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What is acne?
Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It often causes whiteheads, blackheads or pimples, and usually appears on the face, forehead, chest, upper back and shoulders. Acne is most common among teenagers, though it affects people of all ages.
Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.
Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems
- Acne signs and symptoms vary depending on the severity of your condition:
- Whiteheads (closed plugged pores)
- Blackheads (open plugged pores)
- Small red, tender bumps (papules)
- Pimples (pustules), which are papules with pus at their tips
- Large, solid, painful lumps beneath the surface of the skin (nodules)
- Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)
- For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives.
Four main factors cause acne:
- Excess oil production
- Hair follicles clogged by oil and dead skin cells
- Excess activity of a type of hormone (androgens)
Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands.
The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.
Pimples are raised red spots with a white centre that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cyst like lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.
Factors that may worsen acne
These factors can trigger or aggravate acne:
- Hormones. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne.
- Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.
- Diet. Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
- Stress. Stress can make acne worse.
These factors have little effect on acne:
Greasy foods. Eating greasy food has little to no effect on acne. Though working in a greasy area, such as a kitchen with fry vats, does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or promotes acne.
Hygiene. Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
Risk factors for acne include:
Age. People of all ages can get acne, but it’s most common in teenagers.
Hormonal changes. Such changes are common in teenagers, women and girls, and people using certain medications, including those containing corticosteroids, androgens or lithium.
Family history. Genetics plays a role in acne. If both parents had acne, you’re likely to develop it, too.
Greasy or oily substances. You may develop acne where your skin comes into contact with oily lotions and creams or with grease in a work area, such as a kitchen with fry vats.
Friction or pressure on your skin. This can be caused by items such as telephones, mobile phones, helmets, tight collars and backpacks. These hold bacteria.
Stress. Stress doesn’t cause acne, but if you have acne already, it may make it worse.
Depending on the grade of acne, your treatment plan may vary. The most important thing to do is;
Control your acne
Avoid scarring or other damage to your skin
Make scars less noticeable
Acne medications – these can help but also put your skin and body through a whirlwind of reaccuring problems. Yes they may help clear your acne but you will be left fixing skin concerns that’s is left behind. Eg, skin impairment, sensitivity, redness & pigmentation. Not only the mental affects that these can have, these medications have known side effects on the body. Refer to picture.
Topical skin care
The most common topical prescription products for acne are as follows:
Retinoids and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A. You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.
Salicylic acid Salicylic acid help prevent plugged hair follicles and is available as both wash-off and leave-on products. Studies showing its effectiveness are limited.
The treatment regimen that your skin specialist recommends depends on your age, the type and severity of your acne, and what you are willing to commit to.
For example, you may need to wash and apply products to the affected skin twice a day for several weeks.
For moderate to severe acne, you may need oral antibiotics to reduce bacteria and fight inflammation. Usually the first choice for treating acne is tetracycline — such as minocycline or doxycycline — or a macrolide.Oral antibiotics should be used for the shortest time possible to prevent antibiotic resistance.Oral antibiotics are best used with topical retinoids.Antibiotics may cause side effects, such as an upset stomach and dizziness. These drugs also increase your skin’s sun sensitivity.
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.
The most common side effects of these drugs are weight gain, breast tenderness and nausea. A serious potential complication is a slightly increased risk of blood clots.
These therapies may be suggested in select cases, either alone or in combination with medications.
IPL and photodynamic therapy. A variety of light-based therapies have been tried with success.
Chemical peel. This procedure uses repeated applications of a chemical solution, such as salicylic acid, glycolic acid, retinoic acid & enzymes. Any improvement in acne is not long lasting, so repeat treatments are usually needed.
Extraction of whiteheads and blackheads. Your doctor may use special tools to gently remove whiteheads and blackheads (comedos) that haven’t cleared up with topical medications.
You can avoid or control mild acne with good basic skin care and other self-care techniques:
Wash problem areas with a gentle cleanser. Twice a day, use your hands to wash your face with a cleasner and warm water. If you tend to develop acne around your hairline, shampoo your hair every day. And be gentle if you’re shaving affected skin.
Try over-the-counter acne products to dry excess oil and promote peeling. Look for products containing salicylic acid, glycolic acid or alpha hydroxy acids, which help with mild and moderate acne.
Avoid irritants. Avoid oily or greasy cosmetics, sunscreens, hairstyling products or acne concealers. Use products labeled water-based or noncomedogenic, which means they are less likely to cause acne.
Protect your skin from the sun. For some people, the sun worsens acne. And some acne medications make you more susceptible to the sun’s rays. Regularly use a non oily (noncomedogenic) moisturizer that includes a sunscreen. Preferably Zin based
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 at the problem 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 clogging of the pores, bateria build up & inflammation.
Acne scars are stubborn, and no single treatment is best for everyone. Various methods may help improve your complexion. You may benefit from one or a combination of these.
Laser resurfacing. This is a skin procedure that uses a laser to improve the appearance of your skin.
Other energy-based procedures. Pulsed light sources and radiofrequency devices help make scars less noticeable without damaging the outer layer of skin. Results are subtle and you may need to repeat the procedure.
Dermabrasion. This procedure is usually reserved for more severe scarring. It involves removing the top layer of skin with a rapidly rotating wire brush. Surface scars may be completely removed, and deeper acne scars may appear less noticeable.
Chemical peeling. High-potency acid is applied to your skin to remove the top layer and minimize deeper scars.
Needling or rolling. This involves rolling a needle-studded device over the skin to stimulate underlying tissue. It’s a safe, simple and possibly effective technique for acne scarring. The result is subtle, and you may need to repeat the treatments.
A series of these will be needed and can’t be fixed with 1 treatment. It is generally treated over a period of time with regular treatments.