Children's and parenting health centre

What is acne?

If there's one thing you can count on as a teenager, it's acne. Approximately 80% of teenagers suffer from this skin problem, which is marked by clogged pores (whiteheads, blackheads), painful spots, and sometimes, hard, deep lumps on the face, neck, shoulders, chest, back and upper arms.

If your mum and dad had acne, the chances are good that you will, too. But there are many ways to prevent (and treat) acne today to keep the condition minimal, prevent scarring, and leave your skin glowing.

What causes acne?

The pores in your skin contain oil glands. At puberty, there is an increase in sex hormones, called androgens. The excess hormones cause the oil glands to become active, enlarge, and produce lots of oil, or sebum. When there is too much sebum, the pores or hair follicles become blocked with skin cells. The increase in oil also results in an overgrowth of bacteria called Propionibacterium acnes.

If blocked pores become infected or inflamed, a spot -- a raised red spot with a white centre -- forms. If the pore clogs, closes, and then bulges, you have a whitehead. A blackhead occurs when the pore clogs, stays open, and the top has a blackish appearance due to oxidation or exposure to air. (This has nothing to do with skin being "dirty").

When bacteria grow in the blocked pore, a pustule may appear, meaning the spot becomes red and inflamed. Cysts form when the blockage and inflammation deep inside pores produce large, painful lumps beneath the skin's surface.

Hormonal changes related to contraceptive pills, menstrual periods, and pregnancy can trigger acne. Other external acne triggers include heavy face creams and cosmetics, hair dyes, and greasy hair oil - all of which can increase blockage of pores.

Clothing that rubs the skin may also worsen acne, especially on the back and chest. So can heavy sweating during exercise, and hot, humid climates. Stress is known to trigger increased oil production, which is why many teenagers have a new crop of spots on the first day of school or just before that big date.

What are the symptoms of acne?

While the symptoms vary in severity, you will notice these signs on areas of the body with the most oil glands (face, neck, chest, back, shoulders, and upper arms):

Clogged pores (spots, blackheads, and whiteheads)
Papules (raised lesions)
Pustules (raised lesions, with or without pus)
Cysts (nodules filled with pus or fluid)
The least severe type of acne lesion is the whitehead or blackhead. This type is also the most easily treated. With more extensive acne, prescribed medications are often needed to reduce the inflammation, bacterial infection, redness, and pus.

How is acne treated?

Treatment usually depends on how serious the problem is. For instance, if you have an occasional inflamed spot, you may use skin ointments containing: