Acne - what's new? | Expert Guide from the Dailymail

( - In this, the final part of our unique HOW TO BEAT series, we have worked closely with experts in each field of dermatology to bring you cutting-edge information about your complaint and the newest treatments available. It could be life-transforming.

More than half of all women over the age of 25 suffer some form of facial acne and as with teen acne, it is triggered by hormonal changes. In both age groups, high levels of the hormone testosterone cause the oil glands to pump out excess oil, blocking pores and causing pimples. Acne sufferers also appear to have more propionic bacterium (p. acnes) on their skin, which colonises the hair follicles leading to the blockages that cause the acne breakouts.


The first step is over-the-counter acne treatments containing benzoyl peroxide, a mild bleach which removes the top layer of skin, unblocking pores and has an antiseptic effect on the surface bacteria that cause acne (try Quinoderm, Panoxyl and Acnecide, from around £2).

Washes and creams containing salicylic acid (such as the Proactiv + range from Boots, from £19.99) slow the shedding of cells inside the pores which cause clogging and pimples. Repeated studies have found that products containing salicylic acid at concentrations of 2.5 per cent can be effective against acne spots.

For many decades antibiotics have been prescribed for acne, to destroy the bacteria on the skin. However concerns about antibiotic resistance mean GPs are more likely to prescribe higher strength benzoyl peroxide in combination with a mild topical antibiotic or vitamin A cream, which help remove the top layer of the skin so unblocking pores.

Women can be prescribed the contraceptive pill Yasmin or Dianette which can block the increased testosterone that causes acne, but the spots frequently reappear when they later come off the Pill.

Dermatologist Dr Nick Lowe says a newer drug called spironolactone, used mainly as an anti-blood pressure medication has been found to have the same testosterone-blocking effects on acne, without the risks. This is available on the NHS, but only to women (it has ‘feminising effects’ such as reducing hair growth on the body), and is usually prescribed when acne appears as a consequence of Polycystic Ovarian Syndrome — a hormonal disorder where women’s bodies produce too much testosterone.

Another option is light therapy (see box , right). For severe acne and as a last resort, a dermatologist can prescribe strong medication called isotretinoin (perhaps best known by the brand name Roaccutane) which reduces the action of the oil glands and the bacteria that cause acne, and which can also help reduce the formation of scarring.

However, side-effects can include back pain, extreme drying out of the skin, lips and scalp, muscle pain, hair loss and in rare cases psychiatric problems; women taking the drug must also take the Pill to avoid pregnancy as the drug can cause birth defects.

‘For about 95 per cent of patients who go onto isotetinion, their acne will clear,’ says Dr Anthony Bewley, consultant dermatologist at Bart’s and the London NHS Trust. Some doctors are now using lower doses for four to six months to ensure the side-effects are not too severe, monitoring patients with the option to put them on a further dose later on if required. It might also be worth thinking about your diet.

‘We used to say diet was irrelevant in acne but that advice has changed recently,’ says Dr Neil Walker, a consultant dermatologist at the Stratum Clinic, Oxford and Lister Hospital, London. ‘But a substantial number of studies now show diets with a high glycaemic index (sugary foods that are absorbed into the bloodstream quickly) and a diet high in dairy may have an influence after all.

A review published last year by New York University of 50 years of studies, suggested eating foods with a high GI and drinking milk not only aggravated acne but in some cases triggered it, possibly because they trigger hormonal fluctuations.

‘There is evidence a low glycaemic load diet (wholegrains and vegetables) may significantly improve the number of spots,’ says Dr Walker.

The experts’ favourite products: For mild to moderate acne Dr Gach recommends La Roche Posay’s Effaclar Duo, £15.50 (an everyday moisturising cream with salicylic acid to reduce the build up of dead skin); Dr Bewley suggests Clearasil Ultra Rapid Action Treatment Cream (with salicylic acid) £4.26 as a spot treatment, morning and night.

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