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It is commonly thought that acne is cause by something we do such as not washing enough or eating the wrong foods. The true cause of acne is largely unknown, but it has been linked to a number of factors.

Family history
Acne is known to run in families. If both your mother and father had acne, it’s likely that you’ll also have acne.

Hormone levels
Acne is commonly linked to the changes in hormone levels during puberty but can start at any age. Certain hormones cause the oil-producing glands next to hair follicles in the skin to produce larger amounts of sebum (oil). This additional sebum changes the activity of a usually harmless skin bacterium called P. acnes, which can become more aggressive and causes inflammation and pus. The hormones can also thicken the inner lining of the hair follicle, causing a blockage of the pores. Cleaning the skin does not help to remove this blockage.

Hormone changes linked to pregnancy and menstrual cycles may also trigger episodes of acne in women.

You may think that spots are just spots, but there are different types:

1. Blackheads (comedones) – small black or yellowish bumps that develop on the skin; they’re not filled with dirt, but are black because the inner lining of the hair follicle produces colour
2. Whiteheads (comedones) – have a similar appearance to blackheads, but may be firmer and will not empty when squeezed
3. Papules – small red bumps that may feel tender or sore
4. Pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus
5. Nodules – large hard lumps that build up beneath the surface of the skin and can be painful
6. Cysts – the most severe type of spot caused by acne; they’re large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring

You may think that spots are just spots, but there are different types:

1. Blackheads (comedones) – small black or yellowish bumps that develop on the skin; they’re not filled with dirt, but are black because the inner lining of the hair follicle produces colour
2. Whiteheads (comedones) – have a similar appearance to blackheads, but may be firmer and will not empty when squeezed
3. Papules – small red bumps that may feel tender or sore
4. Pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus
5. Nodules – large hard lumps that build up beneath the surface of the skin and can be painful
6. Cysts – the most severe type of spot caused by acne; they’re large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring

The appropriate acne treatment will depend on the degree of acne. This is difficult to define and best judged face to face or via clear photographs.

Mild	Affects one area, most likely the face. The spots seen are mostly whiteheads and blackheads, with a few papules and pustules.	– Topical treatments applied directly to the skin are the first-choice treatment for acne. They contain: – Benzyol peroxide – Retinoids (e.g. adapalene (Differin), tretinoin, isotretinoin) – Topical antibiotics (e.g. erythromycin, tetracycline and clindamycin) – Azelaic acid – Nicotinamide) – Skinoren – Zineryt Combination: – Benzoyl peroxide with retinoids i.e. adapalene (EpiDuo) – Benzoyl peroxide with topical antibiotics – i.e. clindamycin (DUAConcedaily)
Moderate	May affect more than one area across face back and chest. More widespread whiteheads and blackheads, with many papules and pustules.	If the topical treatments above do not settle symptoms, oral antibiotics containing tetracyclines (i.e. lymecycline) or erythromycin should be considered. Depending on severity you may combine topical and oral treatments.
Severe	Likely to affect more than one area across face back and chest. Lots of large, painful papules, pustules, nodules or cysts; possibly with some scarring.	If there is no significant improvement with trials of oral antibiotics referral to a dermatologist should be considered

Other effective treatments for acne include oral contraceptives for women, isotretinoin, light and laser therapy. We do not provide these treatments at PrivateDoc, but you can find out more by speaking your GP or a dermatologist.

There are varying recommendations for when to expect to see results based on the prescription you are issued. Prescriptions for acne can be used alone or in combinations, depending on what your prescriber advises. Treatments include; topical retinoids, topical antibiotics, azelaic acid, antibiotic tablets and for some women use of a contraceptive pill. Many treatments can take 2-3 months before they start to work so it is important to remain patient and persist with a recommended treatment - even if the effects are not obvious immediately.

Topical retinoids and antibiotics are usually prescribed for a 6-8 week course and then stopped to avoid your body becoming resistant to antibiotics.

Antibiotic tablets for acne treatment typically take around 6 weeks for noticeable improvements.With hormonal treatments such as the pill, results typically can be seen faster but may take up to a year before the full benefits are known.

The treatments that you will use to help clear your skin are not intended to replace regular washing. You will need to include these treatments into your daily skincare routine.

Cleanse your skin morning and night, remove any traces of make-up with a mild gentle soap, cleanser or water or oil-free soap substitute. Be gentle, if you over-wash, scrub too hard, the water is too hot or too cold, you can aggravate the acne and irritate your skin.

Many topical acne treatments can dry out your skin leaving it red and irritated. You can apply oil-free moisturisers after you have cleansed, look out for products labelled as ‘non-comedogenic’ which means that will not block your pores which can cause blackheads and whiteheads. If your skin is still irritated, your doctor may advise you to stop treatment for a few days or reduce the amount that you are using.

Try not to pick or squeeze your spots as can aggravate them and may cause scarring.

You may try to hide your spots with a well-placed fringe, but this can trap excess oil. Try keeping your hair clean and away from your face, even if it’s just while you’re at home.

Wearing make-up to disguise your acne can help you feel more confident. Look for products that are oil-free or water-based and labelled as being ‘non-comedogenic’, remember to fully remove your make-up at the end of the day.

Maskne, or mask acne is a type of acne breakout caused by wearing a face mask.

What Causes Maskne?

Maskne is caused by clogged pores and trapped dirt. Oil, dead skin and bacteria are already present on the skin but trapped under the mask and therefore build up causing skin issues. Masks also trap the humid air from your breath which increases your chances of acne.

Friction between the mask and face can also be a cause of maskne, as the rubbing between the skin and mask leads to irritation.

Yes, we need to continue to wear masks in order to prevent the spread of Covid-19 and there are ways in which we can treat and try to prevent maskne.

We encourage washing your mask and face regularly and then seeking a consultation with us to advise on the best treatment for your skin to treat the acne. The biggest factor is consistency so to see results you will need to adhere to the programme set by your GP or prescriber.