Understanding adult acne

Acne, sometimes called acne vulgaris, is a common skin condition. Every year 3.5 million people seek out help from GPs and pharmacists because of the symptoms it causes, which include spots and often oily skin. You can have acne anywhere, but it’s most likely to appear on your face, back or chest. ¹

Acne can be mild, moderate or severe. This means that for some people it can be managed at home, and for others, medical support might be needed, like topical treatments. But no matter how severe your acne is, you can get help if it's affecting your wellbeing or personal life. Healthcare professionals like doctors and pharmacists can advise you on managing inflammation and refer you to talking therapy if you need it.¹

There are six main types of acne spots, which are also called acne lesions. You might be affected by one or more of them.

• Papules are small red bumps on the skin. They might feel sore to touch.
• Pustules are like papules, but they have a white pus-filled bump in their centres.
• Blackheads are small black or yellowish bumps on the skin. Their colour comes from the open hair follicle in the skin. They are usually mild and do not often cause discomfort.
• Whiteheads are like blackheads, except the hair follicle is closed and they feel firmer. They’re also mild and do not usually cause any discomfort.
• Nodules are hard lumps that develop deep under the surface of the skin. They can be skin coloured, or red if they’re inflamed.
• Cysts are fluid filled lumps under the skin, which are usually painful. They are caused by inflammation and can lead to scarring if they’re not treated properly.¹

There are several reasons why adult acne happens. Talking to your GP can help you find out why you may have developed it. Some common reasons for it include:

• Hair follicles becoming inflamed, which may lead to acne lesions
• Bacteria spreading through your hair follicles
• A hormone called testosterone causing your body to make extra sebum, which is the oil on your skin. ²

Since acne is often linked to hormonal changes, it’s more common among teenagers and young adults. It is also why acne is more likely to affect women during their periods or pregnancy It can also happen if you have polycystic ovarian syndrome (PCOS).³

There is a range of treatments for acne. The right one for you will depend on your symptoms and how severe they are.

One type includes topical treatments. These are creams and gels that can be applied to your skin. Some topical treatments to address acne symptoms include benzoyl peroxide, azelaic acid, retinoids like adapalene and topical antibiotics like erythromycin. The products you will be prescribed will combine these ingredients to target your acne. For example, some treatments used to treat severe acne contain both adapalene and benzoyl peroxide.

Oral antibiotics can be used to treat inflamed acne for short periods of time. These are medicines that are designed to prevent bacteria from causing the symptoms you might experience.

You might be prescribed doxycycline and lymecycline. These are often very effective antibiotics, but they’re usually only used when topical treatments haven’t fully worked for you.

If you are prescribed any antibiotic treatments, you must complete the full course for it to work properly and to prevent the bacteria from becoming resistant to the medication

If you have hormonal acne, sometimes the combined contraceptive pill can help. Co-cyprindiol is licensed to treat severe hormonal acne in the UK.⁴

Getting treatment for your acne will depend on how it's affecting you. If it's painful, itchy, or swollen, then speaking to a pharmacist or GP can help with managing it.

If your acne is changing the way you feel about yourself, it's also important to seek out help.

However, not everyone feels they need treatment for their acne. If your acne is mild and doesn’t interfere with your life, you may not need to take medication for it.

All medications come with a risk of side effects, but not everyone will experience them. The main side effect of topical treatments is skin irritation.

Oral antibiotics can sometimes cause issues like nausea (feeling sick) and headaches. The combined pill can sometimes lead to issues like bleeding between your periods or sore breasts. Talk to your GP or pharmacist to find the right treatment for you, or if you’re experiencing any side effects from your medicine.

If you have acne, there are a variety of approaches you can try to improve your symptoms:

• Remove your makeup completely before you go to bed as it can clog your pores
• Change your pillowcases regularly and try to avoid touching your face or letting your hair fall into your face
• Try to avoid washing your face too regularly or using products with harsh ingredients.¹

Some people find that diet changes can have help improve their acne. High glycaemic index foods(foods that cause quick spikes in your blood sugar), like sugary foods, white bread and rice, can aggravate acne for some people. Dairy products like milk can also increase acne for some people.⁵ Keeping a food diary can help you see if your diet is triggering acne symptoms.

Acne can be painful and difficult to deal with, which is why it can be important to find the right treatment. Living with acne can also affect your confidence and relationships with others.

If dealing with acne is affecting your mood or self-esteem, remember there are people who can help you. Your GP may refer you to a dermatologist, a health professional who specialises in skin health, or a counsellor who is trained to listen.