Well over 80% of the UK population will suffer from acne at some point in their lives, and for teens the condition can often lead to more serious issues resulting in low confidence, low self esteem, shyness and even depression. However, teens are not the only ones affected and the incidence of acne in women in their 20’s is on the increase.

Acne can affect anyone, at any age and there are a serious number of misconceptions around what causes it and how it impacts sufferers, both from a psychological perspective, as well as a physical one.

In light of this, the recently founded Acne Academy has undertaken the largest survey of its kind in the UK to provide a valuable insight into just how teenagers with acne are perceived by adults and their peers. The results provide a valuable insight to the extent people with acne are negatively perceived and the long term psychological impact it can have.

The findings also reveal the level to which concerns over their appearance dominate teenagers’ lives and that they are further exacerbated by social networking sites with photosharing facilities, encouraging their generation to obsess over photos of themselves like never before. For people suffering from acne, there literally is nowhere to hide.

If acne is negatively affecting your life then log onto our live show where Dr Hilary Jones from The Acne Academy will be on hand to answer all your questions.

Dr Hilary Jones joins us live online to discuss the issue of acne and talk about the Acne Academy, which has been set up to help people cope with the condition.

H: Jayne Constantinis, host

A: Dr Hilary Jones

H: Do you suffer from acne? Or maybe somebody you know does. Well stay watching, you can’t afford not to

Titles

H: Hello and welcome to Health & Wellbeing I’m Jayne Constantinis. Well over 80% of the UK population will suffer from acne at some point in their lives, and for teens the condition can often lead to more serious issues resulting in low confidence, low self-esteem, shyness and even depression. However teens are not the only ones affected and the incidents of acne in women in their 20s is on the increase. Acne can affect anyone at any age and there are a serious number of misconceptions around what causes it and how it impacts on sufferers both from a psychological perspective as well as a physical one. Well joining me today to discuss the causes of acne and how to cope at whatever age is Dr Hilary Jones. Welcome

A: Thank you

H: Coming up on the show today – acne, what it is, what causes it and how do you cope with it. Emotional support and practical advice. And of course we’ll tackle all of your questions live. So if you do want to ask Dr Hilary a question live then type it in the box on your screen and send it to us with your name of course and we’ll get through as many as we can during the course of the show, and if you’re Tweeting then please use the #studiotalktv. So Dr Hilary let’s begin if we may with a few sort of factual things about what exactly acne is and what’s the difference between acne and just say spots?

A: Well I could say that if 80% of the population develop acne at some stage in their lives, that means that we get spots. We get either the individual spot on the skin or we might get a whole crop of spots at any one time reoccurring over a period of time, and once those spots begin to bother you, it’s acne. There’s no difference between one spot, many spots, spots that run together - it’s all acne, it all comes under the same headline if you like

H: So it’s more about the quantity really than the actual – you can examine one and say that’s a spot, that’s acne

A: Yes if it’s recurrent then it’s acne, the trouble is every individual is different and some people who have just a few spots may be totally preoccupied with them, they may think it’s the worse thing that can ever happen, other people have quite severe acne with cysts and scarring but are not too bothered. So the psychological impact on the individual will vary enormously

H: And can you show us an example of what it looks like and also show us how severe it can be?

A: Sure. Well we’ve got a couple of pictures here. This is a typical adolescent teenage acne. You can see there’s areas of redness with some white spots that are coming to a head, and it’s fairly widely distributed across the cheek. You might also see this on the forehead, on the back or on the chest and what’s happening here the pores which secrete oil onto the skin to lubricate it are becoming blocked. The pores are widening, the hormones are kicking in at this age producing more of the oil, and the normal bacteria that live on the skin can cause infection in those pores and in that oil causing white heads and blackheads. It can become quite a lot worse however and this individual has not only got the red spots of the active acne but you can see these deep craters, these pits which look like fingernails have scraped out part of the skin, and those are the scars caused by cystic acne, and that individual will have those scars for life unless it’s treated with something like dermabrasion or chemical peel treatments

H: And is that because this person has done something, you know has used a treatment or used a product that has caused those craters or is that perfectly normal?

A: Not at all, this is a part of the range of normal acne, nothing this individual has done has caused this, they’re blameless. There are lots of myths that eating chocolate, fizzy drinks, greasy food causes acne – it doesn’t, it’s nothing to do with what you eat, nor is it anything to do with how hygienic or not you are, however much you wash you’re not going to get rid of acne by washing alone, so there are all sorts of myths which are perpetuated. We’ve discussed briefly the real causes of acne, and as we’ve said in the introduction it can occur in the 20s, 30s even 40s in certain individuals

H: But just to go back to two of the things you said there, the eating habits – if what’s causing it is an increase in the

A: Oil

H: Production of oil, that’s not connected in any way with having a very fatty, greasy diet?

A: No

H: It’s all hormonal?

A: Yes. What you eat is processed by the digestive system and bloodstream has a constant level of fat and protein and sugar, so what you eat is not translated into what goes on in the skin. There’s no evidence for that whatsoever, that’s an old wives’ tale and we want to put that one to bed. Now what’s causing this is an elevation in testosterone levels at puberty which cause a greater increase in the secretion of sebum, the natural oil in the skin – some people are born with oily skin some people are born with dry skin, so you’re either going to get a bit of eczema or a bit of acne depending on which end of the scale you are

H: But the other thing you mentioned there was bacteria and you said it doesn’t matter how often or how often you wash your face, if you clean the bacteria it doesn’t make any difference

A: Doesn’t make any difference, no because these bacteria are present on the skin all the time and if you wash you might reduce the population of those bacteria by a little bit but within a few hours they’re back to normal levels, and in most people they do no harm but when there’s a lot of oil and the pores become blocked by a thicker outer layer of skin, then acne is the result

H: I want to ask you about the many products that are out there on the market in a minute, but what can people do to alleviate the symptoms if anything?

A: Well one of the first things to do is to go to the chemist and ask the chemist for an over-the-counter remedy. Now there are many, many available and the fact that there are so many to me means that there’s no one or two that are so fantastic for everybody that you know we need all the others, so some people will respond to one better than another. Another thing is that teenagers often think that because a little bit is thought to be good, a lot of it’s going to be even better so they pour these things on their faces, and sometimes it can do more harm than good. So for the few people that do actually go and see a doctor about their acne (and more should) 91% of them say that they get a really good result if they go and see a professional, someone who’s really interested in acne to get the treatment they need, and with modern treatments today that take off the thicker layer of skin on the outside, unblock the pores, get rid of some of the bacteria, and thin the oil that’s produced, we can get really good results

H: And what sort of treatment might that be?

A: Well it might be a combination of something like tretanoin which is known to take off the outer, thicker layer of skin and benzyl peroxide which is available over-the-counter, but the combination of the two things work very well. Benzyl peroxide again opens up the pores, let’s the oil come away. There are topical antibiotics like lotions, watery lotions that can be applied to the skin which get rid of some of the bacteria to keep the population of those down so you don’t get the blackheads and the whiteheads so much. And then a bit of ultra-violet light. There are so many things that make a difference. The good news is that even with people with severe acne like this we can prevent the scarring and save that person from going through this lifelong psychological problem that the acne has caused

H: I want to come back to the psychological effects in a minute but are you saying then that a lot of people don’t go to the GP?

A: Most don’t

H: Why don’t they?

A: A lot of people think look it’s acne, I’ve got to go through this, it’s a rite of passage, I’m a teenager, my parents have said I’ll grow out of it. The trouble is they don’t always grow out of it and often by the time they have grown out of it the damage is done with scars like this. Now we want to try and avoid that, we can do. So I say to parents look, if you’re interested in your children, they’re not going to come and tell you if they’re worried about their spots, they’re going to keep that to themselves, but if they show any kind of anxiety about it or you’re worried about their facial appearance then encourage them to go and talk to the doctor

H: And there’s been some interesting findings in the research that came out just recently about the psychological impact of it. Tell us about that?

A: Well the biggest survey of its kind ever conducted in the UK talked to 1500 people, 1000 adults and 500 teenagers and what we found was that in 25% of teenagers with acne there was clinical depression as a result of their appearance. The most important thing that came out of the survey for teenagers is their appearance. It’s – they’re very sensitive at this age, they’re trying to make relationships, they’re trying to get on with their peer group, the bullying goes on at school and if you’ve got acne it’s not good news, that is the bottom line. The trouble was as we found in the survey the parents don’t really think about acne in their teenagers so much and they say well you know they’ll grow out of it, you know it’s not a medical condition, don’t waste the doctor’s time with that. And more parents it seems will be prepared to move house to get their teenager to the right school to make them more successful than taking them to the doctor to give them clear skin which they acknowledge they think will also make them more successful. So involve healthcare professionals more because we can deal with this before it gets to this stage

H: Yes, maybe there’s too much of a stiff upper lip going on among parents

A: I think so, but amongst teenagers too

H: Yes

A: Because they might spend an inordinate amount of time looking in the mirror thinking oh I can’t go to the party tonight, look at this Vesuvius on the end of my nose, you know so much of that goes on, but they’re not going to tell their friends about it, they’re not going to admit that they’re hurt by these feelings of poor self-confidence and self-worth. But I would encourage them, come and see us, come and see the doctors or go to a reputable online source where we can give them additional help

H: Well we’re going to be taking lots of questions that have come in live and we’ll be talking about the website, the acneacademy.org where people can go for some very practical help in a minute. So stay watching, we’re going to tackle all your questions live next

Break

H: Well if you’ve just joined us we’re talking about teenagers and the challenges that they often face with spots and acne and we invited you to send us your questions live for Dr Hilary and very many of you have. So let’s start tackling some of those. This is an interesting one, “I’m14, my acne’s getting worse, I’m really worried about the scarring that you just referred to there. Is there anything I can do, going to school is a horrific experience and nothing I do or anything I eat makes it better” – so lots of things that you’ve already talked about there, nothing you can do about your diet will make a difference, but it really highlights the psychological pressure that he feels he’s under

A: Absolutely and what I would say to you is that these spots are normal, 80% of people will develop spots at some stage in their life so you’re not alone. The second thing is that you probably notice them much more than anybody else, so be reassured that what looks horrible to you is perfectly normal to other people. That may not be reassuring to you, but what I would say is this – go to the chemist, talk to the pharmacist who can be very helpful. They’ll have a range of remedies. Probably one of the best ones is benzyl peroxide, this is preparation that you can put onto the skin, maybe every other day to start with, increasing to daily and it helps to think out the outer layer of skin which blocks the pores and enables the increasing amount of oil that everybody produces at your age to escape and not form these cysts that cause that kind of scarring that you’ve seen in earlier pictures. Then if that doesn’t work or causes undue redness, go and see your doctor. Your doctor has at his disposal some prescription medicines, either in topical form – that is you apply to the skin itself – or in tablet form that can make a huge difference. But don’t be put off by how you look today because within a very short period of time, either the pharmacist or the doctor can put it right for you

H: And actually how long typically does acne last?

A: That entirely depends on the individual. Some people will have acne, if it’s untreated all through their life, so 20s, 30s, 40s – that’s unusual. Usually it does stop by the mid 20s but then women who have spots at period times can go on right through to the menopause at the age of 50. In other people who develop for example ovarian cysts, polycystic ovarian syndrome, acne is a problem and it is in certain other medical conditions as well. So there’s no easy answer to that. For most people it will settle down after the age of 19, 20, 21 as the skin gets drier and that happens as you get older, but for other people it will persist

H: Just had one more question from Leona actually and this is interesting because she says “my mother’s in her early 50s, recently had a hysterectomy and is now suffering from terrible skin that looks like acne. Is it normal, is there anything she can do?” so it’s not just about teenagers

A: Well interestingly at the menopause the levels of oestrogen drop and relatively the level of testosterone increases, all women produce testosterone but when it’s unopposed by the oestrogen, then the testosterone can have more of an effect. So again she needs to treat it just as she would as she was a teenager and if she sees her doctor the doctor can come up with some remedies that will make a huge difference

H: Thanks for that. Very sadly we’re out of time but I know that you just want to mention the Acne Academy.org which is a really brilliant website that offers lots of help for sufferers

A: Sometimes you can’t find a pharmacist that’s going to help you as much as you want, or even the doctor, but if you want a specialist who will give you impartial, really good, sound, practical advice, you can do really well by going to this website and it’s www.acneacademy.org

H: Brilliant thank you, fascinating. We could have gone on. I hope that we’ve answered your questions. If not go to acneacademy.org and I’m sure they’ll be able to help you. Thank you for watching, see you again. Bye bye