Acne: All You Need to Know About It

Acne: All You Need to Know About It!

Introduction

Acne (medically known as acne vulgaris) is a skin condition where the pores are clogged by sebum in the form of whiteheads or blackheads, which in turn, takes the form of pimples, cysts or nodules. Acne is normally a temporary condition; however, in some cases, can appear on the skin for a prolonged duration. This is often also called ‘common acne’, for the fact that an acne outbreak is a common phase in everyone’s life.

Although adolescents find themselves most affected by this, a pimple outburst could happen to anyone of any age or gender. Most commonly acne lesions occur on the face; they also appear on the shoulders, neck, chest, upper arms, upper legs and back. The scars that these leave behind are the biggest curse after the ugly looking pimples during the outburst.

What is acne?

Human skin has tiny openings or pores for hair follicles, which is connected to the sebaceous glands or oil glands under the skin. These glands secrete sebum, an oily fluid that carries dead skin cells to the surface of the skin. Hair grows through these follicles to the outer skin. When these follicles get clogged, pimples grow as a result of oil accumulating under the skin. The clogs form into blackheads in case of large openings and whiteheads in case of small openings. These can then take the form of pimples or nodules.

Quick Acne Facts

• Even though washing the face helps remove excess oil on the skin, pimple breakouts will not get better with it. As a matter of fact, over washing may adversely affect the condition. A mild cleansing twice a day should be just enough to remove excessive oil.
• It is not always true that makeup may cause acne; however, use of some cosmetic products may cause irritation or aggravate an existing skin trouble. Some non-comedogenic cosmetic products are said to not lead to pimple breakouts. Before using any products, a patch test is advised to avoid irritation or further trouble.
• Acne medication should be used in the prescribed amount. Overuse of the medication can cause further irritation and can worsen the condition.
• It is a good practice to follow a balanced diet; however, it is not proven reason for causing acne outbreaks. Allergies to a certain food may be a reason to worsen an existing acne condition or a new outbreak.
• Acne condition can worsen with the exposure to sun; however some amount of sun is required by the skin. If acne affected sun is exposed to the sun too much, it could cause irritation and darkening of the skin.
• All products that claim to be organic are not and in fact they contain substances that work inversely on acne affected skin. These products may contribute to clogging of the pores, in turn breakout of ugly pimples.
• Acne is a temporary and curable condition. The condition may last for a prolonged period of time for many. With proper medication and precautions, it is curable. It is important that one pays attention to how some products or foods may react to their skin.
• There is no proven way to prevent acne. However, with proper skincare measures, one can decrease the chances of getting acne. Even if the skin starts to clear after using a certain medication, it is important to complete the course of the medicines to prevent further outbreak.
• A strong immune system can help fight against the bacteria that cause acne and its problems. Some dermatologists suggest supplements to boost the immune system, some of which are vitamin A, C, D and E, methylsulfonylmethane, alpha linolenic acid etc.

What are the causes of acne?

The exact causes of acne are not fully proven; however, experts in the field are of the opinion that the major cause is hormones. Androgen is a hormone type that includes testosterone; increased level of which can cause the oil generating glands to grow and secrete more sebum. This in turn clogs the follicles, giving a chance to the bacteria to grow and form blackheads or whiteheads on the skin. The clogging can also cause the follicle wall to break, which can cause inflammatory acne.

There are medications that contain lithium and androgen; these could also be the cause for acne. Some oily cosmetics could also cause acne.

For some, the adolescent years have not been a lot about the acne problems; they are most likely to get acne at some point. It is also believed by many doctors that acne also depends on person’s skin’s behavior to increased production of sebum and the bacteria. Propionibacterium acnes is the bacteria, when settled in the hair follicles, causes acne. These occur even in healthy hair follicles, and accumulation of too many may trigger breaking down of sebum and inflammation. This reaction may have different results on different people depending on how sensitive the skin is. Where there is a major acne outbreak for one could be a mere couple of pimples for another.

It is said that acne susceptibility could also be genetic. For some women, hormonal changes that happen during pregnancy causes acne.

What are the different types of acne?

Acne can be classified into different types according to their severity and the effects they have on the skin. Below are the most common types acne can be classified into:

• Comedones: These are the most common form of acne found in people, also known as whiteheads or blackheads. When the pores are clogged by sebum and keratin, which blackens at the surface are called blackheads. When the sebum forms in the pores and swells under the tissue, it is known as whiteheads. This is a form of mild acne; if squeezed or picked, can cause infection.
• Acne lesions: Acne lesions are very similar to comedones; the hair follicles are filled with sebum, causing acne affecting the skin in small patches.
• Papules: This is an inflammation on the skin that usually does not contain pus. Papules are normally small and solid and can also occur in a cluster on the skin.
• Pustules: These are somewhat similar to papules, with the difference that these contain pus in them. These usually appear around the hair follicles. The pus consists of bacteria, dead skin cells and white blood cells.
• Maculae: Maculae are red spots on the skin which happen after an acne lesion. These are normally red and flat. Sometimes the regions affected by maculae looks inflamed on the face.
• Nodules: Nodules are among the most painful forms of acne. They even cause tissue destruction in many cases. Nodules are lesions that are solid and can affect deeper layers of the skin. Nodules usually leave scars behind and are considered a part of severe acne. These are treated with isotretinoin.
• Cysts: These are lesions that are very similar to pustules, but bigger in size. Cysts contain pus in them, which could be infected. Cysts also extend to deeper layers of the skin and can leave scars on the skin.

Who can get acne?

Anybody can get acne; it is not confined to a specific age group or sex. Almost everyone in the world gets pimples. The most common time people get a pimple outbreak is when they enter puberty, which is around the age of 12. This is because of the hormonal changes humans go through in the adolescence; it doesn’t matter which part of the world one belongs to or whether one is male or female. A lot of people get severe cases of acne and are required to seek medical help.

While acne is usual for many during the adolescent years, there are many people who do not get it until they are adults. Men are more prone to adult acne because of the presence of higher levels of androgen in them. Women are more likely to get acne during the fertility cycle and the hormonal changes associated with it.

The ugly looking scars left behind by acne causes panic among a lot of people, who try to use different kinds of medications to get rid of the pimples and their marks.

How to cure acne

Acne treatment depends on the type and severity of the acne. Many types of acne could take up to many months to be treated completely. Mild acne forms like whiteheads and blackheads could be treated using topical treatments, which basically include over the counter creams and gels.

If the symptoms do not get better with these over the counter medicines, one must seek help from the general physician. Some of the prescription medications that the general physician would use are:

• Topical antibiotics
• Topical retinoids
• Antibiotic tablets
• Azalaic acid
• Isotretinoin tablets

In some cases of severe acne, the general physician may then refer the patient to a skin specialist or dermatologist. In the event that you have serious skin inflammation, for example, a lot of pustules and papules, your GP can refer you to a specialist in treating skin conditions.

A mix of antibiotic tablets and topical medications is generally the first treatment choice for serious skin break out. On the off chance that this doesn't work, a medicine called isotretinoin may be recommended.

Hormonal treatments or the consolidated oral prophylactic pill can likewise be compelling in ladies who have skin break out. On the other hand, the progestogen pill or prophylactic pill can sometimes exacerbate skin inflammation.

Huge numbers of these medications can take a few months before they begin to work. It's imperative to be patient and hold on with a prescribed treatment, regardless of the fact that there is no prompt impact.

Some of the topical treatments are as follows:

Benzoyl Peroxide

Benzoyl peroxide fills in as a disinfectant to decrease the number of microscopic organisms on the surface of the skin. It additionally decreases the number of whiteheads and zits and has a calming impact.

Benzoyl peroxide can generally be found in the form of a cream or gel. It is normally prescribed to be used twice has to be applied in 20 minutes of washing all parts of your face or the area of the skin affected by inflammation.

It should be used in the right amounts as using a lot of can aggravate your skin. It additionally makes your face more sensitive to sun, so stay away from sun and UV rays, or wear sunscreen.

Basic reactions of benzoyl peroxide include dry, sensitive skin, burning or itching at times and peeling of skin or redness.

Symptoms are typically mellow and ought to pass once the treatment has wrapped up.

Normally, people require a six-week course of treatment to clear most part of their skin break out.

Topical Retinoid

Topical retinoids are used for expelling dead skin cells from the surface of the skin which averts them building up inside of the hair follicles. Tretinoin and adapalene are topical retinoids that are used to treat skin break out. You can buy them in the form of a gel or cream and using them once a day before going to bed is advised. Do not use too much of this as it may cause irritation to skin. Keep this away from the sun. The most widely recognized symptoms of topical retinoids are gentle disturbance and stinging of the skin.

Topical retinoids are not suitable for use amid pregnancy as there is a danger that they may bring about conception deformities.

A six-week course is generally required, yet you may be encouraged to keep using the medicine for a longer time to avoid recurrence.

Topical antibiotics

Topical antibiotics help in getting rid of the microorganisms on the skin that can cause infection in the clogged hair follicles. You can buy them in the form of a gel or cream that has to be applied on the affected areas once in a day.

This treatment is usually prescribed for a period of 6 to 8 weeks. The treatment is generally halted after this period as there is a danger that the microbes all over could get to be impervious to the antibiotics. This could exacerbate your skin break out and cause extra further irritation.

Some of the side effects could be redness in the skin or slight peeling.

Azelaic acid

Azelaic acid is opted as a treatment for acne if one shows signs of allergy with benzoyl peroxide or topical retinoids. Azelaic acid works by disposing of dead skin and eliminating infection-causing bacteria. You can find it in the form of a cream or gel and has to be used normally twice every day.

The medicine normally does not make your skin sensitive to sun. You will normally need to apply azelaic acid for a month to completely get rid of the inflammation.

The symptoms of azelaic acid are generally mellow and include itchiness, dry skin and slight burning or redness.

Antibiotic tablets

Antibiotic tablets are generally used in case of severe acne. This is used along with other topical treatment. In most cases, you will be prescribed to use an antibiotic called teracyclines. This is not prescribed for pregnant women or breastfeeding mothers. There is an alternative antibiotic called erythromycin, which is used in case of pregnant ladies or breastfeeding mother.

The treatment normally takes about 6 weeks to completely cure the acne condition. A course of oral antibiotics can be prescribed for a period of 4 to 6 months depending on how your skin reacts to the medication.

Tetracyclines can also make your skin sensitive to sun or UV rays. This can also make the pill less effective. You may need to opt for other contraception methods, like condoms, during the course of the medication.

Hormonal therapies

Hormonal treatments can regularly advantage ladies with skin break out, particularly if the skin inflammation erupts around periods or is connected with hormonal conditions, for example, polycystic ovary disorder.

On the off chance that you don't as of now utilize it, your GP may prescribe that you begin taking the combined oral contraceptive pill, regardless of the possibility that you are not sexually active. This medication can frequently enhance skin break out in ladies, yet may take up to a year to completely treat the condition.

Co-cyprindiol

Co-cyprindiol is a hormonal treatment that reduces the production of sebum. This can be used in case of severe skin acne that doesn't react to antibiotics. You are normally prescribed to the use of co-cyprindiol for 2 to 6 months depending on how it reacts for you, to completely get rid of the condition.

Co-cyprindiol could get along a risk of getting breast cancer later on. There is also a little risk of co-cyprindiol creating blood clots, though it is estimated as little as 1 in 2,500 in a year. Women are required to go through a pregnancy test before the treatment begins, even though it is considered safe for pregnant women.

Other reactions of co-cyprindiol include:

• Weight gain
• Mood swings
• Headaches
• Sore breasts
• Loss of interest in sex
• Bleeding or spotting in between the periods

Isotretinoin

Some of the advantages of Isotretinoin are as follows:

• It standardizes sebum production
• It decreases the number bacteria
• It prevents clogging of hair follicles
• It helps reduce the redness and inflammation

There could be side effects to this too. Therefore, this medication is only used in case of severe acne problem and if no other options seem to be effective. Keeping the serious side effects it may cause, you must only use this if recommended by the dermatologist or the physician you are consulting.

Isotretinoin is taken orally as a tablet. Normally the skin conditions starts getting better after the initial 7 to 10 days, however, many people may have to continue the course for a period of 4 to 6 months.

Some of the common side effects of the medication could be:

• Bleeding in urine
• Inflammation of eyelids and irritation in the eyes
• Increase or decrease in the blood glucose levels
• Swelling and irritation on the skin

Some other rare cases of side effects could also be:

• Kidney disease
• Liver and pancreas swelling

You might be required to do blood tests before or during the course of the treatment because of the serious side effects associated with it.

Non pharmaceutical treatments

Some of the treatments do not require prescription and are called non pharmaceutical treatments. These are:

• Comedone extractor: Comedone extractor is an instrument in the shape of a pen that is used to clear open the clogged pores. You can also steam the skin before using the comedone extractor on the skin affected with whiteheads or blackheads.
• Chemical peels: Chemical peels can be effective for acne in some cases. Here, a chemical solution is applied to the affected skin. The chemical then forms something like a blister which peels off to bring new skin. This is also used to cure wrinkles, age spots, freckles and sun damage.
• Photodynamic treatment: In this type of medication, a photosensitizer is used along with a certain wavelength of light that kills the affected cells.
• Home remedies: Exfoliation is a great way to get rid of the dead skin, which might appear as a mild scar sometimes. These methods are cheap and pretty much easy to use. You can use things you use in day-to-day life to exfoliate your skin. Some of these things are lemon, baking soda, sugar etc. Most home remedies are effective, however may take time to cure the scars. Home remedies are the most cost effective of all acne scar treatments.

These medications may not work for everyone and therefore cannot be relied upon for definite results.

It is said that toothpaste is a good option to dry up the pimples, however, it can also irritate or worsen some conditions. Toothpaste does contain antibacterial substances that can help fight the infection in the hair follicles. Because of the irritation it may cause, it is not advisable to everyone. You may find better alternatives to it in a pharmacy or from your physician.

Skin care tips

Here are some skin care tips one must keep to hand. These will help avoid pimple outbreaks, if not guarantee preventing them:

• Keep minimum hand contact with the skin

It is almost impossible for people to keep their hands off their face or other places that are prone to the acne infection. One must learn to not touch skin that is affected with acne. Picking and squeezing pimples can result in further aggravation of the situation and serious scarring. Moreover, squeezing pimples will leave open pores that can cause bacteria to enter the skin.

• Do not try to scrub or scrape the affected area

It is important to be very gentle to the skin that is acne affected. Mild cleansing using lukewarm water twice a day should be just enough to remove excessive oil on the skin. Overdoing the medications or scrubbing the face can lead to irritation and darkening of the affected region. Pat dry the face with a gentle pad or towel after washing. Rough scrubbing could open up lesions that may cause bacterial infection.

• Try to avoid contact with sun

Even though, sun is said to be good for the skin if taken in the right amount, contact with the sun during an acne infection is not the best thing to do. The sun’s UV rays dry the outer skin and it starts to peel away. Even though some have the opinion that it is good for acne infected skin, one must avoid it. Too much of exposure to the UV rays can even worsen the condition and it is one of the reasons for skin cancer.

• Use the right kind of razor

For men, it is important that they take extra care of the acne affected skin while shaving. For some, an electric razor is better on an acne affected skin and for some it is regular one. Use of a mild shaving cream is advised.

• Use the right cosmetics

Women who use cosmetics should avoid using oily cosmetics as they may further aggravate the skin condition. During an acne treatment, it is advised that you select cosmetics that specify that they are oil-free. It is also a good idea to conduct a patch test on your skin before using any products.

• Remove make-up before going to bed

Use a mild cleanser to remove make up before you go to bed. Sleeping with the makeup on can cause the pores to clog and infect them with bacteria overnight. Use a fragrance, mild, water based emollient after cleansing your face.

• Wash your hair regularly

If you have a problem of oily scalp or dandruff, they could play an important role in causing pimples or worsening an existing acne condition. It is important that you regularly wash your hair to keep the scalp clean. You must also avoid hair falling over the face.

• Exercise regularly

Even though exercise may not directly help get rid of acne, it helps in staying active and reduces stress.