Acne is the common cause of spots. Most people with acne are aged between 12 and 25 but some older and younger people are affected. Boys are more commonly affected than girls. Acne usually affects the face but may also affect the back, neck and chest. The severity can range from mild to severe. About 8 in 10 teenagers develop some degree of acne. Often it is mild. However, it is estimated that about 3 in 10 teenagers have acne bad enough to need treatment to prevent scarring. Untreated acne usually lasts about 4-5 years before settling. However, it can last for many years in some cases.
Some myths and wrongly held beliefs about acne
- Acne is not caused by poor hygiene. In fact, excessive washing may make it worse.
- Stress does not cause acne.
- Acne is not just a simple skin infection. The cause is a complex interaction of changing hormones, sebum, overgrowth of normally harmless germs (bacteria), inflammation, etc (described above). You cannot catch acne - it is not passed on through touching (contagious).
- Acne cannot be cured by drinking lots of water.
- There is no evidence to say that sunbathing or sunbeds will help to clear acne.
- Some people believe that acne cannot be helped by medical treatment. This is not true. Treatments usually work well if used correctly.
Will acne return after treatment?
Once the spots have cleared, acne commonly flares up again if you stop treatment. Therefore, after the spots have gone or are much reduced, it is common to carry on with a maintenance treatment to prevent acne from flaring up again. It is common to need maintenance treatment for 4-5 years to keep acne away. This is typically until the late teens or early 20s. In a small number of cases, acne persists into the 30s, or even later. For these people it is possible to continue to treat the skin to keep it under control.
Maintenance treatment is usually with either benzoyl peroxide or a topical retinoid. These can both be used indefinitely. The dose used to prevent spots from returning is often lower than that used to treat acne. For example, one application to the skin every other day with a low-strength preparation may be sufficient to keep spots from returning.
It is not usual to use topical antibiotics or antibiotic tablets as maintenance treatment once the spots have cleared. This is because long-term use of antibiotics can lead to resistance of germs to the antibiotics. Also, azelaic acid, another topical treatment, is only licensed for treatment periods of six months. Also, it is best not to take the pill long-term solely to prevent acne. Therefore, if at first you are treated with an antibiotic, azelaic acid or the pill, you may be advised to switch to benzoyl peroxide or a topical retinoid for maintenance treatment
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