Acne 101: The Comprehensive Guide

Acne has been a tormentor to so many people. Infact it is the eighth most common skin disease worldwide.

This pesky, nasty-looking zits not only causes pains, emotional distress and discomfort but also affects one’s self-esteem. But you know what? It’s definitely treatable, and this article contains all the guide and everything you need to know about acne, causes, treatments, and precautions.

What Is Acne?

Acne occurs due to congestion of oil, dead skin cells, bacteria and dirt which leads to pore blockage and when the pores of your skin becomes clogged with these debris, pimples definitely sets it.

“When skin pores get clogged, usually by dead skin cells, oil cannot discharge and accumulates in the pore and under the skin, creating a whitehead or blackhead,” explains Viseslav Tonkovic-Capin, MD, a Kansas City dermatologist and editor DermBoard.org. “This is a perfect environment for [the bacteria] Propionibacterium acnes, which then flourishes and causes inflammation, creating pimples.”

What Causes Acne?

There are several factors that leads to the occurrence of acne.

Puberty.

Between the ages of 13 to 19 puberty kicks in. Although, puberty sometimes occurs earlier in girls between 9 to 14, and in boys between 10 to 16.
Between these teenage age, teens get acne because of the hormonal changes that come with puberty. If your parents had acne as teens, it’s more likely that you will, too. But the good news is that, for most people, acne goes away almost completely by the time they are out of their teens.

Acne doesn’t only appear during our teenage age. They can also pop up at any age too. It all depends on your diet, skin type, hormonal change, environmental factors and stress.

Dr Alison Tam, a dermatologist in Las Vegas, says hormonal changes like perimenopause or menopause, or the use of hormones like testosterone, can cause adult acne. “Adult onset acne may also have no cause, which is extremely common, and progress from just a few pimples to full cystic acne over the course of months to years”.

Clogged Pores.

The main cause of acne breaks outs is pores blockage. The skin has tiny breathable holes (called pores) and when these pores are clogged with dead skin cells and oil, this makes it a perfect environment for acne causing bacteria (P. acne) to grow, and when this occurs, the pores definitely get inflamed which causes the appearance of pimples and zits.

And What Causes Clogged Pores?
They Are:

• When too much oil is produced by your follicles.

• When dead skin cells accumulate in your pores.

• When bacteria build up in your pores.

These problems contribute to the development of pimples.

Pregnancy.

Hormonal changes due to pregnancy can also trigger the occurrence of acne. Many women experience acne during pregnancy. It’s mostly common during the first and second trimesters. An increase in hormones called androgens can cause the glands in your skin to grow and produce more sebum — an oily, waxy substance. This oil can clog pores and lead to bacteria, inflammation, and breakouts.

Certain Medications.

Some certain medications such as birth control pills or corticosteroids can actually trigger acne appearance.
Certain drugs, including corticosteroids, lithium, anticonvulsants, barbiturates, androgenic steroids, DHEA, and medications that contain bromides or iodides, can also cause the eruption of acne.

Certain Skincare Products.

Some skincare products are comedogenic which means, they contain pore-clogging ingredients which can get trapped into your pores. It’s recommended you should know your skin type so as to make the perfect choice of skincare products suitable for your skin.

Skincare products with heavy oils example, certain make-ups, moisturizers, sunscreens should be avoided.

Also using too many skincare products can aggravate the skin causing adult acne.

According to Paul Jarrod Frank, MD, the founder and director of Fifth Avenue Dermatology Surgery and Laser Center in New York. “Switching products or adding a new one before giving it a chance to work challenges your skin with new preservatives and active ingredients, which can be irritating and cause breakouts.”

And here’s a shocker: Even anti-acne products can cause blemishes if you use too many.

“I have patients who have acne because they switch between four or five different acne creams or use an astringent, facial wash, and spot cream, all with acne-fighting ingredients,” Dr. Frank says. “This tears their skin apart.”

Whether your goal is fighting wrinkles or zapping zits, pick one or two products and give them at least four to six weeks to work

“It takes that long for skin to turn over, so you really have to give it that adjustment time,” Frank explains.

Diet.

A diet high in refined sugars or carbohydrates, such as bread and chips can as well invite the occurrence of acne.

One study found that people who frequently consumed added sugars had a 30% greater risk of developing acne, while those who regularly ate pastries and cakes had a 20% greater risk.

Heredity.

Having parents who had acne could one way or the other pass on to you.
Some family line may have a genetic tendency to overproduce sebum, leading to oily skin that can trap bacteria in pores, resulting in more frequent breakouts. That being said, there is every tendency for acne to run in families.

Some studies have shown that one is likelihood of developing acne if his or her mother had acne at any point in her life. And also has a higher chances of developing acne if a higher number of family members had acne history.

Occupation.

Depending on the nature of some jobs, there is a higher tendency that you may develope acne. Example: exposure to industrial products like cutting oils, polyhalogenated hydrocarbons, coal tar, petrol, and other physical, chemical, and environmental agents may produce acne.

Types Of Acne.

• Blackheads: These are mild types of acne that takes a small bumps appearance on the skin due to clogged hair follicles. These bumps are called blackheads because the surface looks dark or black.

• Whiteheads: These are types of acne that forms when dead skin cells, oil, and bacteria become trapped within the pores. whitehead acnes are white in colour because the bacteria inside of it doesn’t undergo a chemical reaction.

Blackheads and whiteheads are still considered acne. However, they are classified as noninflammatory because they don’t cause the red bumps that are associated with other types of acne pimples.

• Papules: These types of acne are usually small, red and raised bumps caused by inflamed or infected hair follicles.

• Pustules: These types of acne are small, red, tender bumps with white pus at their tips. They usually contain pus due to an infection of the pore cavity and they can be painful.

• Nodules: Nodular acne are hard, painful and occurs deep under the skin. Nodular acne often lasts for weeks or months, unlike regular pimples that often heals within few days. Acne nodules don’t develop a white head and may remain as hard knots under the skin.

• Cysts: Cysts acne are tagged as the most serious type of acne. They often develop in large size. They occurs deeper within the skin, often looks like boils on the skin, filled with pus and painful to touch.

Skincare Treatments For Acne.

Benzoyl Peroxide.

This is a well known medication for treating acne (mostly mild acnes). This medication prevents and kills acne causing bacteria, as it unclog pores and breaks down dead skin cells.

Benzoyl peroxide can be found in over the counter products such as spots treatment, cleansers, gels and creams. This ingredient comes in different concentrations for mild to moderate acne breakouts.

While Benzoyl peroxide works well for inflammatory acne, which is characterized by red bumps that contain pus (pustules, papules, cysts, and nodules), it may not effectively treat blackheads and whiteheads like retinoids does. Therefore It can be combined with other acne treatments for more optimum result.

Glycolic Acid.

Glycolic acid belongs to the family of alpha hydroxy acids (AHA’s) and is considered as an effective treatment for acne inflammation Including blackheads and whiteheads as it penetrates deeper into the pores because of its smaller molecular size in weight to break down oil-build up, unclog pores and kill acne causing bacteria (P. acnes).

According to Kenneth Howe, M.D., a dermatologist at Wexler Dermatology in New York City “Of all the AHAs, glycolic is the simplest in structure and the smallest; it has the lowest molecular weight”. That small molecular weight means “it’s easy for it to penetrate your skin and be super effective.”

Not only does its penetrate deeper into the skin to get rid of oil-build up and dead skin cells due to its lower molecular weight, but also mildly exfoliates the skin there by enabling your skincare products penetrate better into your skin to do their jobs.

Glycolic acid is best recommend for individuals with oily skin by dermatologists due to the excess amount of sebum (oil) produced by their skin. Glycolic acid is available in cleansers, creams, serums spots treatments and gels.

Salicylic Acid.

Salicylic acid is a beta hydroxy acid (BHA) which is derived from Willow bark. This oil-soluble acid helps treat milder acne, as it helps unclog pores to resolve and prevent lesions and helps to correct the abnormal shedding of cells because of its skin exfoliating potentials.

Just like glycolic acid, salicylic acid also penetrates deeply into the skin to dissolve any intracellular ‘glue’ that holds skin cells together and breaks down oil-build up and dead skin cells.

Once it penetrates the skin, salicylic acid “dissolves skin debris that clogs pores, [acts] as an anti-inflammatory and also helps red inflamed pimples and pustules go away faster,” explains Naissan O. Wesley, a board-certified dermatologist in Los Angeles.

Essential Oils.

Some essential oils such as tea tree, lavender, lemongrass and peppermint are loaded with anti-bacterial, anti-inflammatory and anti-microbial properties. When applied on the skin, they penetrate into the skin pores to kill acne causing bacteria and calms down inflammatory conditions.

Retinoids.

When it comes to combating all kinds of acne, retinoids are #1.
Retinoids are vitamin A derivatives.
For decades retinoids such as retinol esters, retinol, retinaldehyde, retinoic acid esters, adapalene, tretinoin, tazarotene, trifarotene and Isotretinoin has been used to treat all kinds of acne.

When spread on the skin, retinoids can unclog pores, they work deep beneath the skin to unclog pores and prevents the accumulation of dead skin cells and oil-build up thereby reducing acne outbreaks, as well as reduce the formation of acne scars. Infact retinoids are actually the back bone to acne treatment. They also allow other skincare products to work better.

Retinoids comes in different percentage (strengths) such as 2.5%, 2%, 1%, 0.5%, .0.3% and 0.25%, and may cause mild irritations (especially to sensitive skin) such as skin dryness, redness and shedding.

The higher the concentration, the stronger the skin will respond with visible shedding, dryness and redness. However, this is normal due to the stimulation of cell turnover process. If an increase in percentage triggered more shedding and redness, you can stick back to previous percentage.

Of all retinoids, tretinoin, adapalene, tazarotene, Isotretinoin, and trifarotene are categorized as prescription retinoids, which means they can only be issued under prescription by a licensed dermatologist.

While retinol is the most popular over-the-counter retinoid which can be used without prescription for treating acne and reducing the appearance of aging signs such wrinkles and fine lines.

The combination of retinol and dermaroller has also worked great for fading acne scars.

Caution

We advise you limit retinoids usage to night time only, also follow up with a moisture-rich moisturizer after applying a pea size (small amount). Don’t forget to apply sunscreen during the day to protect your skin from sun rays exposure.

Acne Home-Self Care Tips.

• Always ensure to clean your skin daily with a mild soap to remove excess oil and dirt. Glycolic cleanser has proven to get rid of excess oil, decongesting the pores and leaving the pores clean and unclogged.

• Always shampoo your hair regularly and keeping it out of your face.

• Ensure to use makeup that’s water-based or labeled “noncomedogenic” (won’t clog pores)

• Avoid squeezing or picking pimples, this will spreads bacteria and excess oil.

• Avoid wearing hats or tight headbands

• Avoid touching your face. You wouldn’t want to introduce more bacteria to your pores.

How Can Acne Be Prevented?

To be honest it is difficult to prevent the occurrence of acne. But there are some possible preventable measures to ensure they don’t occur again after treatment.

Avoid Comedogenic Skincare Products.

Skincare products with heavy oils and pore-clogging ingredients should be avoided. Invest more on oil-free moisturizers, sunscreens and body lotions (if need be). Ensure your skincare products is labeled non-comedogenic before purchasing.

Never Sleep With Your Make-Up On.

The worst thing you can do is sleeping with your make-up on. Such act should be totally avoided. Before retiring to bed ensure you wipe off your make-up entirely using make up wipes. Make-ups some times contains heavy oils that can get trapped into the skin pores which can cause inflammation and trigger acne breakouts. You should also avoiding makeup that contains oil.

Washing Your Face Twice Daily Using Oil-Free Cleanser.

It’s very important you should atleast wash your face twice daily (AM & PM) using an oil-free cleanser to get rid of pore-clogging impurities, excess oil and keep the skin pores clean.

Oil-free facial cleansers like glycolic & charcoal does a great job to ensure your pores are free from debris, oils and dirt.

Showering After Exercising.

Keeping a good hygiene also plays a good role to ensure the occurrence of acne is prevented. Always take a cool bath after exercise to wash off dirt and keep the skin clean.

Avoiding Tight-Fitting Clothing.

Tight-fitting clothing such as hat and helmets can cause tightness and rub against your skin. Add sweat and a little dirt to the equation which can eventually trigger acne.

Eating A Healthy Diet.

Eating healthy diet is important. Infact it plays the front role towards preventing the occurrence of acne. Ensure you eat enough veggies, fruits and diets with minimal refined sugars.

Reducing stress.

Although, stress can’t directly cause acne. However, studies have shown that if you already have acne, stress does make it worse. Researchers have found that wounds, including acne, are much slower in healing when a person is under stress. Which means acne will take more longer in healing. Therefore, avoid or minimize stressful activities.
Relieve stress by exercising, listening to music and having a better sleep.

Can I Pop My Pimples?

Treat them, don’t pop them.

Popping your pimples won’t help heal them, rather, It may compound issues, by delaying the healing process, spreading bacteria and also increase the chances of incurring hyperpigmentation (leftovers acne-scars).

Although popping your pimples may seem to be a very tempting thing to do, you should avoid this temptation, it’s for the greater good. You wouldn’t like a scenario whereby you inflame the pimples after doing the popping, or sustain post inflammatory hyperpigmentation (PIH) after your acne is gone or has healed.

Popping your pimples breeds higher chances of incurring leftover acne scars especially for people of skin of color (black skin), because they easily pigment on any slightest provocation.

Therefore treat your acne, and resist the urge of popping them.

If you have stubborn pimples, you can pair multiple acne-targeting ingredients to amplify the healing effect.

• Niacinamide and azelaic acid are a good duo.

• Tretinoin and azelaic acid are sweet couples.

• Azelaic acid and salicylic acid  go well together. It’s best to use both acids at separate times to limit the chances of incurring inflammatory-irritation (azelaic acid in the morning, salicylic acid at night) or use both together at a very low concentration if you have a resistant skin.

Possible Questions & Answers

Q: How is acne diagnosed.

A: You have to visit a dermatologist for proper examination. The dermatologist will have to examine your acne to know the severity, the type of acne and what treatment to be used in treating it.