“I am 22 years old. Ever since I was 15, my skin has been bad. I get regular breakouts on my face and back. I thought this would settle as I got older, but it hasn’t. Is there anything I can do that will help?” Chloe.
Thanks for the question, Chloe. The short answer is yes, absolutely—there are several things that you can try that should improve your skin a lot.
Spots, or acne, are a really common issue, and can lead to low self-esteem and worries about appearance. In severe cases, the spots can result in permanent scarring.
Anyone can develop acne, but it is most common in the 16–18 age range, and often first appears during puberty. Girls are usually affected earlier than boys, but males tend to get more severe forms of acne. You are more likely to get acne if:
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one of your parents had acne when they were younger
you have polycystic ovarian syndrome
you work in a very hot, humid environment
you take certain medications including prednisone, hormones or anticonvulsants
your general health, physical well-being and diet are poor.
Acne most commonly occurs on the face, but can also affect the chest, back and neck area. The cause of acne is not fully understood, but it is likely due to a combination of factors including hormones, blockage of hair follicles by oil or sebum, and infection with the acne bacteria.
If your acne is quite mild, initially I would recommend trialling over-the-counter topical preparations. Milder options include cleansers that remove some of the oiliness from your skin. Stronger, more effective (but often more expensive) options include a topical antibiotic combined with benzoyl peroxide. The antibiotic helps to eradicate the bacteria responsible for the acne, and the benzoyl peroxide reduces the number of whiteheads and blackheads. Be careful with these stronger preparations as they can be quite harsh on your skin and should usually only be applied sparingly once a day.
If your acne is more severe, or you have tried topical treatments without any success, I would talk to your doctor about an oral medication. The following options can be really helpful, but they all require a few months to get a really good result, so don’t give up too quickly:
Oral antibiotics—tablets such as doxycycline and erythromycin, given at a low, once-daily dose, can be remarkably effective at treating acne; they take up to six months to work, and can occasionally have side-effects. Your doctor will advise you if this is a safe option for you. After a course (usually 6–12 months duration), a significant proportion of people will never experience such severe acne again, although unfortunately that is not the case for everyone.
The combined contraceptive pill—if your skin tends to flare up in a cyclical pattern, it is very likely that controlling your cycle with a contraceptive pill will give you a great result. It will also give you contraception, so for many young women it is a great way to kill two birds with one stone, so to speak!
Isotretinoin (oratane)—this is reserved for people whose acne hasn’t responded to other treatments. It requires regular monitoring of your liver with blood tests, and is more likely to cause side-effects than the other options. However, if you have tried everything else, this treatment is well worth exploring.
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