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Acne...bumps and blues...



Almost every adolescent has a few “spots” at some time or another, but approximately 15% of them have acne so severe that it warrants a trip to their GP. Studies suggest there is a strong association between Acne and Polycystic Ovary Syndrome (Raja et al., 2018). Acne is characterised by blackheads, whiteheads and pus-filled spots or pustules. Acne usually starts at puberty and can be found on the face, neck, back and chest. The more severe cases can cause scarring and impact on self-confidence. Normally, it settles by late teenage years or early twenties but it can persist in some cases (Acne | British Skin Foundation, n.d.).

Acne is caused by the production of excess oil by sebaceous glands. Over time there is a build-up of the oil and the dead skin cells. This build-up creates an environment where bacteria can thrive which triggers inflammation and the formation of red or pus-filled spots. This can happen without having PCOS but if you also have unusual hair growth or hair loss and irregular periods then it may be an indication of PCOS (Acne | British Skin Foundation, n.d.).

Treatments for acne include topical treatments, antibiotics, oral contraceptive pills, and other medications. The pill may be contradicted for some women such as those who smoke or those at risk of clots. It can cause migraines for some too. An alternative is isotretinoin treatment (Roaccutane ®) which has been found to have beneficial effects on free testosterone, insulin, acne and hirsutism but it is important not to get pregnant while taking this medication (Acmaz et al., 2019). Isotretinoin can harm an unborn child and there are strict prescribing rules for the drug. Women usually enrol in a pregnancy prevention programme and must test negative before treatment and are tested every month during treatment and five weeks after their last course of treatment. Its also important to use contraception for at least four weeks prior to treatment, while on it and four weeks after (Acne | British Skin Foundation, n.d.). You can read a patient information leaflet on the following website http://www.bad.org.uk/for-the-public/patient-information-leaflets/isotretinoin (British Association of Dermatologists - Patient Information Leaflets (PILs), n.d.).

Scars as a result of acne are difficult to treat. Generally, it depends on local commissioning funding and you need a referral to a dermatologist/plastic surgeon familiar with treating scars. Treatments depend on the type of scars you have and may include ablative lasers, punch excision of small atrophic scars, resurfacing, scar revision, collagen injections, silicone gels or pulsed dye laser (only via specialised hospital departments) (Acne vulgaris | Primary Care Dermatology Society | UK, n.d.).

As well as being important to seek help early, to avoid scarring, it is important for your self-esteem and wellbeing too. Studies have shown that acne can negatively impact your self-esteem. Dermatologists are trained to manage acne and can help provide early treatment that improves both the physical and psychological effects of it on you, so don’t hesitate to seek help (Gallitano & Berson, 2018).

© PCOS Vitality, 2020

Not Medical Advice, always speak to your GP/Healthcare provider.

REFERENCES

Acmaz, G., Cinar, L., Acmaz, B., Aksoy, H., Kafadar, Y. T., Madendag, Y., Ozdemir, F., Sahin, E., & Muderris, I. (2019). The Effects of Oral Isotretinoin in Women with Acne and Polycystic Ovary Syndrome. BioMed Research International, 2019. https://doi.org/10.1155/2019/2513067

Acne | British Skin Foundation. (n.d.). Retrieved February 16, 2020, from https://www.britishskinfoundation.org.uk/acne

Acne vulgaris | Primary Care Dermatology Society | UK. (n.d.). Retrieved February 16, 2020, from http://www.pcds.org.uk/clinical-guidance/acne-vulgaris

British Association of Dermatologists - Patient Information Leaflets (PILs). (n.d.). Retrieved February 16, 2020, from http://www.bad.org.uk/for-the-public/patient-information-leaflets/isotretinoin

Gallitano, S. M., & Berson, D. S. (2018). How Acne Bumps Cause the Blues: The Influence of Acne Vulgaris on Self-Esteem. In International Journal of Women’s Dermatology (Vol. 4, Issue 1, pp. 12–17). Elsevier Inc. https://doi.org/10.1016/j.ijwd.2017.10.004

Raja, S. A., Prasad, P. V. S., & Kaviarasan, P. K. (2018). Prevalence and pattern of PCOS in women presenting with acne, a hospital based prospective observational study. International Journal of Research in Medical Sciences Raja SA et Al. Int J Res Med Sci, 6(3), 899–903. https://doi.org/10.18203/2320-6012.ijrms20180611

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