All About Acne
Acne vulgaris is a skin disease that affects as much as 80% of the population at some stage in their lives. It is most prevalent in teenagers but many adolescents and adults suffer from it too.
It occurs when oil glands under the skin produce excessive sebum which then causes oil and dead skin cells to clog the pores. Thus, the reason why people with oily skin are more prone to breakouts.
Acne can come in the form of whiteheads, blackheads; small, raised red spots or large, painful cystic pimples. They can flare up on the face, neck, chest, back, shoulder or upper arms.
If not treated properly, acne can leave permanent scars on the surface of the skin.
Psychologically, people with moderate to severe acne problems can suffer from low self esteem, poor body image, high levels of anxiety and frustration, and have a greater tendency to experience depression.
Acne Signs and Symptoms
In order from least to most severe, symptoms of acne are:
- Whiteheads: also called closed comedones and characterized by small, white bumps on the skin.
- Blackheads: the oil on top of the open pores turns brown or black when exposed to air and small, dark bumps form on the skin.
- Papules: small, red bumps which are tender to the touch.
- Pustules: commonly called pimples, these are papules with pus at the tip.
- Nodules: big, hard and painful lumps under the skin; they are sensitive to the touch.
- Cystic lesions / Cystic pimples: big, painful lumps beneath the surface of the skin and filled with pus.
Acne Causes and Risk Factors
A clogged pore is the main culprit behind acne.
When the skin is healthy, dead cells that travel to the skin surface are effectively shed by the body.
However, when oil glands are overactive, the excessive sebum prevents the dead skin cells from drying. The combination of oil and dead skin cells then gets stuck inside the hair follicles that connect the oil glands to the pores.
This becomes a friendly place for bacteria to thrive in. Infection caused by multiple bacteria living inside the pores eventually causes the area to become red and swollen which develops into acne.
Other factors believed to play a role in aggravating acne are:
- Hormones. Changes that occur during puberty, pregnancy or due to some other reasons can affect the condition of the skin. Most cases of adult acne are caused by hormonal imbalance in the body.
- Genetics. Though yet to be scientifically proven why, there seems to be a direct link between genetics and a person’s skin condition. If one or both of your parents suffered from severe acne at one point in their lives, you have a higher chance of inheriting the overactive sebum-producing glands that lead to acne.
- Stress. Stress lowers your immune system and wreaks havoc on the body’s normal functioning. Your body responds to high pressure situations by raising cortisol levels. Cortisol helps convert protein into energy but sustained high cortisol levels are associated with oily skin, hair loss and weight gain.
- Diet. It’s a known fact that what we put inside our body manifests itself on our appearance: the health of our skin, hair and nails. Food and ingredients that can cause inflammation in the body are: dairy, sugar, junk food, high-glycemic food and oily food.
- Some kinds of medications. The common medications that can trigger acne breakouts are: anticonvulsants (Dilantin), corticosteroids (Prednisone), disulfuram (Antabuse), Immuran, INH (Isoniazid), quinine and thyroid medications (Thiourea and Thiouracil).
- Cosmetics. When shopping for makeup, keep this term in mind: non-comedogenic. Non-comedogenic means that it does not clog pores and allows the skin to breathe. The use of heavy cosmetics with harsh chemicals can block the pores and cause acne breakouts.
Before acne treatment can be administered, the first step is determining the cause of the condition.
Keeping a journal to record the timing, location and type of acne breakouts can give you a good idea of the main reason behind the flare-ups.
Hormonal acne usually occurs during the same phase of a woman’s menstrual cycle every month. Generally, symptoms peak a week before period starts or during menses. Hormonal acne are located on the lower part of the face, usually along the jawline; and tend to be cystic in appearance.
Acne caused by food, medication, cosmetics and stress can be easier to pin down. When acne breakouts coincide with the consumption of specific food ingredients and medicines, it’s a good indication that you have an inflammatory reaction to them.
There are blood tests that can establish if you have a hormonal imbalance or bacteria present in your body. Hormones that can be tested are: cortisol, estrogen, progesterone, testosterone, adrenal stress and thyroid function.
Treatment Options for Acne
Depending on the severity of the blemishes, it might take several months to fully clear up the skin. Some deep acne scars, especially those caused by big cystic pimples, will even require years to heal.
Some treatments will make the skin condition worse before it becomes better. Make sure to know the proper administration, contraindications and side effects before starting on any treatment.
Topical – Gels, creams, ointments and lotions used to treat acne usually contain one or a combination of these ingredients:
- Benzoyl Peroxide
- Retinoids (adapalene, tretinoin and isotretinoin)
- Salicylic Acid
- Azelaic Acid
- Alpha Hydroxy Acid
These topical solutions are usually available at pharmacies, without a prescription. However, make sure to read the leaflet fully before applying to the skin.
Oral – For more moderate cases, a combination of topical and oral treatment may be prescribed. Oral tablets used to manage acne are:
- Contraceptive pills (hormone therapy)
- Tetracycline-based antibiotics (oxytetracycline, tetracycline, doxycycline and lymecycline)
- Isotretinoin tablets
- Other kinds of antibiotics that can effectively fight bacterial infection
Oral treatments usually require a prescription and are best taken for a limited time only. Follow your physician’s advice and never overdose.
Surgical – Your dermatologist might suggest some procedures to help hasten the healing of acne scars. These include:
- Dermabrasion / Microdermabrasion
- Laser / Light therapy
- Punch replacement graft
- Chemical peel
- Soft tissue fillers
Make sure to consult only with licensed and trustworthy dermatologists and surgeons. Some of these procedures may limit your outdoor activities a few weeks after- be clear on the do’s and don’ts to avoid problems.
Home Remedies – Chemicals can be harsh and heavy on your skin- causing your skin to thin or become extra sensitive to sunlight and air exposure.
Some people would like to opt for more natural remedies, which may take longer to show positive results, but can be just as effective:
- Probiotics (come in capsule form; non-dairy examples are fermented food, kefir beverages, etc.)
- Tea tree oil (topical only)
- Apple cider vinegar
- Homemade facial masks (commonly used ingredients are honey, lemon, egg white, mint, yogurt, oatmeal, etc.)
- Green tea
- Omega-3 fatty acid (in capsule form or food sources such as salmon, tuna, flaxseed, walnuts, etc.)
- Essential oils
Incorporate these tips to your daily routine to help keep your skin healthy:
- Establish a good skin care routine.
Clean well: washing with a mild cleanser twice a day removes bacteria, excess oil and dead skin cells that can cause acne. Avoid harsh soaps as they can irritate your sensitive skin.
After washing, apply toner to completely remove all traces of dirt and makeup from your face. Even non-comedogenic cosmetics can cause oil build-up when left too long on the skin.
Moisturize daily: dry skin signals your oil glands to work faster, which in turn will lead to excess sebum production. Facial creams formulated for oily or combination skin contain oil-controlling ingredients. Look for moisturizers especially tailored for your skin type: oily skin, combination skin or dry skin.
Exfoliate once a week to remove dead cells from the surface of your skin.
- Get adequate sleep.
Sleep time is when your skin cells regenerate and it is crucial that you allow your skin to breathe during this time.
Lack of sleep lowers an individual’s defense against stress and increases the level of cortisol in the body- these will lead to inflammation that triggers acne. 7-8 hours of sleep every day is recommended for general well-being, healthy skin and hair.
Physical movement has numerous health benefits, including cutting down your stress level, promoting blood circulation, increasing oxygen flow and helping balance hormones in the body. When you are healthy from the inside, it shows on your glowing skin.
- Eat healthy and hydrate.
Include more whole grains, fruits and vegetables in your daily diet. Avoid greasy food, junk food and sweets. You might also want to limit your intake of food that can aggravate acne, such as dairy and those that rank high in the glycemic index.
Water also plays a major factor towards the health of your skin and entire body- it flushes out unwanted toxins and hydrates you from the inside. Water is crucial for the normal functioning of the body’s organs and systems- boosting oxygen and blood circulation.
Take time to unwind and de-stress at the end of each day- read a book, meditate, listen to soft music, take a warm bath, laugh with friends and family, do some yoga poses, etc.
Be kind to yourself. Stress is a major contributor to all kinds of diseases and illnesses, including severe acne.
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