Acne sufferers need to drink loads of water - between six and eight glasses a day. Acne is the scourge of teenagers, but a good diet and trial and error with natural and pharmaceutical products can help. Angie Mezzetti reports
Acne is a year-round problem but it isn't as easy to hide in the summer when teenagers like to shed layers of clothes, play sports and go swimming. Exams and emotional stresses can also add to the problem, but there is hope from the medical profession, pharmacists and alternative and complimentary therapists.
"My son drinks plenty of water, eats a healthy diet with lots of fruit and veg and yet I still have to get him antibiotics for his acne." Teresa's boy is now a young man and, like so many others, would like to be rid of the recent outbreak of pimples on his neck and back.
"I bought a huge pack of herbal stuff in the RDS last year," she says "but it didn't do any good." Most mothers and sons and daughters would rather go down the natural route. But despite their best efforts, the likelihood is that most teenagers will encounter spots and pimples during puberty and their 20s.
Dr Alan Irvine, a consultant dermatologist at St James's Hospital and Our Lady's Hospital for Sick Children in Crumlin, says skin pimples and acne generally occur during puberty and are most severe among boys. "Acne is primarily a disease of the hair follicle. It occurs when the opening of the hair follicle becomes occluded or blocked and this leads to a build-up of sebum \. During puberty, sebum production increases dramatically and so the propensity for acne in this age group increases. These blocked hair follicles can become infected leading to pustules or pus-filled areas. If these nodules get bigger and rupture, they can cause scarring from the inflammation. Exams can be a factor in the occurrence of acne not only because of stress, but because kids are more likely to pick at their faces during study times."
Pharmacist Jacqui Hayden of the Maple Pharmacy, Navan Road, says a lot of teenage boys come into the chemist. "The first line of action is cleansers and washes. The boys, some as young as 12, generally want soaps and washes. For girls, we recommend cleansers and toners for acne prone skin."
Their biggest seller for teenagers is Effaclor gel and cream because it is non-drying. After cleansing, an oil-free moisturiser (non-comedogenic) is advised - that is non-blackhead forming. "For actual spot treatment, something like Quiniderm is good and there is also Panoxyl, this comes in two strengths. Bensoil Peroxide we recommend starting off slowly and lightly as it may cause peeling and burning if applied too thickly in the beginning," Hayden says.
Alternative therapist Barbara O'Donovan says she is seeing changes in recent years in the type of clients who come to her for acne treatments. "It isn't always the teenagers and I have even treated women in their 40s.
"Young people eat a lot of sugars, fried foods and Chinese food which I recommend they cut out. Acne sufferers need to drink much more water - between six and eight glasses per day. With sport, dancing and all the running around they do, teens sweat a lot and are better off wearing cotton and natural fabrics. Bath salts, sprays and deodorants are not good either," she says.
The aromatherapy treatments she uses are diluted tea tree essential oil - eight drops to 20 millimetres of base oil such as grape seed oil (available in supermarkets) or almond oil. Although tea tree oil is natural, it is not gentle and should never be used neat. For clearing out the toxins from the skin, O'Donovan recommends a massage with Rosemary and Geranium essential oils, again diluted well.
Family doctors usually start a patient off with a three-month supply of antibiotic tablets. A course is often combined with a skin gel or lotion. Each patient will need his or her own tailored treatment. However, if a form of acne is proving resistant, the person will be referred to a dermatologist.
Dr Irvine says antibiotics are useful to treat infection and they may also have an anti-inflammatory role. However, there is increasing resistance to antibiotics.
According to Dr Irvine, "Time is an important factor because if the pustules and nodules are not treated effectively, scarring may occur. In conjunction with antibiotics, topical vitamin A analogues [these are called retinoids\] have an important role in reducing the production of grease."
Dr Irvine says there has been a change in recent years in the profile of the typical patient. More women are now getting acne and the age is tending upwards into the 20s. The contraceptive pill is also used as a treatment for women as there is a relationship with testosterone levels, as this drives up the sebum level.
Brian Kennedy, a homeopath based in Kilkenny, says a common sense approach tells you that a diet with plenty of fresh fruit and vegetables is very important. However, when acne gets endemic, the diet has less effect. Although homeopathic remedies are available over the counter, a DIY approach is not advisable as everybody reacts to treatments differently and sometimes a condition gets worse before it gets better. Kennedy says an effective option in organic treatments is a range by Dr Hauske. It makes natural washes to improve the skin. Calendula is often recommended by homeopaths because it promotes healing and is a natural antiseptic.
Dr Brendan Fitzpatrick, who combines conventional with complimentary medicine, says diet is more a factor in older age groups with late onset acne. "If they present with yeast infections, thrush, irritable bowel or dandruff, I look for dietary factors first which may indicate other signs of food intolerance."
In young people he finds hormonal factors are important. He typically adds in zinc or vitamin E in capsule form into the patient's diet but individual dosage has to be tailored. For women with acne associated with premenstrual problems, he finds agnus castus helpful.
All types of treatment practitioners agree on the necessity of getting individually tailored treatment from a qualified and registered practitioner. Doing nothing may lead to long-term scarring.