Acne is a common skin condition which causes spots, oiliness and sometimes hot or painful skin.
It affects most people at some stage in their lives. It is often linked to hormone changes during puberty, with about 95% of those aged 11 to 30 affected at some point. In girls, it is most common between the ages of 14 and 17, with boys most often affected between the ages of 16 and 19. Symptoms usually disappear after a number of flare-ups, often in the mid-20s. About 3% of people have acne after the age of 35.
Whether you experience persistent acne or occasional flare-ups, you may feel self-conscious about the effect the condition has on your appearance. However, there is plenty of support available to help you manage these difficulties. On this page, we explain what acne is, acne symptoms and the acne support we can provide to help you manage the impacts it may have on your life.
In most people, acne symptoms affect the face. More than half have acne symptoms on their back and about 15% on their chest.
There are six types of spots associated with acne:
- Blackheads: Small black or yellowish lumps which feel bumpy when touched. Along with whiteheads, blackheads are a type of “comedone”.
- Whiteheads: A type of comedone similar to blackheads, with a white tip. Like blackheads they feel bumpy when touched. Whiteheads are firmer than blackheads and do not empty when squeezed.
- Papules: Small red bumps, tender or sore. Larger than blackheads and whiteheads and hard when touched.
- Pustules: Similar to papules, but with a pus-filled white tip in the centre. Similarly to papules, they are bigger than blackheads and whiteheads and hard when touched.
- Nodules: Large, hard lumps, often painful, which build up beneath the skin surface.
- Cysts: Large, pus-filled lumps which resemble boils. Unlike nodules, they feel soft.
Spots caused by acne, especially cysts, may cause permanent marks, scarring or discolouration. This can leave bumps or indents in the skin, or skin that is redder, darker or lighter than your natural skin tone. There are treatments and services which can lessen the permanent effects of acne.
Acne is linked to changes in hormone levels. Most commonly, this happens during puberty but it can occur at any age.
In people with acne, the glands are more sensitive even to normal levels of hormones. This causes the grease-producing glands next to hair follicles to make larger amounts of oil than usual. This in turn causes the skin bacterium Cutibacterium acnes (“C acnes”) to become more aggressive, leading to inflammation and the production of pus. Hormones also thicken the lining of the hair follicles. The excess oil and dead skin then block the pores, causing spots to form.
Hormonal changes linked to menstruation (periods) or pregnancy can cause acne in women.
Acne can also be brought on by medication taken for other health conditions, contraceptive pills or injections, and hormone-containing tablets taken by body-builders.
There is also some evidence that eating high glycaemic index (GI) foods can cause or aggravate acne. This includes sugary foods and drinks, white bread, potatoes and white rice.
Acne tends to run in families. If both parents had or have it, it is more likely that you will have it too. However, many people with acne have no family history of the condition.
There are many types of acne. You can visit the DermNet NZ website to view a comprehensive list of the different types. Here are a few of the most common types of acne:
Acne vulgaris is the “classic” and most common type of acne. It is characterised by comedones, papules, pustules and cysts.
This is a severe type of the condition affecting the face and upper body, which can leave scarring. It comes in various forms.
Acne fulminans is rare but it can be severe. It usually affects teenage boys and causes symptoms such as fever, malaise, appetite loss, joint pain and enlarged liver and spleen. It may be caused by an increase in androgens (a group of hormones) or an autoimmune response (the body attacking itself). It can also be caused by a hypersensitivity to the bacterium “C acnes” (discussed above) and some people may have a genetic tendency towards it. If you have it, it is important that you see a dermatologist straight away.