Acne: Causes and Management

Acne is the most common skin condition that occurs when the pores of your skin become blocked with oil, dead skin, or bacteria.

Each pore of your skin opens to a follicle. The follicle is made up of hair and a sebaceous (oil) gland.

The oil gland releases sebum (oil), which travels up the hair, out of the pore, and onto your skin. Sebum helps keep your skin lubricated and soft.

One or more problems in this lubrication process can contribute to acne.

Acne might occur, for example, when:

• Your follicles produce too much oil.
• Dead skin cells accumulate in your pores.
• Bacteria build up in your pores.

Any of these concerns can lead to pimples, which develop when bacteria grow in a clogged pore and the oil can’t escape.

SIGNS AND SYMPTOMS

• If you have acne, you might notice a mix of pimple types.
• Whiteheads and blackheads, both also referred to as comedones, are the most common acne lesions.
• Blackheads, or open comedones, open at the surface of your skin. Oxygen in the air (not dirt) gives the top of these pimples their darker appearance.
• Whiteheads, or closed comedones, form as raised bumps under the surface of your skin. They remain flesh-colored.
• Inflammatory lesions, which are more likely to cause scarring of your skin, include:
• These small, red, raised bumps are caused by inflamed or infected hair follicles.
• These small red pimples have pus at their tips.
• These solid, often painful lumps develop beneath the surface of your skin.
• These large lumps beneath your skin contain pus and are usually painful.

TRIGGERS OF ACNE

Certain things in your environment contribute to acne or they can make an acne breakout worse, including:

• Wearing tight-fitting clothing and headgear, like hats and sports helmets.
• Air pollution and certain weather conditions, especially high humidity.
• Using oily or greasy personal care products, like heavy lotions and creams, or working in an area where you routinely come in contact with grease, such as working at a restaurant with frying oil.
• Stress, which increases the hormone cortisol.
• A side effect of a medication.
• Picking at your acne.

Foods that cause acne:

• Skim milk.
• Whey protein.
• Diets high in sugar.

While high-sugar diets may lead to acne outbreaks, chocolate isn’t directly linked to acne.

To reduce your risk of acne, choose to eat a balanced, nutritious diet with plenty of fresh fruits and vegetables, especially those rich in vitamin C and beta-carotene, which helps reduce inflammation.

Hormones and acne:

• Acne is largely a hormonal condition that’s driven by androgen hormones(testosterone).
• This typically becomes active during teenage and young adult years.
• You might also notice acne forming around the time of your period as a result of hormone activity.
• Sensitivity to this hormone combined with surface bacteria on your skin and substances released from your body’s glands can result in acne.

DIAGNOSIS

  Your healthcare provider can diagnose acne during a physical examination. During this exam, the provider will closely look at your skin to learn more about your symptoms. In addition, they may also ask about risk factors for acne, like:

Your healthcare provider won’t need to do any diagnostic tests for acne, but they may offer tests to diagnose any underlying conditions if you have sudden, severe acne outbreaks, especially if you’re an adult.

PREVENTION

You can try to avoid or control mild or moderate acne with nonprescription products, good basic skincare, and other self-care techniques:

• Wash problem areas with a gentle cleanser. Twice a day, use your hands to wash your face with mild soap or a gentle cleanser (Cetaphil, Vanicream, others) and warm water. And be gentle if you’re shaving affected skin.
• Avoid certain products, such as facial scrubs, astringents, and masks. They tend to irritate the skin, which can worsen acne. Too much washing and scrubbing also can irritate the skin.
• Avoid irritants
• Protect your skin from the sun
• Avoid friction or pressure on your skin. Protect your acne-prone skin from contact with items such as phones, helmets, tight collars or straps, and backpacks.
• Avoid touching or picking acne-prone areas. Doing so can trigger more acne or lead to infection or scarring.
• Shower after strenuous activities. Oil and sweat on your skin can lead to breakouts.

• Certain foods, including sugary drinks, white breads, and rice, have been shown to increase acne.Try to minimize the intake of such foods.

 TREATMENT

Acne can be treated with over-the-counter (OTC) and prescription medicines. Your doctor will determine which is best for you and the treatment for acne generally depends on its severity.

OTC treatments include:

• Benzoyl peroxide and salicylic acid. This is the most common treatment. It comes in the form of a lotion, gel, soap, or cleansing pad. It kills the bacteria and dries up the oil. It may take up to 8 weeks to see any improvement. Side effects include additional skin irritation, burning, and redness.

Prescription medicines include:

• Retinoid creams or gels. These are applied to the pimples. Pregnant women should not use certain retinoid products. They can cause birth defects. Tell your doctor if you are pregnant. Sun exposure can irritate acne treated with retinoid cream.
• Certain types of antibiotics can be used with other acne treatments.
• This is a strong medicine available under certain brand names. It can cause serious side effects. Talk to your doctor about the side effects.
• Birth control pills. These are sometimes effective for women diagnosed with acne.
• Additional treatments include skin peels, skin ablation, and laser or light treatments. These treatments may reduce scarring caused by acne.
• Small injections of steroid medicines can help treat large acne cysts.
• Finally, certain lifestyle changes may help. This includes a healthy diet and regular exercise.

OUTLOOK

• If you live with acne, know that it’s a common condition.
• Keep in mind, too, that acne is very treatable.
• Getting treatment for acne sooner rather than later can also help prevent scarring. If you’ve already noticed some acne scars, a dermatologist can offer more guidance on treatments.
• A number of effective treatments exist, so you have options for reducing the number of pimples you get and minimizing your chances of scarring.