AT YOUR FINGERTIPS A CNE ‘By far the best book I have read on the subject’ Peter Lapsley, Chief Executive, Skin Care Campaign Dr Tim Mitchell and Alison Dudley Acne ayf Final 31/10/02 12:36 pm Page i Comments on Acne – the ‘at your fingertips’ guide from readers ‘Over all splendid – and I learnt a lot.’ Dr Stephen Kownacki, General Practitioner and Secretary of the Primary Care Dermatology Society ‘I will recommend it to my patients.’ Jane Watts, Dermatology Nurse Practitioner, Department of Dermatology, King George Hospital, Essex ‘Good tips and an interesting read.’ Polly Bealby, a teenager with personal experience of acne Acne ayf Final 31/10/02 12:36 pm Page ii Acne ayf Final 31/10/02 12:36 pm Page iii ACNE The ‘at your fingertips’ guide Dr Tim MitchellMBChB, DRCOG, DPD General Practitioner, Montpelier Health Centre, Bristol; Founder Member and Secretary of the Primary Care Dermatology Society; Advisor to the Associate Parliamentary Group on Skin and Alison Dudley Chief Executive of the Acne Support Group; Founder Member and Director of the Skin Care Campaign CLASS PUBLISHING • LONDON Acne ayf Final 31/10/02 12:36 pm Page iv Text © Tim Mitchell and Alison Dudley 2002 © Class Publishing (London) Ltd 2002 All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by and means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of the above publisher of this book. The right of Tim Mitchell and Alison Dudley to be identified as the authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. Printing history First published 2002 The authors and publishers welcome feedback from the users of this book. Please contact the publishers. Class Publishing, Barb House, Barb Mews, London, W6 7PA, UK Telephone: 020 7371 2119 [International +4420] Fax: 020 7371 2878 Email: [email protected] Website: www.class.co.uk The information presented in this book is accurate and current to the best of the authors’ knowledge. The authors and publisher, however, make no guarantee as to, and assume no responsibility for, the correctness, sufficiency or completeness of such information or recommendation. The reader is advised to consult a doctor regarding all aspects of individual health care. A CIP catalogue record for this book is available from the British Library ISBN 1 85959 073 X Edited by Gillian Clarke Typeset by Martin Bristow Cartoons by Jane Taylor Diagrams by David Woodroffe Indexed by Valerie Elliston Printed and bound in Finland by WS Bookwell, Juva Acne ayf Final 31/10/02 12:36 pm Page v Contents Foreword by Peter Lapsley ix Acknowledgements xi Introduction xiii CHAPTER 1 What is acne? 1 Introduction 1 Comedones 3 Inflamed spots 5 Nodules and cysts 6 Getting acne 7 ‘Grading’ your acne 13 Hormones and acne 15 CHAPTER 2 What causes acne? 17 Introduction 17 Who gets acne, and why? 18 A word about hormones 21 What doesn’t cause acne 24 CHAPTER 3 You and your doctor 28 Introduction 28 Helping your doctor to help you 29 When you and your doctor have a problem 33 v Acne ayf Final 31/10/02 12:36 pm Page vi vi Acne – the ‘at your fingertips’guide CHAPTER 4 Treatment from your GP 40 Introduction 40 The different types of treatment 41 Topical treatments 42 Tablet treatments 46 Using the treatments 48 Associated problems 53 Things that don’t work! 58 Squeezing spots 60 CHAPTER 5 Specialist treatments 63 Introduction 63 Referral to a dermatologist 64 Isotretinoin (Roaccutane) 65 Other treatments 70 CHAPTER 6 The physical scars 73 Introduction 73 Extra skin tissue (raised scars) 74 Loss of skin tissue (sunken scars) 74 Treating scars 76 CHAPTER 7 Emotional scars 84 Introduction 84 You and your acne 87 The family 94 Friends 97 At school or work 98 CHAPTER 8 Complementary and alternative treatment 100 Introduction 100 Safety 102 Aromatherapy 105 Reflexology 105 Acne ayf Final 31/10/02 12:36 pm Page vii Contents vii Hypnotherapy 106 Homoeopathy 106 Autogenic training 108 Other approaches 109 CHAPTER 9 Sex, growing up and practical concerns 113 Introduction 113 Hormones, sex and pregnancy 115 Work prospects 117 Costs of NHS prescriptions 119 Other concerns 120 CHAPTER 10 Skin-care 122 Introduction 122 Skin-care and make-up products 125 Moisturising 128 Camouflage 130 Other products 131 CHAPTER 11 Research and future treatments 134 Introduction 134 Where we are now 135 Research for new treatments 137 GLOSSARY 140 APPENDIX 1 Useful addresses 145 APPENDIX 2 Useful publications 151 INDEX 153 Acne ayf Final 31/10/02 12:36 pm Page viii Acne ayf Final 31/10/02 12:36 pm Page ix Foreword This book makes an outstanding contribution to the subject of acne. It is down-to-earth and packed with common sense, as you would expect from two such experienced and well-qualified authors as Alison Dudley, Chief Executive of the Acne Support Group and a founder member and Director of the Skin Care Campaign, and Dr Tim Mitchell, a GP at Montpelier Health Centre in Bristol with a special interest in dermatology. It answers all the questions you may have on the subject of acne, giving straightforward answers to questions asked by people with acne and their families. The question-and-answer format makes it very easy to dip into the book and find the answer to any question on acne – but then you will almost certainly find yourself reading on and discovering much more. It is comprehensive, coherent and accessible – by far the best book I have seen on the subject. In addition to being an invaluable guide for people with acne and those close to them, I believe it is an essential work of reference for health professionals, especially GPs and practice nurses, many of whom are taught too little about skin diseases. Peter Lapsley Chief Executive, Skin Care Campaign ix