Acne normally starts at puberty and tends to resolve itself once a person reaches their mid-20s. However, in some people, acne can continue into adult life.

What are the causes?

There are a number of factors that cause acne, but it begins with the hormone testosterone. During puberty, the body becomes more sensitive to testosterone, which can lead to greater amounts of sebum being produced by the sebaceous glands in the skin.

Sebum is a natural, oily substance that reaches the surface of the skin through special ducts that lead into hair follicles. Sebum helps to keep the skin moist and waterproof. However, when too much is produced, it can get trapped in the hair follicles, along with skin cells, and cause a blockage. This is what causes whiteheads and blackheads.

Acne is triggered by bacteria called Propionibacterium acnes or P.acnes. Skin is covered with bacteria, which normally don’t cause problems. However, a change in skin acidity levels encourages the growth of P.acnes, which feed on sebum. If bacteria get into a blocked follicle, it can become infected and lead to an inflamed spot.

Acne affects men and women, but in slightly different ways. Young men are more likely to have acne that is severe and longer lasting. Women are more likely to have acne that comes and goes – often linked to their menstrual cycle.

Acne can be a symptom of a serious medical condition in some women, such as polycystic ovary syndrome (PCOS) or rosacea. If this is suspected, customers should be referred to the pharmacist.

What are the symptoms?

Spots vary in their severity. They normally appear on the face, but can also be found on other parts of the body, such as the neck, back and chest. Customers with acne may also notice that their skin feels greasy and looks shiny. There are a number of different types of spots:

Pustules – these are red, raised spots that contain pus, which can normally be seen as a yellow head. Spots may look inflamed and may burst, releasing the pus

Papules – also known as nodules or pimples, these are red, raised spots that feel harder than pustules. They don’t have a visible white or yellow head and don’t burst open. They are normally found in more severe cases of acne and are more likely to lead to scarring

Blackheads – also known as open comedones, these are spots that have a firm brown or black centre. This discolouration can be seen through the broken skin and is caused by the skin pigment melanin oxidising and turning black/brown; it is not dirt as is often thought

Whiteheads – also known as closed comedones, these are spots that have a firm, white centre. The skin covering a whitehead is not broken.