Code red

Most people are horrified to discover their first wrinkle. Our skin – especially for women – is incredibly important for our self-image. So spare a thought for those who suffer from acne or rosacea.

According to experts most people are thought to suffer from acne at some point during their lives – typically during their teens. But while it's widespread among youngsters going through puberty, acne is also thought to affect around five percent of women and one percent of men over the age of 25.

Rosacea, on the other hand, is estimated to affect up to one in 10 people. And this time the symptoms are more likely to start between the ages of 30 and 50. Either way, the psychological effects of having acne or rosacea – especially when it affects the face – can be distressing, to say the least.

If either problem affects you, here's our guide to what they are, what causes them and how your pharmacist can help you cope.

What is acne?

Most people have experienced the odd zit or two, especially when they were in their teens. But acne is a chronic condition that affects the skin, usually on the face (in 99 percent of cases), back (60 percent) and chest (15 percent). It can cause blackheads, whiteheads, pustules and hard, painful lumps under the skin. And when your skin is also red and swollen, you may have inflammatory acne.

If you're lucky your acne will only be mild. But many suffer from moderate or severe acne, and that can really affect your self-esteem.

Girls tend to suffer most from acne when they are between the ages of 14 and 17, with boys getting spots when they are slightly older, from 16 to 19 years old. Things often get better as you get older, though – as the number of people with adult acne suggests – becoming an adult doesn't always mean your skin will improve.

What causes acne?

You get acne when your pores are blocked with excess oil that’s mixed up with dead skin cells. Normal amounts of oil, which is produced by the sebaceous glands, help moisturise the skin; but when these glands are affected by a rise in hormones called androgens, they go into overdrive. So the pores get blocked and, if there’s bacteria present, you get spots.

Unfortunately for teenagers, larger-than-normal levels of androgens are triggered during puberty, which explains why so many teens get spots

How do you treat acne?

If your acne is mild, give the following a try:

• Products with an ingredient called benzoyl peroxide will help dry up spots and kill the bacteria that cause them. Ask your pharmacist to help you choose a suitable benzoyl peroxide-based gel or cream.
• Another ingredient to look out for is salicylic acid, which is thought to help unblock pores and prevents scarring. Again, your pharmacist can help you choose a cleanser that contains salicylic acid.
• Tea tree oil, dabbed neat onto spots, may also help.

If you suffer from more severe acne, your GP can advise you on the prescription medicines that are available, including antibiotics in cream, gel or tablet form, retinoid gels or creams or azelaic acid creams. In severe cases, you may be advised to use a gel or cream as well as tablets.

The main thing to realise is that there are many different treatments available, so don't suffer in silence. Ask your pharmacist for advice on products that might help. Your pharmacist can also recommend that you see your GP for prescription treatments if your acne is more than just mild.

What is rosacea?

Flushing, redness, noticeable blood vessels and even spots are symptoms of the skin condition rosacea, which affects twice as many women as men, usually those with fair skin. Other symptoms include a burning or stinging sensation, swelling, and dry skin, as well as red patches known as plaques.

Flushing – which is when your skin turns red – is usually the first symptom to appear, with more severe cases also including thickening of the skin, usually on and around the nose. It also tends to come and go, with sufferers experiencing periods when their symptoms are particularly bad, followed by periods when their skin is much calmer. 

And as with acne, people who have rosacea may also suffer from low self-esteem and embarrassment as a result of their condition.

What causes rosacea?

Experts aren't really sure what causes rosacea. Some think abnormalities in the blood vessels of the face may be to blame, while others suggest it's a genetic problem, since rosacea can run in families.

What we do know, however, is that many things can trigger rosacea symptoms, including stress, heat, cold, sunlight, alcohol, spicy foods, wind, high blood pressure and even things like drinking caffeine or taking a hot bath. Some medicines are also thought to trigger rosacea, including the type of medicine often used to treat high blood pressure.

How do you treat rosacea?

There is no cure for rosacea. However treatments are available that might help you manage your symptoms. Avoiding whatever triggers your rosacea is a good place to start – if exposure to sunlight causes a flare-up, for instance, ask your pharmacist to recommend a suitable sunscreen product that you can wear all year round.

Other products available over the counter at pharmacies include gentle skincare products such as soaps, cleansers and moisturisers that may help reduce redness in sensitive skin. However, avoid skincare products that are harsh or abrasive – skin scrubs, for instance, may make your symptoms worse.

There are also a number of treatments your GP can prescribe if your rosacea is more than mild, including antibiotic creams, gels and tablets and topical products that contain metronidazole and azelaic acid. Your pharmacist can advise you about these products, but you will have to see your doctor if you want to try them.

• For more information on acne, rosacea and other skin problems, visit the website of the British Association of Dermatologists at www.bad.org.uk

Spot check

If you have acne, here are some additional tips on how to manage it:

• Don’t touch your spots. This is likely to result in the skin being damaged, and the spot can last much longer than if it had been left alone.

• Take a daily supplement of zinc or a multivitamin and mineral tablet to maintain your general wellbeing (ask your pharmacist to recommend a supplement that would be suitable for you).

• Don’t stop eating chocolate. It’s a myth that eating chocolate and fried foods give you spots. But a good diet with lots of fresh fruit and vegetables will help in the long run.

• Use make-up that’s labelled non-comedogenic. That means it won’t block your pores. And thoroughly wash your make-up brushes and sponges regularly to avoid spreading bacteria. Wait for 20 minutes after using any acne treatment before applying make-up, and remove it thoroughly at night.