It's not just spots! (My Experience of Acne)

Name: DarkLady

Hello doyoo user, You have to be logged in to use these functions... Login or register Close window

Send message to member

Product:	My Experience of Acne
Date:	27/09/01 (2588 review reads)
Rating:

Advantages: None

Disadvantages: Horrid

Look around you when you're next on a bus or train. What do you see? Chances are you'll see a couple of people with acne spots. They might be teenagers but they could even be people in their forties and fifties. In fact more people than ever are seeking acne treatment well beyond adolescence.

When I was fourteen I started to get blackheads and spots. Thankfully they are no longer as it spontaneously cleared up a few months down the line. My Mother said "it's only spots". It wasn't only spots though. It was a total change in the way I saw myself. I imagined people pitying me, "Oh poor thing, look at those spots." I felt dirty, my skin was red and inflamed from endless picking and I was suddenly purchasing things like clearasil and big scarves to wrap round my face.

Acne is one of the most distressing skin conditions simply becasue it strikes at a time when physical appearances are very important to the sufferer and to that person's peer group. A consultant dermatologist of my acquaintance takes acne referrals as urgent referrals because of the psychological damage that can be caused.
Acne sufferers also suffer poorer employment prospects than their clear skinned cousins, have less satisfactory relationships and may skip work or school simply because they cannot "face" going out of the house. So it's not "just spots" is it?

Acne is caused by thickening of the opening of a follicle (pore), increased oil production, infection with bacteria (especially Propionibacter acnes) and the inflammatory response of the sufferer. Treatment is difficult as it often takes months to have an effect.

Acne comes in many forms: Acne vulgaris which blights the life of so many young people which may take the form of blocked pores and blackheads (comedones), red areas with inflammation and a white head filled with pus (pustules) or inflamed, painful lesions with no head (papules). Acne
conglobata (also called cystic acne) is far worse and may cause abscesses, cysts, keloid (raised) scarring and is more common in males than in females.

Treatment of acne is often carried out by the individual without medical help. The use of antibacterial washes and lotions is futile as the bacteria and the thickening of the skin are not dealt with and the harsh soaps may inflame damaged skin. Benzoyl peroxide creams are available over the counter but many sufferers a discouraged from using them as they can cause peeling. This peeling will usually disappear after a couple of weeks.

Benzoyl peroxide is very useful as it strips away the excess keratin, lowers oil production and is bacteriostatic to P.acnes. If you opt for this treatment be careful to keep it off clothes and sheets as it makes the dye wash out of them and do not expect any improvement for about a month after you first start treatment.

Your doctor will be able to help you with your acne, often by prescribing either the benzoyl peroxide cream or another topical treatment called tretinoin/isotretinoin (retin-a, isotrex). This again acts like chemical sandpaper and dries up the oil. The side effects which leave you looking like you have been horrifically sunburned for about two weeks are unnaceptable to many but with perseverance they will disappear. Users often find it helpful to stop for a day or two if the side effects get too bad and then recommence once the skin has recovered slightly. Like Benzoyl peroxide tretinoin needs time to work (about six weeks before you improve)

If you are using either benzoyl peroxide or retin-a then you should not go in the sun without protection as you risk burning. Furthermore laboratory studies in rats show that rats exposed to retin-a have an increased risk of skin cancer when exposed to UV light. The implications are not known in humans but hey, you do the maths.

Other topical treatments available include topical antibio
tics and zinc. These are seldom as effective as oral antibiotics but can be used if you do not tolerate oral antibiotics very well (eg. they make you throw up).

Antibiotics are often prescribed by GPs and
are usually effective in clearing up mild to moderate acne. Minocycline is one of the commonest and is usually prescribed in six month courses. It is well tolerated but you should once again avoid the sun as you can develop black spots on your skin. These are permanent and never go away! Oxytetracycline is another commonly prescribed antibiotic which is similar in action to minocycline, it is also cheaper.

If the tetracyclines don't work you will probably be given erythromycin. This gives you tummy ache. Whatever antibiotic you go on you should remain on it for a minimum of six months and expect to see an improvement in about a month. This is because the capillaries that feed your skin are very small and so the drug needs plenty of time to get into your system. The antihistamine Triludan (terfenadine) must not be taken with antibiotics. Antibiotics work best when combined with a topical peeling agent such as tretinoin.

The last line of defence in the way of antibiotics is Trimethoprin. A rather nasty antibiotic compound of sulphur trimethoprin is usually prescribed for water infections. It should only be prescribed by a named dermatologist and repeat courses are not recommended.

If you have cystic acne or have acne vulgaris, are over twenty-two and have failed to respond to two courses of antibiotics then you may be offered Roaccutane (oral isotretinoin). This is given in hospital and because it is so toxic requires regularly blood tests. It has severe side effects which include very dry skin/mouth/penis/vagina, flaking skin, dry eyes, mouth ulcers, pain, blood in urine, psychiatric reations and sudden visual disturbances/loss of hearing. Treatment is quite long and repeat courses are not recommended.

Some peop
le who take roaccutane have been reported to become very depressed and may commit suicide. It is important if you are on this drug to be aware of changes in your mood and report them to your doctor. You will often be offered counselling to cope with the side effects of this drug.

The outcomes are very good with roaccutane with only 30% of patients suffering a recurrence of the acne and in most cases these are easily controlled by a topical treatment. The side effects are so severe however that many people come off the pills before they do any good. Oh and by the way, if you are pregnant or planning to become preganant do not take roaccutane as it will cause a deformed baby.

There are alternative treatments available, sun lamps and non-uv light boxes have been used with good effect by some sufferers and homeopathic treatments are well spoken of.

If you do have acne remember that there is help available and most cases respond favourably to first line treaments. See your GP without delay.

Summary: