All You Ever Wanted To Know About Acne - The Definitive Guide (Part 4)

How long and how often should I use products?

It is very common for patients to walk away with their prescription, products, and treatments only to give up on them too soon. TV adverts have persuaded too many influential teenagers that product X can clear spots in days!! Therefore a lack of compliance can contribute towards failure to treat acne effectively. Encouraging compliance can literally make the difference between scarred skin and emotional scars and someone who treats their skin and gets on with their lives. Therefore compliance can be encouraged in the following ways:

- Apply any topical treatments to all areas affected, every day - even when there are no spots. Many people will wait for a spot to appear before applying treatment and then, may be tempted to 'slap it on'. The aim of acne treatments is to avoid new spots forming and only regular, daily use of treatments will give the skin a chance to start reacting.

- Use any acne treatment for a minimum of two months. If, after this time, there is no significant improvement in the skin, then try another treatment. This TWO MONTH RULE applies to any treatment used for acne, including alternative and complementary medicine. Continue to use acne treatments until advised to stop by a doctor (prescription treatments only), or until you notice no further improvement. Never stop acne treatments suddenly, as this may cause a flare up of the skin.

- Some treatments may make the skin dry and flaky. It is perfectly acceptable to use an oil-free moisturiser to help counteract dryness. Allow treatments to absorb into the skin for approximately five minutes before applying moisturiser.

- Start off using creams or lotions just once a day, to build up tolerance. This may reduce the commonly heard complaint - 'It made my skin sore and red'

- Ensure medication is being used or taken correctly. For example, there is a huge amount of people that take oxytetracycline tablets with a cup of tea and as milk will inhibit the absorption of the drug, this makes the drug useless. Some treatments may need to be kept refrigerated or tablets taken with or without food. The pharmacist is able to help answer any concerns about how to take medication correctly.

What are the different types of acne?

The most common type of acne is called 'acne vulgaris' and is evident by the familiar spots, blackheads, whiteheads and greasy skin that affects up to 90% of the population at some time in their lives.

Acne is not necessarily a progressive disease - it may never be more than what a doctor would classify as mild, but a patient may end up suffering from this type of mild acne for 20 years or more. There have also been accounts of patients who have suddenly developed severe scarring acne within a matter of weeks.

Usually, treatments will depend upon the severity of the acne.

Acne - when should it start and when should it stop?

For some people, acne may last no longer than a few months, whilst others may be plagued for, in some cases, many decades. It is impossible to predict exactly how long acne will last. However, it may be an indicator that the acne could be persistent if either one or both of the two below has occurred:

- They had acne as a baby: This may be an indicator that the acne will return in early adolescence. In rare cases, it may never disappear from a baby, continuing well into late adult life. This type of acne, which occurs in babies or toddlers, is called infantile acne and can usually be treated with OTC topical creams. If the acne doesn't respond, they should consult a G.P.

- There is a family history of acne: Hereditary factors are a key to predicting who may be worse affected. Any close family relative may indicate a pre-disposition to developing acne, which may be stubborn and slow to respond to conventional acne treatments. These patients should seek treatment earlier and should be reminded to tell their GP about family history. This may make a difference to the type of treatment prescribed.

Acne may also persist well in the later years. SkinMed customers range in age from 10 to 80. This is unusual, but gives an idea how acne should not just be considered to be the bane of teenage life.
Possible reasons for people presenting with acne into their 30's could be:

- Polycystic ovarian syndrome (P.C.O.S.). See section on acne causes for further information.

- Stress. As we take on more responsibilities in our lives, so our levels of stress may have a 'knock-on' effect with our hormones. As we know, it is hormones responsible for acne and therefore, it is fair to assume that some people's hectic, stressful lives may indeed be a reason for a flare-up or outbreak of acne. De-stressing is an obvious answer to this particular problem, but it is not simple to change a lifestyle overnight. It is sensible to advise that this type of acne should still be treated appropriately with medication, whilst the person considers their lifestyle and changes they may need to make to help improve their acne.

- Coming off contraceptive pills. This may not be proven, but certainly some people report they have developed acne for the first time only since withdrawing from oral contraception.

Whatever the reason someone may have acne, they can still successfully treat it. There's simply no reason for someone to suffer the misery of acne - whatever their age.

CONTINUED IN PART 5

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