centre, in Westfield Warringah Mall. We are located in the food court, next to McDonald’s. Alternatively, you can call 02 9188 3807 to book an appointment.

Dr. Su-Yin Yeong is a specialist General Practitioner and Fellow of the Royal Australian College of General Practitioners (FRACGP). She is passionate about lifestyle and preventive medicine, and believe that health involves physical, mental, social and emotional wellbeing – not simply the absence of disease. She is knowledgeable in all areas of general medicine including women’s health and paediatrics. Her particular areas of interest are weight management and skin cancer medicine.

Shop 2505A, Level 1, Westfield Warringah Mall
Cnr Condamine St & Old Pittwater Rd
Brookvale, NSW 2100
Ph: 02 9188 3807
Fax: 02 9188 6487

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