From main causes to the dos and don’ts of treating it, we’ve done the research so you don’t have to
Confused about acne? You’re not alone. From the causes to triggers and treatments, our keyboards often serve as a valuable resource when it comes to untapping a fountain of skincare knowledge.
But the influx of info can be somewhat overwhelming and it can be hard to separate the blemish-busting facts from fiction.
If you’re suffering from a case of skincare overload when it comes to spots, you’ve come to the right place. We’ve done the clicking so you don’t have to, bringing together the answers to your most frequently asked questions about acne and putting them all in one place. From face to back blemishes, cystic to hormonal lumps and bumps and acne scars, we hope this guide acts as a useful starting point to your skincare journey.
1. ‘What is acne?’
A good one to begin with! In a nutshell, acne is a chronic inflammatory skin condition, categorised by the blockage and inflammation of hair follicles, which are tiny holes in the skin, and overproduction of sebum produced by the sebaceous glands, which are tiny glands found near the skin’s surface that are attached to the hair follicles. It affects most people at some point in their lives and, while most common in teenagers, it can also affect adults.
There are six main types of spots caused by acne: blackheads (small, black or yellow-coloured bumps), whiteheads (similar to blackheads but firmer and don’t empty when squeezed), papules (small, red bumps that may feel sore), pustules (like papules but with white tips), nodules (large, hard and painful lumps that build up underneath the skin’s surface) and finally, cysts (boil-like spots).
2. ‘What causes acne?’
It starts with the activity of our sebaceous glands, which lubricate the hair follicles they’re attached to, and sebum production.
If they produce too much sebum, this can mix with dead skin cells and clog the follicles. Naturally occurring bacteria on skin (which are usually harmless) then infect these, which can lead to papules, nodules, pustules or cysts.
Excess sebum production can be caused by a range of triggers, such as increased levels of testosterone (which occurs during puberty). On the subject of hormones, women are more likely than men to have adult acne, because of hormonal fluctuations that occur as a result of periods, pregnancy and conditions such as polycystic ovary syndrome.
Acne may also be linked to genetic factors, say if one of your parents had acne, as well as certain medications, diet and smoking.
3. ‘How do you get rid of acne?’
It’s the million-dollar question. Unfortunately, there isn’t a quick fix for it yet (as much as we’d like that to be the case!).
A good starting point in helping you decide how to go about treating it is to have a quick examination of your skin to determine how severe your acne is.
Mild acne usually consists of mostly whiteheads and blackheads, with a few papules and pustules.
More widespread whiteheads and blackheads, with many papules and pustules, could be classed as moderate.
If you have lots of large papules, pustules, nodules or cysts, you may have severe acne. These type of spots can be painful and you might also have some scarring from previous ones.
If you have acne, there may be some changes you can make to your skincare routine that could help.
Here’s our dos and don’ts:
Dos:
• Use lukewarm water when cleansing
• Opt for non-comedogenic or oil-free make-up and skincare (ie, products that are less likely to clog pores)
• Remove all of your make-up before bed
• Shower as soon as you finish a workout
• Wash your hair regularly
Don’ts:
• Overwash skin as this can irritate it (stick to no more than twice a day)
• Resist the urge to squeeze spots as this can result in scarring
• Avoid using too much make-up and skincare products
If you’re still experiencing mild acne after making these changes, it could be a good idea to pop in-store to have a chat with a Boots pharmacist to see if there are any over-the-counter products that could help. These include topical treatments, such as gels, lotions or creams, which are applied to the skin and contain ingredients like benzoyl peroxide.
It’s also important to consider making some skincare tweaks and to be guided by your skin type. “If you have sensitive skin, try a good, gentle face wash,” says Dr Shaaira Nasir, a consultant dermatologist. “If you have oily skin, try a wash containing salicylic acid.” When it comes to your moisturiser, Dr Nasir suggests looking for one that contains anti-inflammatory properties, or try niacinamide, to support the skin barrier.
For more severe cases, it’s best to seek out the support of a skincare professional, whether that’s your GP or a dermatologist, for guidance in order to create a tailored plan of action for your long-term needs, to help avoid scarring and to reduce the risk of making your acne worse. “For moderate and severe cases of acne, patients may need oral medication in combination with a topical treatment, such as oral antibiotics or an oral retinoid, such as isotretinoin,” says Dr Nasir. Whatever your strategy, patience is key. It can take up to three months for some treatments to work.
Want to go the virtual route? For those with mild to moderate acne, you may want to check out the Boots Online Doctor Acne Treatment Service, our quick and easy service that’s all about giving you convenient and confidential access to clinician advice from the comfort of your own home. After a quick online consultation (it takes just five to 10 minutes to complete), a clinician will review it within 24 hours, prescribing suitable treatment, if appropriate, that you can pick up in store or get delivered to your door (charges apply for treatments provided).
4. ‘Is tea tree oil good for acne?’
Tea tree oil, also known as melaleuca, after the native Australian plant from which it was originally derived, has been used for years as a way to soothe skin. Like other plant oils, it can cause irritation, particularly for sensitive skin types, and might not be a good option for those with severe acne. As with any acne skincare plan, it’s best to check in with your pharmacist, GP or dermatologist before trying it to make sure it fits in with the rest of your regime and to see if there are other ingredients out there better suited to your needs.
5. ‘How to get rid of body acne?’
While facial acne is the most common type, acne can also affect other parts of the body. For example, according to the NHS, chest acne affects about 15% of people with acne while back acne affects more than half. It’s not unusual to also experience bum acne – another highly searched-for topic.
When it comes to reducing its appearance, your plan of action will be largely determined by how mild or severe it is. For mild cases, “use exfoliating ingredients such as salicylic or lactic acids in body washes,” recommends Dr Nasir. “This will remove dead skin cells and reduce the tendency of skin pores to block up.
“Benzoyl peroxide is another useful ingredient as it dries out oily skin, is antibacterial and has anti-inflammatory effects. It can be found in creams, gels and washes.” As benzoyl peroxide products are medicines, it’s recommended you seek advice from your GP or pharmacist before using it. If you’re not sure about the right treatment for you, you could pop in-store to have a chat with a Boots pharmacist.
Dr Nasir also recommends antibacterial washes or ones that include tea tree oil. However, if acne is moderate to severe and causing scarring, seek some advice from your GP, a dermatologist or the Boots Online Doctor Acne Treatment Service to find the best option for your needs.
6. ‘How to get rid of hormonal acne?’
In addition to the above treatments and general acne skincare advice, there are some prescription medications that may be helpful if your acne is due to hormonal fluctuations. These include a hormonal treatment called co-cyprindiol that reduces sebum production in women and can be used for severe acne that has not responded to antibiotics.
7. ‘How to get rid of fungal acne?’
While a lot of us are typing this into our search bars, Dr Nasir points out that the use of the term ‘fungal acne’ is a misnomer. “It’s actually inflammation of the follicles caused by a yeast called malassezia,” she explains. “The proper name is pityrosporum folliculitis.”
The yeast responsible for this type of acne is always present on your skin and usually your body can balance the yeast, alongside other fungi and bacteria that are also part of your skin. But if that natural balance is upset, an overgrowth can occur. That’s when the infection of hair follicles develops and acne-like symptoms show up. This type of acne most commonly appears as small pimples, often along with itching and can cause whiteheads and skin irritation. It’s particularly prevalent among men with beards. While it’s regularly confused for acne vulgaris, which is commonly associated with blackheads and whiteheads, it won’t respond to the same treatment.
Now that that’s cleared up, what can help, well, clear it up? “Treatment includes antifungal shampoos containing selenium sulphide or ketoconazole applied during showering. Sometimes antifungal tablets are needed, too,” says Dr Nasir.
8. ‘What is cystic acne?’
Cystic acne is where spots look almost boil-like. It’s characterised by large and pus-filled lumps that are most commonly found on the face and trunk. They may be painful to touch, too.
This type of acne is usually a more severe form and it’s recommended to seek advice from your GP for guidance on how to best treat it.
9. ‘How do you fade acne scars?’
This depends on the type of scarring or inflammation you have. When it comes to over-the-counter skincare, it’s important to manage expectations. As highlighted by Dr Derrick Phillips, consultant dermatologist at the Cadogan Clinic, in our guide on the best products for acne scars, if you’re concerned about dark marks, products containing ingredients such as niacinamide may help calm and brighten, while ones with azelaic acid, a mild exfoliant, may help refine skin texture and tone down dark spots.
If you have ice-pick acne scars (v-shaped depressions in the skin), non-prescribed skincare products are likely to be ineffective at reducing their appearance. If this is the case, maybe speak to your pharmacist, doctor or dermatologist who can recommend and prescribe further treatments that could help.
