Acne
Tiny bumps on your face are not acne. Acne is different from tiny bumps. You will learn about acne, its causes, symptoms and treatments in detail here.
Acne is an inflammation of the skin caused due to the hair follicles, bacteria, oil from sebaceous glands and dead skin cells clogging the pores.
This block leads to an outbreak of lesions, commonly called pimples or zits. These outbreaks may appear on the face usually but may also appear on the back, chest and shoulders.
Our skin exfoliates dead skin cells for every 28 to 45 days. The dead skin cells are replaced by new skin cells. When these dead cells are not exfoliated properly, it may clog the pores with the sebum and result in acne formation.
This mix of oil and cells lets bacteria grow in the clogged follicles and causes inflammation. If the clogged follicles break down, the bacteria, sebum and skin cells spill out into nearby skin, creating pimples.
Causes of acne
Excess oil production
Increased sebum production is the fuel of acne. The development of acne affects four key processes — increased inflammation, increased bacterial count, blockage of the pilosebaceous unit (a collection of the hair follicle, hair shaft and sebaceous gland) and production of sebum. The exact sequence of these events is still unknown due to the complexity of acne, says Science direct.
Clogging of hair follicles
When excess sebum production is observed, there is an increased growth, reproduction and accumulation of skin cells in the hair follicles.
Blackheads or whiteheads develop when the sebum and skin cells accumulate in the microcomedo. Microcomedos are invisible to the naked eye, but they are the primary source for developing comedones.
Bacteria
The lack of oxygen in the environment will make bacterium, propionibacterium acnes, turn sebum into fatty acids that cause inflammation in nearby skin cells.
NCBI reports that this bacterium is believed to play a vital role in developing the common skin condition acne vulgaris.
Acne vulgaris is an inflammatory disorder of the pilosebaceous unit where bacteria trigger inflammation, resulting in severe acne.
Inflammation
The clogged dead skin cells and sebum (oil) in the hair follicle cause inflammation. Data from NCBI indicates that acne vulgaris is a primary inflammatory disease, suggesting inflammation occurs at all stages of acne scar development.
Hormonal changes
Androgenic steroids are increased during puberty, stimulating the sebum production and causing acne in both genders. Hormonal changes in women during midlife or pregnancy may lead to the acne breakout.
Certain medications
Certain medications, including hormonal medicines, corticosteroids and lithium, may cause acne. From NCBI’s research, it is proved that drug-induced acne is an adverse effect of using systemic drugs, like
- Corticosteroids,
- Lithium,
- Vitamin B12,
- Thyroid hormones,
- Halogen compounds,
- Antibiotics and
- Antimycotics.
Stress
Corticotropin-releasing hormone (CRH) is the main element related to the body’s response to manage stress. Stress causes acne by stimulating sebum production from sebaceous glands with the increased release of stress hormones (CRH). Stress acne can be treated by stress management, using anti-inflammatory creams and not picking at pimples.
Diet
Research article titled “The relationship between diet and acne” reported glycaemic index, such as sugary foods, soft drinks, white bread, sweet potatoes and white rice, may contribute to acne by elevating serum insulin, suppressing SHBG (sex hormone binding globulin), and raising androgen concentrations.
In addition to the above information, NCBI also states that low-glycaemic index foods such as green vegetables, raw carrots, fruits, kidney beans and bran breakfast cereals may increase SHBG and reduce androgen levels. It is important to know that higher SHBG levels were associated with reduced severity of acne.
Symptoms of acne
Usually, acne appears on the face, forehead, upper back, chest and shoulders. The signs of acne can be different based on its severity. Among them, a few common symptoms are listed below.
- Tiny red and tender bumps (papules)
- Pimples with pus at the tip (pustules)
- Whiteheads (clogged tiny pores)
- Blackheads (tiny open bumps filled with excess oil and dead skin cells)
- Solid, painful lumps beneath the skin
- Pus-filled lumps under the skin cause pain
Risk factors of acne
Pressure on your skin
Continuous pressure on the skin and friction causes acne mechanica. Acne Mechanica can break out when the skin is rubbed, stretched or squeezed. This acne may break out from the pre-existing acne or appear without any underlying outbreak.
Oily substances
When the sebaceous gland forms too much sebum, it results in oily skin. Sebum is an oily and waxy substance that protects and hydrates your skin. For keeping your skin healthy, sebum is very important. But too much sebum can lead to clogged pores, oily skin and acne.
Genetics
A study from Research gate says that chromosomal abnormalities, HLA phenotypes and polymorphisms of various genes are associated with acne. Data from family studies proved familial clustering (hereditary).
Acne lesions in boys are mostly due to genetic factors, whereas in girls, it is most commonly due to environmental factors.
Hormonal changes
Hormonal changes are common during puberty and increase the risk of acne in both boys and girls, especially in their teenage. Acne vulgaris is common due to hormonal changes.
Age
Puberty leads to hormone fluctuation. Both boys and girls may develop acne during their teenage. It may get severe in oily skin. In older adults, the sudden appearance of acne may be a sign of underlying diseases.
Diagnosis of acne
There is no specific test for acne. A medical practitioner may diagnose acne by looking at your face, back or chest to examine the spots or blackheads type.
Your medical practitioner may ask a few questions, like whether your acne is hereditary or if you are undergoing stress, all of that are risk factors for acne.
The severity of acne can be categorized under three divisions.
- Mild – a few whiteheads and blackheads with papules and pustules
- Moderate – many whiteheads and blackheads with moderate papules and pustules
- Severe – lots of painful, large papules and pustules with numerous whiteheads and blackheads.
Teen girls and women may be questioned about their period cycles, as the appearance of acne is related to their menstrual cycles sometimes.
The sudden development of acne in older people is a sign of another underlying disease that requires clinical attention.
Treatments of acne
Medications
Doxycycline tablet is an oral medication. Doxycycline is a tetracycline antibiotic used to treat various bacterial infections like acne and urinary tract infections.
Acne can be treated with Clindamycin cream or gel. Clindamycin is an antibiotic which stops the bacterial growth that causes acne.
Light therapy
MDPI shows that Light therapy is an alternative which offers a unique type of treatment for acne. Topical retinoids and benzoyl peroxide are to be taken daily, which may cause irritation.
To avoid such incomplete treatment, alternative methods like light therapies have emerged that offer a unique type of treatment for acne.
Some light therapy treatments to treat acne are listed below.
- Intense pulsed light (IPL)
- Photodynamic therapy (PDT)
- Photobiomodulation (PBM)
NCBI reports that combining blue light and blue-red light effectively treats light to moderate acne lesions.
Photobiomodulation (PBM) is a non-thermal light therapy used to treat acne with other dermatological conditions.
Drainage and extraction
According to an open-access journal MDPI (multidisciplinary digital publishing institute), the mechanical extraction method involves the following procedures.
- Gently rub the acne lesion with alcohol, and pierce the epidermis lightly with a needle or surgical blade.
- Then, a comedone extractor is used to apply mild to medium pressure on top of the lesion until all the contents are oozed.
- Before performing the manual removal of comedones, enzymatic or mechanical exfoliation can be used to reduce hyperkeratosis.
- After treatment, the skin must be treated with an anti-inflammatory or antimicrobial agent for non-residual scarring.
Chemical peel
In general, chemical peels remove the dead skin cells in the top layer of the skin. Once the skin’s top layer (dead skin cells) is removed, the new skin grows smoother and can lessen acne scars.
NCBI records that chemical peels have antibacterial, anti-inflammatory, keratolytic (compounds that break down the outer layer of the skin) and comedolytic (medications that prevent the formation of comedones) effects, and they can reduce sebum production.
Steroid injection
Severe acne can be treated with steroid injections. These steroid injections are injected into large nodules to reduce inflammation.
Prevention of Acne
Wash your face twice a day
A person must wash their face 1-2 times a day. Washing your face for the third time is okay when you come from a sporting event where you sweat a lot.
Be gentle with your skin
Being gentle on your skin is vital to prevent acne. Scrubbing your skin may make acne worse. So gently rub if you feel too itchy. Use gentle cleansers on your skin to prevent acne from spreading.
Let your skin heal on its own
Squeezing to treat heat pimples may lead to scabs and may leave you with permanent scars. Patience is a way to cure mild acne without treatment. Over time, your pimples may heal on their own and by leaving no scars.
Use a non-abrasive cleanser
A salicylic acid face wash is an exfoliator that helps unclog pores and removes dead skin cells. Salicylic acid keeps your skin clean, reducing wrinkles and giving an even-out skin tone. Salicylic acid acts as a defence against blackheads, whiteheads and mild acne.
Serum
Niacinamide serums are used to treat acne. Niacinamide helps build skin cells and also helps protect from environmental stresses, like sunlight, pollution and toxins. Niacinamide is used for severe acne, especially inflammatory forms such as papules and pustules. As a result of using niacinamide on the skin, you may see fewer lesions and improved skin texture.
Keep your hands off your face
Acne Mechanica is caused due to touching, rubbing, scratching, or stretching your skin. Such actions will increase sebum production. This will lead to clogged pores and ends with acne. So, try to keep your hands off your face.
Rinse with lukewarm water
Acne is caused due to the clogging of oil, dead skin cells and their contact with bacteria. So, cleansing your face often with lukewarm water will remove the oil residue and reduce acne. Using lukewarm water while washing your face will remove dirt and maintains natural oil content in the skin.
When to see a doctor?
If home remedies are not working on your acne, seek help from your dermatologist. For many women, acne can be lifelongand its spread is common during menstrual cycle. Such acne can be cured on its own without treatment.
Medical attention is required when the sudden spread of acne is noticed in older adults. Such acne can be a sign of an underlying condition.
Some popular non-prescribed acne lotions, cleansers and other skin products may cause adverse effects on the skin.
Conclusion
Acne can be cured mostly with home made remedies. If it does not work on your skin, seeking a dermatologist’s help is recommended. Severe acne can be treated with regular administration of medications.
There are numerous pain-free treatments available to treat acne at a low cost. Utilising such treatments are advised to retrieve your clear glassy skin and render a new glow.
FAQs
What causes acne?
What are the 3 stages of acne?
1. Grade 1 (mild): Whiteheads and blackheads are mostly visible, whereas very few papules and pustules are seen.
2. Grade 2 (moderate or pustular acne): Numerous papules and pustules are seen on your face.
3. Grade 3 (moderately severe): Many papules and pustules are seen with inflamed nodules.
4. Grade 4 (severe acne): Numerous papules and pustules with painful and inflamed acne are observed on your face and sometimes on your chest and back.
