What causes it?
We’ve all been there, you wake up in the morning before an important event and there it is on your face…a giant, red pimple. What are you going to do? There might not be much you can do that moment, but there are things that you can do to reduce future acne. What are these things?
Acne is a condition that affects the skin and is when the hair follicles become clogged with oil and dead skin cells. It’s caused by four main factors, which are excess oil production, hair follicles being blocked with oil and dead skin cells, bacteria and excess activity of androgens (type of hormone which increases during puberty). Hormonal changes related to pregnancy and use of oral contraceptives can also impact sebum production. This is why despite being common in teenagers, acne can happen to anyone. Typically, it appears on your face, forehead, chest, upper back and shoulders. This is where your body has the most sebaceous (oil) glands, which is what the hair follicle is connected to and are different from sweat glands.
There are a variety of symptoms that are based off of the severity of your acne. If the pore is closed and bulges, it results in a whitehead. If the plug is open to the surface, it means that the bacteria and oil in the pore are exposed to air and causes a blackhead. Often, this can look like dirt in your pores. If the area becomes inflamed, it’ll form either a small red, tender bump (papule) or a red spot with white center (pimple), which is a papule with pus at its tip. Sometimes, these blockages can develop into large, solid painful lumps deeper beneath the skin surface (nodules) or into painful, pus-filled lumps beneath the skin surface (cystic lesions).
Besides hormones, other things can increase your chances of acne or aggravating it. If you take certain medications, such as corticosteroids, testosterone or lithium, you’re at greater risk. Some food can make acne worse. Skim milk, chocolate and carbohydrate-rich foods, like bread, bagels and chips, are thought to be main contributors. Stress also plays a role in the development of acne. In addition, wearing greasy or oily lotions or creams can block pores and result in it. If something presses or rubs on your skin, such as tight clothing, it can lead to acne in that area. There are factors that some people believe cause acne, but haven’t been proven to. One of these is eating greasy food. Another is wearing makeup, which really depends on the type. A big issue that many people believe causes acne and doesn’t is poor hygiene. In fact, the opposite is true, if you scrub your skin too hard when washing or use harsh soaps, your skin can become irritated and make acne worse.
The first step in treating acne is trying techniques to manage it at home. The most important thing to do is to wash the problem areas twice a day with a gentle soap and warm water. If you get acne around your hairline, you should wash your hair every day. If you need to shave the affected skin, do so carefully. It’s key to avoid anything that can irritate your skin and potentially make your acne worse. Products that fall into this category include facial scrubs, astringents, masks, oily/greasy cosmetics, sunscreens, hairstyling products or acne concealers. If you’re planning on using cosmetics, make sure that they’re water based or noncomedogenic (less likely to result in acne). It’s also essential to protect your skin from the sun since it can make acne worse. The best way to do this is to use non-oily, moisturizing sunscreen regularly. Avoid tight clothing and items that place pressure on your skin. After any strenuous activity, take a shower to wash off sweat and oil from your skin. You can try over-the-counter acne products that dry excess oil and encourage peeling. Products that could be helpful contain benzoyl peroxide, salicylic acid, glycolic acid or alpha hydroxy acids. Keep in mind that it can take a few weeks to notice any changes and that sometimes you can have side effects, like redness, dryness and scaling, which should get better after the first month. It’s vital to avoid scratching at your acne because this often results in more acne appearing and scarring of the skin.
If the at home methods don’t work after you’ve tried them for several weeks, you should see your doctor or a dermatologist (skin doctor). They can help you control your acne and avoid scarring. There are different types of medication available to treat acne. Most work by reducing oil production, speeding up skin cell turnover, fighting bacterial infections or decreasing inflammation. After you start a treatment course, it can take four to eight weeks to see improvements and it can take months or years for your acne to completely go away. Your treatment regimen depends on your age, type/severity of your acne and what level of participation you’re willing to commit to. It’s important to note that in the majority of cases, your acne will get worse before it gets better.
There are two main types of medications used to treat acne. The first are topicals that are applied directly to your skin. These can include retinoids/retinoid-like drugs, antibiotics, salicylic acid, azelaic acid and dapsone. The second type are oral medications, which are antibiotics, combined oral contraceptives (for women), anti-androgen agents and isotretinoin (very powerful, but has serious side effects). Some other possible treatments include lasers/photodynamic therapies, chemical peels, extraction of whiteheads/blackheads and steroid injections. You can use all of these individually or a variation of them together depending on what your doctor thinks will work best for your acne. Note: If at any point, you’re using any of the medications and feel faint, have difficulty breathing, swelling to your eyes/lips/tongue/face or tightness in your throat, seek emergency medical care.
There isn’t much that you can do to prevent acne from occurring. The best things you can do are to follow the at home techniques already discussed in the treatment section. This should help to keep your skin clean without drying it out.
Acne can be embarrassing to have, but it can be managed. If you have any questions or concerns about acne, please speak with your doctor. If you would like more information, please visit the American Academy of Dermatology’s acne page at https://www.aad.org/public/diseases/acne/really-acne/overview