No one likes spots but we all get them from time to time. Find out why and what you can do to get rid of them.
In order to get rid of spots, we need to know what we’re dealing with. So what is acne?
Acne (Acne Vulgaris) is a common condition which causes spots or pimples to appear on the skin. They occur when the skin’s natural oil, sebum, blocks the skin’s pores – tiny holes out of which hairs grow. The spots usually occur on the face and neck, and sometimes on the back or chest.
There are different types of spots caused by acne. Blackheads and whiteheads (which are collectively known as comedones) are small bumps over clogged skin pores that are either black/dark (blackheads) or white (whiteheads). Papules are small red pimples and, along with blackheads and whiteheads, are seen in mild-moderate acne. In moderate-severe acne, pus can build up beneath spots causing pustules. In more severe acne, the pustules can enlarge into hard nodules or pus-filled cysts.
Treatments range from self-help or over-the-counter products to prescription-only medicines depending on how severe the acne symptoms are and how much they bother you. The aim is to reduce the appearance of spots and ultimately, to avoid scarring.
Common topical treatments include:
Benzyl peroxide creams and gels – an antiseptic cream or gel that helps limit the sebum production and reduces the amount of acne causing bacteria on the skin. They can sting, burn and dry the skin and should only be used short term.
Creams containing Vitamin A are also available and although they are not as strong as their prescription counterparts (see below) they may be helpful in mild to moderate acne and after prescription treatments are finished.
Some over-the-counter Vitamin A products that have good evidence behind them for treating acne include Beaute Pacifique’s Clinical Super 3 Booster
It’s the most potent Vitamin A product in the Beaute Pacifique line but unlike other Vitamin A products it shouldn’t irritate the skin as it’s been cleverly formulated for slow release. IF the skin does become dry and flakey, try using it every second night until you develop a tolerance.
Beaute Pacifique’s Scars and Stripes in another product that is useful for those who have acne scars. It contains four different active ingredients – each designed to reduce redness and inflammation and to normalize the damaged tissue structure that results in visible scars and stretch marks. It also contains three different active Vitamin A esters that rejuvenate and soften the skin and provice it with a powerful anti-age “boost” for better elasticity and a more uniform skin surface.
Azaleic or salicylic acid
Azaleic acid is an alternative if other topical treatments are too irritating or painful. It removes dead skin and reduces bacteria. You usually need to use this for four weeks before you notice an improvement.
Salicylic acid is another that is commonly used and has good results. It acts in a similar manner to clear the debris that’s blocking pores and help control sebum.
Dr Nick Lowe’s acclenz Purify and Renew Foaming cleanser contains Salicylic acid. His range of products has been specifically developed for acne treatment. It gently exfoliates to leave the skin looking fresher and helps to control inflammation and redness.
Harley Street Skin Care Clean Tech Renewal Lotion is another product with Salicylic acid that helps clear pores and get inflammation under control.
The Salicylic Acid reduces excess oil production and is anti-inflammatory, reducing redness while its Glycolic Acid gently removes the build-up of dead skin cells.
Together they work to increase skin cell turnover and reduce oil production which helps controlling acne. (Added bonus: they also work well to reduce hyper-pigmentation and fine lines.)
Prescription retinoids, which includes drugs such as tretinoin and adapalene, are substances that are similar in chemical structure to Vitamin A. Retinoid gels and creams are prescribed for acne because they can help unblock clogged pores. They may also reduce inflammation. Studies show topical retinoids to be effective in reducing blackheads, whiteheads and mildly inflamed spots.
Retinoid gels and creams are usually used once a day, before bed. They shouldn’t be used during pregnancy, and you should avoid sun exposure after use of retinoid creams. They may sting or cause redness or flaky skin, and should be used as directed.
Antibiotic lotions or gels are applied to the skin once or twice daily, to reduce the amount of bacteria on the skin and may be used in conjunction with benzyl peroxide or a retinoid cream in addition to a topical antibiotic.
Antibiotic tablets are used for more severe acne, or if topical treatments alone have not worked. The type most often used is the tetracycline class of antibiotics, which includes drugs such as doxycycline, limecycline and tetracycline. They are often prescribed alongside a topical treatment, for four to six months, depending on how well they work. Tetracycline antibiotics cannot be used in pregnancy.
Combined Oral contraceptive pill
The combined oral contraceptive pill (commonly known as “the pill”) may be offered as a treatment to girls or women with acne. It helps acne by controlling over-production of sebum related to hormonal changes. For example, it may be helpful in acne that becomes worse at the time of a period.
A different type of pill, called co-cyprindol (Dianette) may be given when other treatments have failed. Co-cyprindol blocks the effect of hormones called ‘androgens’, which may contribute to acne in some people. Co-cyprindol is not suitable as a long term contraceptive and is discontinued after acne has cleared up.
Isotretinoin is a retinoid (substance related to Vitamin A), but one that is taken orally rather than applied to the skin. It can be an effective treatment, reducing oil production, preventing follicles from getting clogged up, decreasing bacteria and reducing swelling. However, it can have serious side effects, including mood changes, and is only prescribed by dermatologists for people with severe acne. It can’t be used during pregnancy or breastfeeding.
Laser therapy is sometimes used to treat severe acne in a hospital setting. It works by targeting and destroying Propionibacterium acnes bacteria in the sebaceous glands. Laser therapy is also occasionally used to reduce the appearance of scars that can appear due to acne.
While evidence backing this treatment for acne is in its infancy, many people have found that exposure to blue LED light can help reduce the amount of acne causing bacteria. It is a non-invasive treatment which involves wearing a mask with the lights inside it for about 30 minutes.
Chemical peels with salicylic acid or a coctail of acids can be useful in unblocking the pores and reducing inflammation. These should be performed by a dermatologist or aesthetic practitioner who is qualified in administering peels as they can be painful and burn the skin if not done properly.
Surgical procedures may be required for very serious acne. Cysts and nodules that are filled with pus may have to be incised (cut) and drained. Scar tissue resulting from acne can be removed by inserting and manoeuvering a needle into the scar – a surgical technique called ‘subcision’. A plastic surgeon may also consider ‘dermabrasion’ to remove scarring from acne. This involves using special rotating tool to remove the top layers of skin.
If you have concerns about your acne, see your doctor or dermatologist to get expert advice.