WEBVTT 00:00:08.599 --> 00:00:12.000 Acne is very common among teenagers. 00:00:12.000 --> 00:00:15.863 It occurs much more rarely in adults. 00:00:15.864 --> 00:00:19.000 Almost everyone gets acne during puberty 00:00:19.000 --> 00:00:23.910 but most teens experience the mild form. 00:00:23.911 --> 00:00:29.629 Up to one third of people get moderate to severe acne. 00:00:29.630 --> 00:00:32.000 Compared with regular spots, 00:00:32.000 --> 00:00:35.000 acne spots take longer to develop 00:00:35.000 --> 00:00:37.669 and are harder to get rid of. 00:00:37.670 --> 00:00:39.583 With the mild form, 00:00:39.584 --> 00:00:42.910 the spots are few in number or small in size. 00:00:42.911 --> 00:00:45.056 However, moderate and severe acne 00:00:45.057 --> 00:00:47.575 cause many more spots 00:00:47.576 --> 00:00:50.235 and greater inflammation of the spots. 00:00:50.236 --> 00:00:53.235 Papules and pustules also form. 00:00:53.236 --> 00:00:58.823 Papules are bumps on the skin with no accumulation of pus. 00:00:58.824 --> 00:01:02.495 When pus builds up under the skin, it causes pustules. 00:01:02.496 --> 00:01:07.222 Severe acne also causes painful swellings called nodules, 00:01:07.223 --> 00:01:11.000 which often leave visible scars. 00:01:11.000 --> 00:01:13.000 The main cause of acne 00:01:13.000 --> 00:01:17.582 is the body's production of male sex hormones 00:01:17.583 --> 00:01:19.830 called androgens. 00:01:19.831 --> 00:01:23.000 Production of these increases during puberty, 00:01:23.000 --> 00:01:27.630 not only in boys but also in girls. 00:01:27.631 --> 00:01:32.055 These androgens stimulate the skin to produce more oil. 00:01:32.056 --> 00:01:35.395 Skin oil is also known as sebum 00:01:35.396 --> 00:01:38.716 and is produced by sebaceous glands. 00:01:38.717 --> 00:01:41.916 As well as increasing sebum, androgens also cause 00:01:41.917 --> 00:01:44.000 a build-up of horny skin cells. 00:01:44.000 --> 00:01:47.669 These may block the pores or openings of the glands, 00:01:47.670 --> 00:01:52.000 causing them to become clogged with sebum. 00:01:52.000 --> 00:01:54.596 This appears as a blackhead or whitehead on the skin. 00:01:54.597 --> 00:01:57.082 If the gland simply remains clogged with oil, 00:01:57.083 --> 00:01:59.682 this is known as non-inflamed acne. 00:01:59.683 --> 00:02:03.000 However, if the build-up of sebum becomes inflamed, 00:02:03.000 --> 00:02:05.950 this is called inflamed acne. 00:02:05.951 --> 00:02:09.776 Bacteria are often involved in the inflammation. 00:02:11.070 --> 00:02:13.342 Acne mostly occurs on the parts of the skin 00:02:13.343 --> 00:02:16.109 that have lots of sebaceous glands – 00:02:16.110 --> 00:02:21.000 the face, chest, back and shoulders. 00:02:21.000 --> 00:02:23.830 As some teenagers are unaffected by acne, 00:02:23.831 --> 00:02:26.308 it’s thought that its occurrence is influenced 00:02:26.309 --> 00:02:28.000 not only by androgen production, 00:02:28.000 --> 00:02:30.435 but also by genetic predisposition 00:02:30.436 --> 00:02:33.000 and the immune system. 00:02:33.000 --> 00:02:37.536 Certain external factors can make acne worse. 00:02:37.537 --> 00:02:39.000 These include: 00:02:39.000 --> 00:02:43.000 • certain skincare products that close the skin pores 00:02:43.000 --> 00:02:45.000 • vigorous skin rubbing 00:02:45.000 --> 00:02:48.000 • and squeezing of blackheads. 00:02:48.000 --> 00:02:51.589 Gentle oil-in-water emulsions, 00:02:51.590 --> 00:02:56.442 such as lotions or moisture-retaining gels (known as hydrogels) 00:02:56.443 --> 00:02:57.723 are recommended. 00:02:57.724 --> 00:03:02.000 Oil-containing ointments may also clog the pores. 00:03:02.000 --> 00:03:05.000 Also beneficial are soap-free cleansers 00:03:05.000 --> 00:03:09.015 that match the skin's pH value of 5.5. 00:03:09.016 --> 00:03:12.000 It's also important not to overdo it – 00:03:12.000 --> 00:03:16.000 excessive skincare may cause skin irritations. 00:03:16.000 --> 00:03:20.000 There are various acne treatment options. 00:03:20.000 --> 00:03:24.590 Almost all of these take some time to work. 00:03:24.591 --> 00:03:30.629 The chosen method depends on various factors, such as 00:03:30.630 --> 00:03:32.335 • the severity of the acne 00:03:32.336 --> 00:03:33.442 •the patient’s skin type 00:03:33.443 --> 00:03:36.242 • and the psychological impact the acne is having. 00:03:36.243 --> 00:03:40.135 Medicated treatments are available as creams or lotions 00:03:40.136 --> 00:03:44.000 with active ingredients to apply to the skin. 00:03:44.000 --> 00:03:47.542 For example, benzoyl peroxide, available without prescription 00:03:47.543 --> 00:03:50.242 or prescribed antibiotics. 00:03:50.243 --> 00:03:53.470 • Benzoyl peroxide encourages shedding 00:03:53.471 --> 00:03:55.743 of the uppermost horny layers of the skin, 00:03:55.744 --> 00:03:59.582 preventing the blockage of sebaceous glands. 00:03:59.583 --> 00:04:02.970 It also has an anti-bacterial effect. 00:04:02.971 --> 00:04:06.000 • Antibiotics also target bacteria. 00:04:06.000 --> 00:04:07.910 However, there is a risk 00:04:07.911 --> 00:04:11.000 that prolonged use may cause resistance, 00:04:11.000 --> 00:04:14.536 where the bacteria become insensitive to the active ingredient. 00:04:14.537 --> 00:04:17.623 Oral medication is normally only used 00:04:17.624 --> 00:04:20.135 to treat moderately severe to severe acne. 00:04:20.136 --> 00:04:24.000 This includes antibiotic tablets, retinoid tablets 00:04:24.000 --> 00:04:27.000 and hormone preparations. 00:04:27.000 --> 00:04:30.000 • Retinoids suppress sebum production 00:04:30.000 --> 00:04:33.950 and are among the most effective acne treatments. 00:04:33.951 --> 00:04:36.970 However, they also have the most side-effects 00:04:36.971 --> 00:04:39.642 and are normally only used 00:04:39.643 --> 00:04:41.829 after other treatments have failed. 00:04:41.830 --> 00:04:45.895 • Hormone preparations reduce the production and effects of androgens, 00:04:45.896 --> 00:04:49.000 so that fewer acne spots develop. 00:04:49.000 --> 00:04:52.096 They also act as contraceptives. 00:04:53.056 --> 00:04:54.915 To sum up: 00:04:54.916 --> 00:05:00.000 • Most people have acne during puberty, often in its mildest form. 00:05:00.000 --> 00:05:02.629 • Compared with regular spots, 00:05:02.630 --> 00:05:05.889 acne spots take longer to develop and to heal. 00:05:05.890 --> 00:05:07.615 • Acne is usually caused 00:05:07.616 --> 00:05:11.389 by increased androgen production during puberty. 00:05:11.390 --> 00:05:16.000 This causes clogged sebaceous glands, which often become inflamed. 00:05:16.000 --> 00:05:19.635 • Creams and tablets containing various active ingredients 00:05:19.636 --> 00:05:21.083 can be used to treat acne.