Vitamin D deficiency: This is an intracellular hormone that affects the balance of other hormones. When it is low, it can affect immunity, including how skin repairs itself and fights off bacteria. It also suppresses sebaceous gland activity and oil production.


What to do

“Acne usually gets better over a year or two, so the first line is to suppress the inflammation until the acne disappears,” explains Dr Adam Friedmann, leading dermatologist at The Harley Street Dermatology Clinic. “The more severe the disease, the stronger ¬the medication required.”

Discuss medication and whether the contraceptive pill might help with your doctor if you have hormonal acne. It’s worth asking to be referred to a ¬dermatologist, but this can be tricky on the NHS.


Acne types and treatment

“Acne is a complex process involving the blocking of the pore with ¬impurities, excessive oil, inflammation, P. acne (Propionibacterium acne) bacteria and a sluggish skin turnover,” explains Dr Loong. Adult acne occurs on cheeks (81%), chin (67%) and the jaw (58.3%).


The main spot types


Comedones

These are follicles clogged with oil and dead skin cells and they can develop into whiteheads and blackheads.

Treatment: Retinoid gels or creams. “For whiteheads, look for benzoyl peroxide and salicylic acid in a product. But prescription antibiotic gels and creams work best if topical creams don’t work,” explains Dr Friedmann. Look for the words non-comedogenic (non-clogging) on labels when choosing make-up and creams.


Papules and pustules

Papules are comedones that have become inflamed, forming a sore small red or pink bump. Pustules resemble a whitehead with a red ring around the bump with white or yellow pus.

Treatment: Use products with anti-inflammatory ingredients such as tea tree oil or benzoyl peroxide to reduce inflammation. And consider taking a contraceptive pill like Yasmin. A low-dose long course of antibiotics, such as tetracycline, may be prescribed.


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