The good news - acne can be treated very effectively and long term effects prevented.

Breakouts are common in teenage years and may persist throughout adult life.  Bad for self-confidence, treatment is aimed at controlling the inflammatory disease, then dealing with persistent acne scarring.

Acne is not caused by bad diets or bad hygiene. Both however worsen it. Sunshine improves it so acne is worse in winter, and hormonally may worsen around the time of periods in women.

Excessive thickening of the skin’s surface layer of cells, excessive oil gland numbers and production, with plugging of pores (blackheads) sets up an environment suitable for the causative bacteria (Propionebacterium acne) to proliferate.   This causes whiteheads. Squeezing these may cause rupture of the swollen inflamed pore and cystic acne or scarring may result.

Wearing camouflage makeup adds to the plugging of pores and is best avoided.

Washing with suitable skin cleansers once or twice daily and applying topical products is helpful.  Vitamin A is available in clear gels;  keratolytics such as glycolic and salicylic acid breakdown plugs to allow oxygen into the pore and natural oily secretions to come out onto the skin to lubricate it; peroxide products release oxygen to counter the acne organisms; scrubs assist in thinning the surface skin layer; using alcohol or lotion based makeup or sunscreens helps.

Dermabrasion and curettage of stubborn plugged pores are minor surgical treatments that make quite a difference.

Laser treatments can readily reduce acne, and repeated fractional CO2 laser treatment can smooth acne scars.  Photodynamic therapy (PDT) is a very effective treatment with quick results. Two treatments 2-4 weeks apart are needed.

Oral medicines such as some antibiotics reduce follicular inflammation well, especially Tetracyclines.  Oral Vitamin A or “Isotretinoin” (Roaccutane, Oratane, etc) is useful for severe acne, but has some significant side effects to be avoided.

Needle rolling assists smoothing of acne scarring, and stimulates collagen growth. Self rollering at home can be done for maintenance.