‘Teenagers’ bane’ a treatable disease

Press, 21 August 1989, Page 4

‘Teenagers’ bane’ a treatable disease

Acne is the bane of the lives of many teenagers, and some adults. Many fail to recognise that it is very treatable and put up with unsightly pimples, blackheads, whiteheads, pustules and cysts on their faces and to a lesser extent, their backs and chests. Acne can affect employment opportunities and sufferers often have to contend with feelings of tension and loss of selfesteem and confidence. Acne can also cause physical problems in the workplace. Severe acne with deep lesions may be very painful and rub against clothing or acne cysts may burst or bleed during activity. Acne usually appears during early puberty in both sexes. Girls generally develop puberty changes earlier and may therefore suffer from acne earlier, but conversely, it will settle by the age of 17, compared with 20 in a male. Some adults have a continuing problem with acne, or may develop it for the first time as an adult. Normal skin contains sweat glands, sebaceous glands producing sebum and hair follicles. At puberty, the sebaceous glands and hair follicles enlarge as a result of hormonal stimulation by androgens.

The cause of acne is not known, but contributing factors include an increased production of sebum, colonisation of the sebaceous glands by bac-

teria and inflammatory lesions, as sebum acts as an irritant. Mild acne can often be treated with preparations bought from pharmacies. Surface acting creams and lotions are available containing benzoyl peroxide, resorcinol and sulphur. Watch for dryness and soreness in the treated area as some skins react to these preparations. Abrasive agents are also available to unblock pores and get rid of blackheads, acting like a sandpaper on the skin. Stronger agents, keratolytics, peel the skin surface.

Astringents and detergent lotions make the skin feel less greasy but have no lasting effect on acne. Stronger medication should be used if the acne does not improve in a month or two.

Doctors prescribe a number of effective surface acting agents which unblock pores, reduce inflammation and kill bacteria. They contain benzoyl peroxide, sulphur and vitamin A derivatives. Low dose antibiotics, usually tetracyclines, help reduce inflammation around sebaceous glands and hair follicles. One month brings some improvement and this is usually significant in three months. These can be given in intermittent courses or continued over a long period of time, quite safely, depending on severity and response to treatment. Two new treatments are available. The first is a hormonal treatment, cyproterone acetate. It is used for women only and although marketed as a treatment for acne and mild hirsutism and therefore available only on a three month prescription, it is also able to be used as a contraceptive, pill.

The second is available only by prescription from a skin specialist and is used to treat severe acne resistant to other treatments. It is teratogenic, which means it may damage a foetus, and is therefore not used in young women.

Family Doctor

Wr From Doctor Tessa Turnbull for the Royal New Zealand College of General Practitioners