Acne is a very common skin condition characterized by comedones (blackheads and whiteheads) and pus-filled spots (pustules). It usually starts at puberty and varies in severity from a few spots on the face, neck, back and chest, which most adolescents will have at some time, to a more significant problem that may cause scarring and impact on self-confidence. For the majority it tends to resolve by the late teens or early twenties, but it can persist for longer in some people. Acne can develop for the first time in people in their late twenties or even the thirties. It occasionally occurs in young children as blackheads and/or pustules on the cheeks or nose.
Acne & Rosacea
What is acne?
What is Rosacea?
Rosacea is a common skin condition, usually occurring on the face, which predominantly affects fair-skinned but may affect all skin types in people aged 40 to 60 years old. It is more common in women but when affecting men, it may be more severe. It is a chronic condition, and can persist for a long time and, in any individual, the severity tends to fluctuate. Rosacea tends to affect the cheeks, forehead, chin and nose, and is characterized by persistent redness caused by dilated blood vessels, small bumps and pus-filled spots similar to acne There may also be uncomfortable inflammation of the surface of the eyes and eyelids.
What You should know / Frequently Ask Questions
Acne can run in families, but most cases are sporadic and occur for unknown reasons.
At present there is no ‘cure’ for acne, although the available treatments can be very effective in preventing the formation of new spots and scarring.
If you have acne but have had no success with over-the-counter products then it is probably time for you to visit your doctor. In general, most treatments take two to four months to produce their maximum effect. Acne treatments fall into the following categories:
- Topical treatments, i.e. those that are applied directly to the skin
- Oral antibiotics, i.e. tablets taken by mouth
- Oral contraceptive pills
- Isotretinoin capsules
- Other treatments(laser and lights)
- Try not to pick or squeeze your spots as this usually aggravates them and may cause scarring.
- However your acne affects you, it is important to take action to control it as soon as it appears. This helps to avoid permanent scarring and reduces embarrassment. If your acne is mild it is worth trying over-the-counter preparations in the first instance.
.•Expect to use your treatments for at least two months before you see much improvement. Make sure that you understand how to use them correctly so you get the maximum benefit.
- Some topical treatments may dry or irritate the skin when you start using them. If your face goes red and is irritated by a lotion or cream, stop treatment for a few days and try using the treatment less often and then building up gradually.
- Make-up may help your confidence. Use products that are oil-free or water-based. Choose products that are labelled as being ‘non-comedogenic’ (should not cause blackheads or whiteheads) or non-acnegenic (should not cause acne).
- Cleanse your skin and remove make-up with a mild soap or a gentle cleanser and water, or an oil-free soap substitute. Scrubbing too hard can irritate the skin and make your acne worse. Remember blackheads are not due to poor washing.
- •There is little evidence that any foods cause acne, such as chocolate and “fast foods”; however, your health will benefit overall from a balanced diet including fresh fruit and vegetables.
The cause of rosacea is not fully understood. Yours genetic, immune system factors, and environmental factors may all play a part. Factors that trigger rosacea cause the blood vessels in the skin on the face to enlarge (dilate). The theory that rosacea is due to bacteria on the skin or in the gut has not been proven. However, antibiotics have proven helpful to treat rosacea. This is because of their anti-inflammatory effect. Rosacea is not contagious. There are a variety of triggers that may make rosacea worse. These include alcohol, exercise, high and low temperatures, hot drinks, spicy foods and stress. Rosacea can be sun sensitive.
Rosacea does seem to run in some families, but there is no clear genetic link.
The rash and the blushing associated with rosacea can lead to embarrassment, lowered self-esteem and self-confidence, anxiety and even depression. Furthermore, the skin of the face is often sensitive, and the affected area can feel very hot or sting. Some people with rosacea have eye symptoms. A few patients with rosacea may develop more serious eye problems, such as painful inflammation involving the front part of the eye (rosacea keratitis) and this may cause blurred vision. It is important that you consult a dermatologist or an optician if you develop symptoms affecting the eyes.
Rosacea usually starts with a tendency of blush easily. After a while, the central areas of the face become a permanent deeper shade of red, with small dilated blood vessels, bumps and pus-filled spots. Occasionally, there may be some swelling of the facial skin (lymphoedema), especially around the eyes. Occasionally, an overgrowth of the oil-secreting glands on the nose may cause the nose to become enlarged, bulbous and red (called rhinophyma). Rhinophyma is more common in men than women.
The inflammation that accompanies rosacea can be treated with preparations applied to the skin or taken by mouth; however, not all these will help the redness or blushing that may be associated with rosacea.
Local applications: The inflammatory element of rosacea may be controlled with a medication applied to the affected areas It takes at least 8 weeks for their effect to become evident and some applications work specifically to reduce the redness associated with rosacea
Oral antibiotics:These are helpful for the inflammatory element of moderate or severe rosacea. The most commonly used antibiotics belong to the tetracycline group and include tetracycline, oxytetracycline, doxycycline, lymecycline and minocycline. Erythromycin is another commonly used antibiotic. The duration of an antibiotic course depends on your response.
- An eye specialist should manage the severe types of eye involvement.
- A bulbous nose affected by rhinophyma can be reduced by a dermatologist or a plastic surgeon•Redness and dilated blood vessels can be treated with laser therapy.by a dermatologist.
- A beta-blocker tablet or clonidine may be prescribed by the dermatologist it may help if blushing is a significant problem.
- Isotretinoin tablets are sometimes prescribed by a dermatologist forsevere rosacea.
Protect your skin from the sun by using a sun block (with a sun protection factor of at least 30) on your face every day and needs re-applying frequently if outdoors.
- Do not rub or scrub your face when cleansing as this can make rosacea worse.
- Do not use perfumed soap as this can make rosacea worse.
- Use a soap substitute (emollient) to cleanse your face.
- Use an un-perfumed moisturizer on a regular basis if your skin is dry or sensitive.
- Consider the lifestyle factors that can worsen rosacea and avoid them; a written record of your flare-ups may help.
- Some Cosmetics can often cover up rosacea effectively, and some rosacea patients may benefit from the use of skin camouflage. This may help hide excessive redness. A skin camouflage consultation can be discussed with your health care professional. or by contacting the organizations listed at the end of this leaflet.
- Unless they are specifically recommended to you by your dermatologist it may be best to avoid some treatments for acne, as they can irritate skin that is prone to rosacea.
- Do not use topical preparations containing corticosteroids, unless specifically recommended by your dermatologist as these may make rosacea worse in the long run.
- If your eyes are affected, do not ignore them – consult your dermatologist or an eye specialist doctor.
- Some drugs can aggravate blushing, and your doctor or dermatologist may make appropriate changes to your medication.