Health: Facing up to the misery of acne

Draft-dodgers longed for them, but spots can cause devastation.

THERE IS A condition that afflicts nine out of 10 adolescents and millions of adults all over the world. It can damage relationships, ruin careers, trigger mental health problems and even lead to suicide.

It's acne, and the effects can be devastating.

Researchers from Churchill Hospital and Oxford University recently conducted a study, that compared the experiences of acne sufferers aged 16 to 39, with a random sample of the population. They found that the impact on the acne sufferers' lives was at least as great as that of patients with chronic disabling asthma, epilepsy, diabetes, back pain or arthritis.

Dr Sarah Stewart-Brown, one of the authors of the report, says: "It is to do with people being ashamed of their faces and that is to do with how we behave as a society, the view that people can and should look in a particular way and that that way is beautiful and everything else isn't," she says.

"It means that people who don't live up to expectations in a whole host of different ways feel awful because they don't feel acceptable or attractive."

Acne is a skin condition that occurs when the oil-secreting glands in the skin get clogged and become inflamed or infected. It usually begins at puberty when hormonal changes are taking place in the body. The sebaceous glands in the skin produce too much sebum oil, and the ducts or pores in the skin get blocked, often with the help of other debris. The glands are still producing oil and that results in a swelling behind the blockage.

The blocked pores can also become infected with bacteria, leading to swellings and the classic large red spots of acne, which in some cases can cause permanent scarring.

The most common places for outbreaks are the face, shoulders, back and chest, where the oil-producing skin structures are most heavily concentrated.

Most sufferers get acne in their teens or early twenties, with the peak risk years between 16 and 20, and it is estimated that up to 90 per cent of teenagers get acne to some degree. The majority get over it within a few years but for some the problem is lifelong, and as many as one in 25 men over 40 still have acne.

Over time it has been wrongly associated with triggers as diverse as masturbation, lack of exercise, too much chocolate and too little personal hygiene.

It is now thought that emotional stress, fatigue, and the use of some cosmetics can worsen the condition. Barrier creams, lotions and sweating may also trigger symptoms.

Nikki Bradford, author of Men's Health Matters, says that humidity can be a problem too: "The connection is so strong that the armed forces will not take on men with even mild acne because it often flares up if they are sent to humid countries.

"During the Vietnam war, potential conscripts longed for spots. Some of them did develop significant acne and they deliberately did not take the medication they were given, hoping that it would help them avoid being drafted. In many cases, it did."

Jane Turner developed acne 10 years ago, when she was 15: "You spend hours in front of a mirror looking at the spots and they get bigger and bigger in your mind," she said.

"When you go out, you are convinced that when people look at you, they are looking at the spots. You try to cover it with make-up, but it doesn't work because you know it's there, so you feel lousy anyway.''

Treatments for Acne

Creams and lotions: A first-stage treatment to help unblock the plugs, reduce sebum production and kill bacteria. Antiseptic liquid cleansers are also available.

Antibiotics: Oral antibiotics are designed for severe cases and kill the bacteria by working from the inside. Antibiotic creams penetrate the skin to get at the bacteria.

Isotretinoin: A drug based on vitamin A, it is effective against severe forms of acne, but has a number of potential side-effects, including dry lips and headaches, and there is a risk that it may harm an unborn baby if taken during pregnancy.

Laser: Laser treatment for acne scars uses infrared light to help to peel away the skin and allow the body to re-surface the upper layers, and tighten the fibres under the skin for a smoother complexion.

Alternative acne treatments include:

Essential oils: Tea tree oil has antiseptic properties and an anti-inflammatory effect. The Body Shop stocks a range of products containing tea tree oil.

Homeopathy: A number of treatments are available, including mountain grape for pimply, rough skin; marsh tea for painful acne on the forehead; and silicea for scars that become itchy or inflamed. Sulphur is also used to help kill bacteria.

Things to avoid: Although acne cannot be prevented, its impact can be reduced. Tips include not wearing headbands or chinstraps, not using oil- based soaps and cosmetics, not constantly touching the face and thereby spreading infection. Oily and humid environments are best avoided, as is extreme stress.

The Acne Support Group: 0181-561 6868