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There’s no scientific proof washing face with urine’ll clear acne – Dermatologist

The Punch logo The Punch 04/12/2021 The Punch
Published 5 December 2021

A consultant dermatologist at Federal Medical Centre, Abuja, Dr Haroun Adamu, discusses acne, in this interview with TOLUWALOPE KAREEM

What is acne?

Acne is a very common skin condition that occurs as a result of pores on the skin getting blocked by dead skin, oil and by bacteria. This results in all types of pimples, whether white heads or black heads. It is quite common. About 80 per cent of people between the ages of 11 and 30 years would develop acne at some point in their lives.

What are the causes of acne?

The underlying cause of acne is the blockage of pores or holes on the surface of the skin by accumulated oil, bacteria and dead skin. People believe that things like chips, milk, chocolates contributes to acne, but there is no scientific proof for that. However, there are certain changes that may occur in one’s life that can contribute to having breakouts of acne or pimples and this include hormonal changes that take place as a child goes into puberty. Also, use of hormonal medications like contraceptives, eating sugary foods. Generally, all these can trigger acne. Pregnancy, which is associated with hormonal changes, can help trigger acne.

How is it diagnosed?

Acne is usually diagnosed by what we doctors call clinical assessment. The doctor examines the skin and looks for signs of pimples, like the black head, nodules etc, or even scars related to acne. A test is hardly necessary to diagnose acne.

How best is acne treated?

There are many methods of treating acne. Most times we use a combination of two or three methods. We make use of topical creams, topical or oral antibiotics or hormonal tablets. Sometimes we combine these treatments with chemical peels or we use light therapy. Acne is treated on an individual basis, based on severity. Some are mild, some are associated with pigmentation, some are associated with scars and some develop keloids as a complication.

All forms of acne are treatable, although certain forms of acne can be challenging such as hormonal acne, nodular acne, pustular acne, and certain forms of treatment might not be successful, but when you take all the available forms of treatment, whether creams, tablets, antibiotics, hormonals, chemicals, you can hardly find a type of acne that is not treatable. There can be challenges with treatment of some types of acne, especially if for one reason or the other you are not able to use one or more of the forms of treatment that we have. In that case it can be a challenge. For instance, if you react to a certain tablet because of some medical condition you are not able to take a tablet or use certain creams because you have sensitive skin. With the service of a professional and trained dermatologist, you’ll be able to overcome the condition.

How long does it take to get it treated?

The time it takes to treat acne varies; you need to give it time to work, four weeks at least. It can be shorter, but the usual period is four to six weeks to see improvement. It can also take up to three months; it is highly variable depending on the severity and nature of acne.

If acne is not treated, can it go away on its own?

Yes, a lot of acne does go away on its own especially when the person passes puberty, it heals and goes away on its own, but remember a lot of people also carry their acne into adulthood. There is acne that starts from adulthood, i.e. the people that didn’t have acne as adolescents, but develop it now during adulthood.

What are the factors that make acne worse and people do not know off?

There are factors that can make acne worse which people are not aware of. Such factors including frequent changes in creams or medications especially in the context of self-mediation. Doing this puts the skin under pressure. Another thing is improper removal of makeup or the use of hair cream or ointment used can roll down to your forehead and face and cause acne. Other factors that can trigger acne are hair removal; foods that are high in carbohydrates and sugary food. Other factors are Heavy makeup, excessive use of skin care products and anti acne treatment.

Is it true that factors such as stress, makeup, greasy foods, dirty skin can cause acne?

The truth is stress, makeup, greasy food, dirty skin can trigger and worsen acne. Stress worsens acne by increasing your stress hormone level and can block the pores. Heavy makeup would not allow the skin to breathe, and that can worsen acne. For greasy food and dirty skin, of course, when you don’t wash your skin, the dirt and bacteria would accumulate and this can block your pores spaces and worsen acne. They are not really myths; they can contribute to and worsen your acne.

People have said using urine to wash their faces cures acne, how true is this?

Scientifically, I am not aware that washing your face with urine can cure acne; people who do that should best avoid such practices, and there are dermatologists that are trained in the care and treatment of acne. If you have acne, you should see a qualified and trained dermatologist to manage your acne. There is absolutely no proof of that and I don’t think it is healthy, so people should deviate from such practices. Urine is a waste material from the body and should not be used as a treatment for acne or any other medical condition.

How true it is that aloe vera, apple ciders are effective in treating acne?

Well, aloe vera has a potential role to play in clearing the skin and preventing acne; it calms and hydrates the face. But standing alone on its own is not certain it can cure acne. There is no scientific evidence that apple cider vinegar can treat acne. It contains acids like lactic acid, acetic acid etc. That may theoretically make it useful for killing propionibacterium acnes, the bacteria involved in causation of ace. But practically, using ACV to treat acne, especially at home, only predisposes the user to irritation and burns when used in high concentration.

How effective is self-care effective in the treatment of acne?

Self-care for mild acne can work if the carrier is adequately informed about the dos and don’ts and if the products used over the counter are ethical and scientifically proven for effectiveness. The best results are, of course, always obtained by consulting a dermatologist.

A lot of people go through emotional and mental stress because of acne; what do you advise?

It is true that severe acne, even mild acne, has a lot of effects and can impact on the quality of life and the way the person perceives him or herself. It can lead to anxiety and depression, but it shouldn’t be so. Acne in most cases is treatable; it is important that people who suffer from acne seek treatment from qualified professionals to alleviate the mental stress and restore their self-confidence.

Acne makes some people lose self-esteem or feel stigmatised; what is your advice for them?

Acne sufferers should not feel stigmatised, they should channel their energy and resources into getting the best available treatment and care for their skin. There is no need for the feeling of stigmatisation. Consult with a dermatologist, be patient with your treatment and that acne can be overcome. More challenging, of course, is the acne scars that follow after treatment, but acne itself should not cause stigmatisation. Yes, it is true that sufferers feel a low self-esteem, anxiety, depression, loss of confidence and this has been proven in several studies, both within and outside Nigeria. Our society places great emphasis on looks and acne on the face is difficult to hide. You find acne sufferers avoiding reunions, avoiding group photographs or “selfies”. This shouldn’t be. Find a dermatologist who understands your emotional anguish and addresses them with empathy as your acne gets treated.

What are some of the basic tips to prevent acne?

There are certain basic tips that can help prevent acne, such as cleanliness and regular exercise. If you have discovered any food that tends to worsen your acne, you should avoid them. Repeated touching of your face and popping of pimples is not good, it makes it worse. Do not go to bed with your makeup on. Avoid excessive use of acne medication, jumping from one set of medication to another without medical supervision. Avoid using unknown or unproven mixed creams. Seek professional help when you have acne.

Can acne be genetic?

Certain inherited factors can make one susceptible to the development of acne. An example is Polycystic Ovary Syndrome, which leads to hormonal imbalance. This can run in families and when you inherit this syndrome you also have a high tendency to develop acne that is associated with PCOS. The PCOS is a metabolic hormonal imbalance that’s complex but one of its manifestation is the development and disposition to acne. One can also inherit an immune system that is unable to handle the bacterium implicated in the constitution of acne. If you inherit an immune system that is unable to handle it, then you may be predisposed to acne. Again, there are chances that if you have one or both of your parents having or have had acne, there is a tendency you will have acne, too. But in terms of a direct genetic transfer or a direct gene that will predispose you to acne, there is no such gene. Your having acne is an interplay of multiple factors.

Does acne have any relationship with age?

Yes, there is a relationship with acne and age. Girls start to have acne between the ages of 14-17, and boys have theirs between the ages of 16-19. Of course, people have acne for a number of years before it begins to clear. Mostly acne begins to disappear when a person is in their mid-20s, in some cases acne can proceed to adulthood. There are cases of acne that commences at adulthood in the 30s and sometimes 40s.

What happens if acne is not treated?

It may go away, it may worsen and it may lead to scaring, pigmentation or keloids, it depends.

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