Acne - Don't Suffer in Silence

Today's highly visual social media environment means the psychosocial impact of having acne, especially as a teenager can be severe.

Having a skin condition such as acne in today's image dominated social media landscape can have an effect on patients' lives well beyond the physical discomfort. This is why acne, its impact, and new treatments are being discussed at this year's Annual Scientific Meeting (ASM) held by the Australasian College of Dermatologists (ACD) this weekend, 9-11 April 2021.

"Quite often we see the effects acne has on our patients such as lack of self-esteem which can result in them not wanting to go out in public. If they have truncal acne, which is acne on the chest and back, they might not want to go to the beach or go swimming with their friends" dermatologist and ACD Fellow, Dr Jo-Ann See said. "As dermatologists we are here to help treat the condition and as a result, help the patient achieve a better quality of life through alleviation of their symptoms".

Today's social media landscape means that many teens and young adults are routinely exposed to unrealistic images that can have a psychosocial effect on those with a skin condition such as acne. "We are aware that these issues are more than just skin deep for our patients and that is why people need to know that there are treatments available" Dr See said.

"Acne is often perceived by the public as something that can be treated using over-the-counter creams and face washes but as acne is a medical skin condition, this is not always the best course of action" Dr See said. "Caring for patients with a range of skin conditions, including acne, is what dermatologists do".

In today's social media landscape, Dr See says the rise of 'influencers' is changing the way people perceive what healthy skin looks like. Photos are often taken with filters or are heavily photoshopped to show 'miracle' cures. This can lead to people spending a lot of money on products that don't work or are not right for their skin and delay getting the right treatment. "It is important not to delay treatment for acne as it can lead to scarring which can be permanent or more difficult to treat than the original condition" she said.

"There are a wide range of treatments dermatologists can offer to help treat acne. There are over-the-counter topical acne preparations as well as prescription topical and oral medications. Dermatologists can prescribe medications such as oral isotretinoin, which is very effective in many patients. There are also non-medical treatments such as light chemical peel or laser for acne scarring" she said, "People don't need to suffer in silence".

"As part of our ASM we will be discussing research which could lead to new therapies in the future including breaking up the bacterial biofilm and how the microbiome of the gut may play a role in acne development".

The ACD recommends that anyone who is suffering from acne, whether it's mild, moderate or severe, especially if it is impacting their quality of life, contact their GP for a referral to a dermatologist if specialist treatment is necessary or to explore all options available.

"It is important to realise that there is help out there" Dr See says. "There are many treatments available these days so people don't have to suffer in silence. Dermatologists can help".

Additional Information - Acne

Acne can affect both teens and adults and can appear on the face and neck as well as the body, usually the chest and back.

The acne lesions look the same in teens and adults and they are in the same distribution.

Adult acne is acne that continues past the ages of 18 to 20, or starts in the early 20s in people who may not have had a previous problem with acne. It can occur in men but is more frequently seen in women and can be more resistant to treatment. It is also known as Hormonal Acne, Female Acne, Post-adolescent Acne, or Late Onset Acne.

Acne vulgaris is the type of acne that typically affects adolescents or teens.

The treatments for adult and teen acne are very similar although if there is a hormonal component this is taken into account for women and the oral contraceptive or antiandrogens can be used.

Acne that appears on the chest and back is known as truncal acne and isn't something that is often discussed. Studies show that most people who suffer from truncal acne won't mention it to their doctor.

There are many factors that interact to cause acne. These include:

- An increase in oil (sebum)
- Increased numbers of acne bacteria (Propionibacterium acnes) in the oil glands
- Blockage of the pilosebaceous duct because of increased skin cells and inflammation.

It is unclear whether increased levels of male hormone (androgens) in the blood from the adrenal glands or ovaries or tiny amounts of locally produced male hormones stimulate the oil gland to produce more oil or sebum, leading to adult acne.