Acne (or more popularly known as pimples) is a very common skin disorder that affects many individuals. It is very common skin condition among teens, adults, and even in some children. It is most prevalent among adolescents and is reported to affect more than 70% of this age group. It is not just simply a skin condition but a condition that has a big psychosocial impact on many afflicted individuals.
Acne lesions are a spectrum of different skin lesions.
- Whiteheads are skin lesions that represent clogged pores
- Blackheads are skin lesions that represent clogged pores that have been exposed to air or have been oxidized.
- Pimples represent the red, painful skin lesions that develop pus in them.
- Nodules are the big, round, painful lumps that usually grow under the skin.
How acne forms
Acne requires three main ingredients for it for form:
- Sebum or oil
- Dead skin cells
- Bacteria (Propionibacterium acnes)
Our skin has pores or openings where the hair strands exit. The base of our hair (or hair follicle) is connected to sebaceous glands, which are glands that produce sebum or oil that lubricate our hair and skin. Our skin regularly creates new cells and sloughs off dead cells. Sometimes, these dead cells are not completely sloughed off and end up blocking the opening of our skin pores. When the pores are blocked by dead skin cells, the sebum from the sebaceous gland is trapped inside. This is seen on our skin as white heads. When the blockage is relieved and the sebum is exposed to air, it is oxidized and turns dark in color. This is what we call blackheads. The mixture of dead skin cells and sebum makes a good concoction for bacterial growth. Bacterial infection of the pores leads to inflammation, swelling, and pus formation. This is what we call pimples.
Pimples are most common on areas of the body with many sebaceous glands. This includes the face, neck, chest, back, and shoulders. In some individuals, the lesions are minimal and isolated. However, in other unfortunate individuals, the lesions are numerous, large and distributed in many parts of the body.
Many elements have been identified to be strongly associated with the formation of acne. This include:
- Genetics - Your chances of getting acne increases if your parents have suffered acne.
- Hormonal changes - Hormonal changes affect the amount of sebum that our glands excrete. This is the reason why acne is very common during the adolescent period.
- Oil - Oily substances like some cosmetic products can aggravate the blockage of your pores and cause acne
- Stress - Stress is strongly associated with acne flare-ups or sudden increase in the number and size of acne lesions.
Mild acne can be treated with non-prescription products initially. Non-prescription acne treatments may include sulfur, salicylic acid, tea tree oil, benzoyl peroxide, or alpha hydroxy acids, all of which are available in non-prescription strengths. Difficult to treat acne may require a consultation with a dermatologist.
- Facial wash or facial scrubs - These aim to remove dead skin cells and keep the skin free from bacteria.
- Topical Retinoids - Topical Retinoids are Vitamin A derived medications in the form of creams or gels that prevent clogging of the pores. Examples of these are adapalene and tretinoin (Retin A) available as gels or creams.
- Topical keratolytics - Keratolytics are medications that promote sloughing of dead cells. Examples of these are benzoyl peroxide and salicylic acid.
- Topical antibiotics - Topical antibiotics are antibiotic medications in the form of creams or gels that kill the bacteria on the skin. Examples of these are clindamycin and erythromycin.
- Oral antibiotics - For moderate to severe acne that are distributed on a wider area, doxycycline or minocycline can be prescribed.
- Oral contraceptives - In women, oral contraceptives aim to control the hormones in the body and decrease the production of sebum.
- Oral Isotretinoin - Isotretinoin is also a Vitamin A derived medication. This is very effective in treating acne, but it is reserved for people with severe acne because of its side effects. This medication can be harmful to the liver and can cause congenital anomalies if taken by a pregnant woman.
Aside from the medications listed above, here are some recommendations to help you prevent acne formation or worsening of acne:
- Keep your face clean. Do not wash more than twice daily and only use gentle non-soap facial skin cleanser (for example Cetaphil, Dove, or Oil of Olay) and luke-warm water.
- Do not pop your pimples because it can cause infection or scarring.
- Minimize application of cosmetic products to your skin. When buying cosmetic products or moisturizers, choose the non-comedogenic ones.
- Use gentle skin cleanser to prevent irritating your skin.
- Get enough sleep.
- Avoid stress.