PRINT AN INFORMATION SHEET

WHAT IS IT?
Acne (pimples) is a very common skin condition that affects most school students at some stage. Although it is most common in secondary school students, it can occur in primary school students.

Because acne is so common, many people think of it as a normal part of growing up. However, acne can have serious effects on the way a young person performs at school and acts socially.

A pimple begins as a blockage to a sebaceous (oil) gland duct. This usually starts at puberty when certain hormones (androgens) are released. The hormones cause the sebaceous glands to overproduce sebum (oil). We normally have dead skin cells and bacteria on the surface of our skin, which can combine with the sebum to form a plug in the hair follicles, resulting in a blackhead (comedone).

What happens then all takes place under the skin. Even though the sebaceous gland duct is blocked, oil continues to be produced and the gland keeps getting bigger and bigger, a bit like a balloon. Bacteria grow in the blocked gland and produce fatty acids and other very irritating substances. Eventually the balloon bursts and releases the irritating material. This causes intense inflammation (swelling) which is what we see as the pimple.

Acne usually occurs on areas where there are large numbers of sebaceous (oil) glands such as the face, neck, chest, back and shoulders.

WHAT CAUSES IT?
Although we do not know the exact cause, there are many things which can lead to acne and these vary from person to person.

Acne does not usually develop until puberty when the hormones which stimulate oil glands are first produced. These hormones include testosterone (a type of androgen) and progesterone. Acne usually appears earlier in females than males, because females tend to start puberty earlier. Males often have more severe acne than females, as they have much higher levels of testosterone.

Acne can be made worse by certain skin products such as cosmetics and sunscreens. Some products contain oils which can increase the blockage in the oil glands. People with acne should avoid using oil-based products.

There is no proof that chocolate, fatty or fried foods, dairy products, cakes or sweets can cause acne or make acne worse. For most people with a healthy balanced diet, eating the occasional chocolate or sweet does not seem to make any difference to their acne.

Cycle of a pimple

MYTHS ABOUT ACNE
Most people have been given advice on how to avoid acne or treat acne, such as "get plenty of sun", "don’t worry about it – everyone gets it and it’s a normal part of growing up". While those providing the advice are trying to help, there are many myths about acne. The following list provides examples.

•	Eating chocolate causes acne.
•	Acne is related to a bad diet.
•	Acne is an infection and can be spread from one person to another.
•	Acne is an allergic reaction to something.
•	All types of make-up cause acne.
•	Acne is due to lack of cleanliness.
•	Acne is caused by oily hair.
•	Blackheads are dirt trapped in the skin.
•	Squeezing pimples will make them spread.
•	Lying in the sun or using a sun lamp will clear acne.

HOW IS IT TREATED?
There are some very effective treatments for acne. The treatment used varies between individuals and depends on the type of acne. Treatment for acne usually needs to be used for at least one to two years. However, some people with minimal acne may not require any treatment at all.

For primary school students, most of the acne when it first occurs can be treated by applying topical preparations such as creams, lotions or gels to the skin. These are available from the chemist/pharmacist without a prescription. Topical preparations need to be used on all areas of the skin where acne tends to occur, not just on the inflamed spots present today. The aim is to prevent future spots appearing.

Acne that does not respond to treatment with preparations from the chemist/pharmacist may require treatment prescribed by a doctor in addition to the topical products.

Severe acne including nodules, cysts and scarring may require treatment by a skin specialist to prevent both the pimples and long term scarring.

WHAT DOES IT LOOK LIKE?

Mild acne on the side of the face.	Moderate acne on the face with some scarring.	Severe acne on the face with some scarring.

© 2002, Department of Dermatology, St. Vincent’s Hospital Melbourne, Victoria Parade, Fitzroy, Victoria 3065 Australia.