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Acne wonders can really hit the spots.

Byline: Dr Miriam Stoppard's health focus

Recently I've had several letters about acne. It's a condition that can cause great distress.

lf When I ran an acne clinic, I saw for myself the psychological stress and the loss of morale and self-belief that acne can cause.

And for many sufferers it couldn't come at a worse time - the teen years when hormones are rampaging and bringing on feelings of isolation.

Acne, for some, confirms their image of being a misfit. But acne sufferers should take heart. It is an eminently treatable condition and no one should feel beaten by it.

For success, you may need supervision from a dermatologist.

Acne has the same cause in males and females - androgens, male hormones. Yes, girls and women have them, though in lower levels than boys and men.

And the particular actions of androgens that are the root cause of acne are the effect they have on the sebaceous, or grease glands, in the skin.

Firstly they boost grease, or sebum, production, and secondly they increase the turnover of cells so that the openings of the sebaceous ducts on the skin become blocked. Grease production, however, continues, backs up, eventually bursting the gland and liberating sebum into and liberating sebum into the lower level of the skin.

It's highly irritant and leads to redness, swelling, discolouration, infection and hard lumps. Healing may leave unsightly scars.

There are many myths surrounding acne. For starters, blackheads aren't dirt, the black colour is melanin pigment. Hygiene plays no part in acne's development, and aggressive cleansing only irritates the skin, resulting in more sebum. Also, chocolate and fats don't make it worse but lots of dairy and sugar may. Smoking can definitely make acne worse. Giving up can be as good as some other specific treatments.

Retinoids, both as creams and pills, have a remarkable effect on acne. They are derivatives of vitamin A and work by normalising cell growth and sebum production, and preventing blackheads.

They can also be anti-inflammatory, but they're very powerful drugs and must be carefully supervised by your doctor.

Research shows you should see a difference within weeks and improvement will continue for three or four months. Retinoids will keep acne at bay when used for maintenance.

Sometimes skin antibiotics are successful when used in combination to prevent resistance, especially if used with benzoyl peroxide.

Anything that makes the skin peel, such as sunshine, is good for acne. Peeling unblocks the sebaceous glands so acne usually improves in summer. As androgens play such an important role it's logical to use something to oppose them. For women that could be the Pill - always worth considering.

acne at It is treatable and no one should feel beaten by it
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Title Annotation:Features; Opinion, Column
Publication:The Mirror (London, England)
Date:Sep 19, 2013
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