Acne: Types, Causes, Treatment & Prevention
Acne is a common skin condition that affects millions worldwide. It's the red, inflamed bumps on the skin, sometimes accompanied by blackheads, whiteheads, and pustules. While it is most commonly associated with puberty and teenage years, acne can affect people of all ages.
For many people who suffer from acne breakouts regularly, finding an effective treatment can be a frustrating journey. It's important to understand that there isn't a one-size-fits-all solution to treating acne. Different types of acne require different approaches for effective management.
Whiteheads and Blackheads
Two of the most common types of acne, whiteheads, and blackheads, cause no redness or swelling on the skin. However, they can still be a source of frustration and self-consciousness for those who struggle with them.
Whiteheads, also known as closed comedones, are small bumps that appear on the skin’s surface. They form when dead skin cells, oil, and bacteria trap in hair follicles. The trapped substances cause a plug to form at the opening of the follicle, resulting in a white or flesh-colored bump. Whiteheads commonly appear on the forehead, chin, and nose.
On the other hand, blackheads (open comedones) have a dark appearance because of exposure to air. They occur when pores become clogged with excess oil and dead skin cells but remain open at the surface. This allows oxygen to enter and oxidize the debris inside, giving it a black or dark color. Blackheads usually appear in oily areas like the nose, cheeks, and chin.
The key difference between whiteheads and blackheads is their level of blockage. Whiteheads have a complete blockage at the surface while blackheads only have partial blockage. Treating whiteheads is more difficult than blackheads because it's harder to extract them from the surface.
Papules and Pustules
Papules and pustules are two common types of acne lesions characterized by small, raised bumps on the skin. They have distinct differences in appearance and treatment.
Papules are small, red, or pink bumps that form when pores become clogged with excess oil, dead skin cells, and bacteria. They typically measure less than 5mm in diameter and do not contain pus. Papules can be tender to the touch and may cause mild discomfort or itchiness. Papules are usually in clusters found on the face, neck, chest, back, and shoulders.
On the other hand, pustules are similar to papules in size but differ in their appearance. They have a white or yellow center surrounded by a red base and may resemble a small blister filled with pus. Pustules form when bacteria infect a blocked pore and cause inflammation.
Hormonal changes and excess sebum production cause papules and pustules. Factors such as genetics, diet, stress levels, medication use, and certain skincare products can also contribute to their formation.
Cysts and Nodules
Cysts and nodules are severe forms of acne that can be painful, long-lasting, and may cause scarring if not treated properly. They differ from traditional pimples in their size and depth within the skin. Cysts are larger than traditional pimples, often measuring about 5 mm or more in diameter. Nodules, on the other hand, are solid lumps that develop deeper within the skin's layers.
The development of cysts and nodules starts with clogged hair follicles. The excess oil produced by our sebaceous glands combines with dead skin cells to block hair follicles' openings. This creates an ideal environment for bacteria to thrive and causes inflammation.
Typically this inflammation remains near the surface of the skin usually as a pimple or whitehead. However, in cystic or nodular acne cases, this inflammation spreads deep into the skin resulting in larger lesions.
One key difference between cystic/nodular acne and other forms is that they do not have a "head" as regular pimples do. This makes them harder to treat because it's challenging to reach them using topical treatments such as creams or gels.
Cystic acne lumps are softer than nodules. Nodules are firmer, very painful, and feel like knots under your skin. Some people have both cysts and nodules.
Causes of Acne
1. Hormonal changes: During puberty, there's an increase in androgen hormones, causing an overproduction of sebum in the skin. This excess oil can clog pores and lead to the formation of acne lesions.
The most common hormonal triggers for acne are androgens, also known as male hormones. Both males and females have these hormones present in their bodies, but they tend to be more active during puberty and adolescence. Androgens stimulate the production of sebum from the sebaceous glands, increasing oil on the skin's surface.
Women also experience hormonal fluctuations during their menstrual cycle and pregnancy. These changes can trigger breakouts because of increased sebum production or inflammation.
2. Genetics: Studies have shown that genetics play a role in determining one's susceptibility to acne. People with acne-prone skin tend to have larger sebaceous glands and produce more sebum than those without it. This excess oil can clog pores and lead to breakouts.
Certain genes can make skin more sensitive to bacteria commonly found on the skin, such as Propionibacterium acnes (P.acnes). When these bacteria come into contact with excess oil and dead skin cells, they can cause inflammation and form pimples.
Additionally, some people may inherit their body's response to inflammation from their parents. If both parents had severe acne, your risk of having acne breakouts may be higher.
3. Diet: While there is no direct causation between diet and acne, certain foods have been linked to worsening existing breakouts or triggering new ones.
Before diving into specific foods, it's important to understand how certain choices can impact acne. One major way is through inflammation. When the body experiences inflammation, it triggers an immune response and causes increased blood flow to the affected area. This can result in redness, swelling, and irritation - all symptoms commonly associated with acne.
Foods high in sugar and unhealthy fats cause inflammation in the body. This includes processed snacks such as chips and cookies, as well as sugary drinks like soda and juice. These types of foods also have a high glycemic index (GI), which means they cause a spike in blood sugar levels. Studies have shown that diets high in GI foods link to more severe cases of acne.
Another culprit for acne flare-ups is dairy products. Milk contains hormones that can increase oil production in the skin, leading to clogged pores and breakouts. Dairy products contain high amounts of saturated fat which links to increased inflammation in the body.
Treatment Options for Acne
1. Topical medications: This type of treatment involves applying creams, gels, or lotions directly to the affected area. Ingredients like benzoyl peroxide, salicylic acid, and retinoids work by unclogging pores, reducing inflammation, and killing bacteria on the skin's surface.
2. Oral medications: Topical treatments may not be enough to control acne, so prescribed oral medications are necessary. Antibiotics can help reduce inflammation and kill bacteria, while hormonal contraceptives can regulate hormone levels.
3. Chemical peels: Chemical peels involve applying alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) to the skin, causing it to peel off. These treatments can help improve mild acne and reduce scarring over time.
4. Light therapy: Using different types of light such as blue light or red light can target specific bacteria on the skin. This treatment helps decrease inflammation and reduces the number of bacteria on the skin's surface.
5. Extraction: In-office extraction involves using sterile tools to remove blackheads and whiteheads from the skin. This process can help prevent further breakouts and improve the appearance of existing acne. Don't try extraction on your own.
6. Lifestyle changes: Making small changes to your daily routine can also help manage acne. Wash your face twice a day, avoid touching or picking at your acne, and find a skincare routine that works well for you.
7. Diet: Avoid high-glycemic foods like white bread, sugary drinks, and dairy products. It may be beneficial to reduce consumption of these foods if you notice they trigger your acne.
8. Stress management: High levels of stress can increase levels of cortisol in the body, which can trigger acne breakouts. Finding healthy ways to manage stress such as exercise, meditation, or therapy may help improve acne symptoms.
Prevention
While there may not be a foolproof way to completely prevent acne, there are steps you can take to reduce the development of it or minimize its severity.
1. Keep skin clean: One of the primary causes of acne is the buildup of dirt, bacteria, and oil on the skin's surface. This clogs pores and leads to breakouts. Therefore, it is crucial to keep your skin clean by washing it twice a day with a gentle cleanser. Avoid using harsh scrubs or over-washing as this can strip the skin of its natural oils and cause irritation.
2. Hydrate skin: Dehydrated skin produces more oil, which can lead to clogged pores and acne. Make sure you drink enough water throughout the day to keep your skin hydrated from within. Also, use an oil-free moisturizer to lock in moisture without clogging pores.
3. Choose non-comedogenic products: These products are specially formulated to not clog pores or aggravate acne-prone skin. Look for labels that say "non-comedogenic" or "oil-free" when choosing products.
4. Avoid touching your face: Our hands come into contact with numerous germs throughout the day, which can transfer to our face when we touch it. This can lead to clogged pores and breakouts. Make a conscious effort to avoid touching your face, and if you must, make sure your hands are clean.
5. Use sun protection: Sun exposure can worsen acne by causing inflammation and redness. Make sure you use sunscreen with an SPF of 30 or higher every day, even on cloudy days.
6. Eat a healthy diet: What you eat plays a significant role in your skin's health. Consuming a balanced diet rich in fruits, vegetables, lean proteins, and healthy fats can help prevent acne by providing the necessary nutrients for healthy skin.
7. Manage stress: Studies have shown that stress can worsen acne by triggering the production of cortisol, a hormone that increases oil production in the skin. Find ways to manage stress such as exercise, meditation, or talking to a therapist.
8. Don't pop your pimples: While it may be tempting to squeeze or pop pimples, this can lead to scarring and further inflammation. It's best to leave them alone or seek professional help from a dermatologist.
While it may not be possible to prevent acne entirely, following these prevention techniques can help reduce its occurrence and severity.
If you do develop acne, seek professional help from a dermatologist for proper treatment. With patience and consistency, you can achieve clear and healthy skin.