CHILD’S HEALTH/SKIN DISORDERS: ACNE

Acne (also known as pimples or acne vulgaris) is most common during the teenage years. Most teenagers will have acne at some stage. Its usual onset is at puberty, and it can occasionally continue on into the twenties. It can range from a very mild case of pimples for a few weeks, to ongoing severe cystic acne, which can leave permanent scars if not treated adequately.

Cause

Acne is caused by the overactivity of oil-producing glands (sebaceous glands) in the skin. With the secretion of too much oil, these glands become blocked, and the subsequent accumulation of oil leads to the formation of pimples, blackheads and whiteheads. The greatest influence on the development of acne are hormonal changes during puberty and adolescence. Contrary to popular belief, there is no evidence that certain foods cause acne or make it worse. It also has nothing to do with hygiene, although good skin care can help avoid aggravation of the condition.

Clinical features

Acne most commonly affects the face, chest and back. In particular it can affect the brow, the nose and the chin. The pimples initially appear as red lumps under the skin, which soon form a head. Sometimes when the secreted oils reach the surface of the skin, the contact with air turns the pimples black, forming blackheads. In more severe cases cysts, filled with a cheesy material (sebum or oil) may appear, and become quite large and unsightly.

There are a few basic measures which can improve most cases of acne:

1. Wash the skin gently twice a day, morning and evening, with a mild soap. Do not use medicated soap, as this can be too harsh on the skin. Make sure the skin does not become too dry from overwashing. Do not scrub the skin.

2. Wash hair daily with a mild shampoo, and tie it back if it covers the face, or rubs against the neck. Do not apply greasy hair gels.

3. Encourage your teenager not to squeeze pimples or pick at his skin. As tempting as this may be, it can lead to permanent scarring, which is unsightly.

4. Do not cover pimples with makeup. This can aggravate the condition by blocking off the oil glands.

In addition, your doctor may recommend certain specific treatments, depending on the severity of the acne. These may include lotions or creams containing benzoyl peroxide, which helps to destroy bacteria. Sometimes antibiotics taken in small doses for several weeks may be helpful. In very severe cases of acne, a skin specialist may recommend the use of retinoic acid. Whatever the treatment, your teenager will need to have patience. Acne may take weeks or even months to clear up, and very often recurs periodically — a fluctuating pattern of severity is very common.

When to see your doctor

• if despite the above simple measures, the acne does not improve after 4-6 weeks;

• there are boils or cysts present;

• your teenager is distressed by the appearance of his skin and needs some reassurance that something can be done about it.

Prevention

Acne cannot be prevented. Attention to skin care as described above and a healthy, balanced diet may minimise the severity.

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