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Acne is one of the most common diseases in dermatology. It usually begins at puberty due to hormonal changes which cause an increase in oil (sebum) production. Acne sufferers usually have larger sebaceous glands and produce more sebum than people with healthy skin. The tendency to develop acne may be hereditary. The size and activity of the sebaceous glands is also inherited. The increased activity of the sebaceous glands at puberty is due to the hormone, dihydrotestosterone.

The initial event in the development of acne is an abnormally rapid generation of cells lining the hair follicle wall. Under normal circumstances these cells are swept out of the follicle, but in the case of acne the newly generated cells stick together to form a keratin plug, blocking the hair follicle. This blockage causes retention of sebum and provides an ideal environment for bacteria to grow.

As the bacteria grow, they break down some ingredients of sebum into free fatty acids which cause irritation and initiate inflammation. The most severe form of acne comes about when the build up of sebum, bacteria and other skin debris ruptures into the lining of the hair follicle and breaks into the deeper part of the skin. When this happens, healing is slow and considerable scarring often occurs.

Picking and squeezing acne spots should be avoided, as the process may cause the unnecessary rupturing of the hair follicle and thus the inflammatory form of acne, resulting in scar tissue.

In general, effective topical treatment for acne should:
a. unblock the oil ducts,
b. decrease the amount of sebum being secreted,
c. be anti-bacterial,
d. be anti-inflammatory.

Any dandruff present should also be treated.

Advice for the Patient

Acne can cause emotional stress. You can help by offering encouragement and advice like the following:
1. DON’T pick, don’t poke and don’t squeeze your pimples, this will only spread and deepen the inflammation and may cause scarring.
2. DON’T use heavy moisturisers as they may clog up the hair follicles. If your skin becomes dry, use a light moisturiser. If you wear make-up, apply it sparingly and make sure you remove all traces of it before you go to bed.
3. DO try to maintain a healthy, well balanced diet. Although diet has not been shown to cause acne, a healthy diet leads to healthy skin. Try to avoid greasy foods such as chips and other fried foods. Instead, try wholegrain breads and pastas, fresh fruit, vegetables and salads.
4. DO try to avoid stress; it commonly aggravates acne.
5. DO try to get some exercise as well as plenty of sleep.

Products to Help

Azclear Action Foaming Wash is a highly effective antiseptic solution which contains a mild, low irritant surfactant which gently cleanses the skin of dirt and excess sebum, while providing a rich foaming mousse from a non-aerosol pack. It contains antimicrobial agents to reduce the levels of surface bacteria associated with acne. It helps to prevent secondary infections of inflamed or irritated skin and contains glycerin which leaves the skin soft and smooth without drying.

Azclear Action Foaming Wash should be used to cleanse the skin in the morning and at night as an alternative to soap.

Azclear Action Medicated Lotion is an oil free, invisible acne treatment which combats pimples by fighting bacteria, unlocking oil ducts, reducing redness and drying up pimples. It contains micronized azelaic acid at 20% w/w dispersed in aqueous oil free base. Azelaic acid is a potent and well-tolerated anti-acne agent.

Oily hair is a common occurrence in acne patients due to the excess sebum. Regular use of a shampoo such as Hairscience Purifying Shampoo for Oily Hair will help to keep the hair clean to ensure it does not further aggravate the skin it comes into contact with. Hairscience Purifying Shampoo will also help to manage a flaky scalp.