Mr Läuchli, what protects against spots?
Mr Läuchli, why do young people in particular suffer from acne?
Two processes in the body are responsible for the skin disease. On the one hand, the increased production of sex hormones during puberty causes the skin to produce more sebum. Sebum is important because this fatty substance forms a film over the skin and protects it from external influences. On the other hand, some people tend to form so-called horny cells in the duct of the sebaceous glands, which do not allow the sebum to flow out. As a result, the pores become clogged and blackheads develop, which can become inflamed.
The adverts are always talking about skin blemishes. Is acne the result of a lack of hygiene?
No, not at all. The black colour of blackheads comes from the skin pigment melanin and from a discolouration of the sebaceous plug. It therefore has nothing to do with dirt. Young people cannot prevent acne by frequently cleansing their skin. It is sufficient for them to wash their skin once a day with a cleansing lotion or synthetic soap.
Which factors are decisive for the development of acne?
Almost all girls and boys have blackheads or spots during puberty. The extent of horn cell formation and sebaceous gland activity is controlled by the genes. If both parents were affected by acne in adolescence, their child also has an increased risk of this skin condition.
«If both parents were affected by acne, their child also has an increased risk.»
Acne specialist, Severin Läuchli
Some young people try to protect themselves from acne by giving up chocolate, for example. Does this really help?
There is much speculation about the influence of diet on acne. We know that a diet high in simple carbohydrates and large amounts of dairy products can favour the development of acne. However, the influence of individual foods on the skin has not been scientifically proven. Young people therefore do not have to give up chocolate, nuts or salami. However, moderate consumption certainly makes sense.
Where does acne form?
Most frequently on the forehead, nose, chin and the V-shaped chest and back. There are particularly many sebaceous glands here.
What can favour acne?
Many teenagers try to squeeze out their pimples and blackheads. This promotes inflammation of the surrounding skin tissue, delays healing and increases the risk of scars. Today we also know that certain medications, such as cortisone, high-dose vitamin B supplements and anabolic steroids, promote acne. Highly oily skin care products and smoking also favour acne.
«Blackhead strips can irritate the skin. I advise against them.»
Severin Läuchli about blackhead strips
Blackhead strips are all the rage with young girls. What do you think of these products that promise to eradicate blackheads and cleanse deep into the pores?
The products not only remove the top layer of blackheads, but also additional skin when wiped off. They can irritate the skin. In addition, the blackheads form again immediately. I therefore advise against it.
What helps with blackheads?
Creams and gels with vitamin A acid help with both open blackheads, which can be recognised by the dark horny plug, and closed blackheads, which manifest themselves as small, skin-coloured bumps ; salicylic acid is also helpful in less pronounced cases.
How do you treat acne when pus-filled blisters or small nodules appear?
The creams or gels with benzoyl peroxide that are freely available in pharmacies have an antibacterial and anti-inflammatory effect, but only help with mild forms of acne. For pustules and papules, we recommend treatment with vitamin A acid, also known as retinoid, which has a mild peeling effect. For more severe forms, this can also be combined well with benzoyl peroxide or an antibiotic.
And apart from that?
In the most severe form of acne, where there are extensive inflammatory changes with large pustules and sometimes painful lumps, we usually use the active ingredient isotretinoin - especially if we are concerned about the development of scars. However, girls must never become pregnant during treatment because the substance damages the unborn child. Sometimes we also prescribe oral antibiotics. These are effective for inflammatory forms of acne, but should only be used for a limited period of time as the bacteria can become resistant if used for a longer period of time.
«Antibiotics help with inflammatory forms of acne, but should only be used for a limited time.»
Severin Läuchli, acne specialist
What do teenagers need to consider when treating the skin externally?
It is important that you not only apply the cream to the pimples, but to all areas of skin where you do not want new acne to develop. The treatment requires a little patience. The first results can be seen after four weeks at the earliest. Vitamin A acid preparations cause the skin to peel and form scales. This means that fewer horny cells can form and sebum can drain away better. Skin irritation is possible at the beginning of treatment. It is important that the skin is not irritated even more by peelings or sun exposure.
Can the contraceptive pill help with acne?
Yes, especially products that reduce the production of male hormones. This reduces the production of sebum. However, acne often reappears when you stop taking the pill.
Tips for acne:
Young people who suffer from blackheads and spots should:
- ihre Haut nicht mit zu fettigen Präparaten pflegen oder mit pudrigen Kosmetika abdecken, weil diese die Poren zusätzlich verstopfen können, was Akne fördert.
- ihre Haut einmal pro Tag sanft mit einer Reinigungslotion oder synthetischer Seife waschen.
- auf Blackhead-Masken oder Strips verzichten, weil sie die Haut irritieren und die Talgproduktion sogar ankurbeln können.
- keine Sonnenschutzmittel verwenden, die fetten. Besser sind Gels mit dem Hinweis «nicht komedogen». Ein mässiges Sonnenbad kann die Akne etwas verbessern.
- nicht an den Mitessern und Pickeln herumdrücken, weil sich dadurch die umliegende Haut entzünden und sich Narben bilden können. Mitesser und Pickel sollten nur von einer entsprechend ausgebildeten Kosmetikerin entfernt werden.
- aufs Rauchen verzichten.
- einen Hautarzt aufsuchen, denn fast jede Akne lässt sich behandeln. Die Beseitigung von Aknenarben ist hingegen schwierig.
