February 4, 2022 Great Joy Madura
Acne is a skin disorder. Acne occurs when hair follicles become clogged with oil and dead skin cells. This leads to blackheads, whiteheads, or pimples. Acne can impact people of all ages, but it mainly affects teenagers.
There are effective acne treatments, but acne can be stubborn. The pimples and bumps are slow to heal, and when one pimple disappears, others pop up.
Acne can cause emotional distress and scar the skin depending on the severity. You can lower the risk of such a problem by starting the treatment as soon as possible.
What are the symptoms of acne?
You can have acne anywhere on your body. Most commonly develops on your face, neck, shoulders, back, and chest.
If you have acne, you’ll see black or white pimples. Whiteheads and blackheads are known as comedones.
Blackheads open on the surface of your skin, causing them to appear black due to oxygen in the air. Whiteheads are closed just below the skin’s surface, making them look white.
Even though blackheads and whiteheads are the most common lesions in acne, other types may occur. Inflammatory lesions are more possibly to cause scarring on your skin. These can include:
- Nodules are firm, often painful lumps under the surface of the skin.
- Pustules are tiny red pimples that have pus at the tip.
- Papules are little, red, raised bumps caused by inflamed or infected hair follicles.
- Cysts are large lumps under the skin that contain pus and are usually painful.
Human skin has pores connected to the sebaceous glands under the skin, and the gland is connected to the pores by follicles. Follicles are tiny sacs that produce and secrete fluid.
The glands produce an oily fluid called sebum. Sebum transmits dead skin cells through follicles to the surface of the skin. A small hair grows out of the skin through the follicle.
Pimples occur when these follicles become clogged, and oil accumulates underneath the skin.
Sebum, skin cells, and hair can accumulate in a plug. This plug becomes infected with bacteria, and swelling occurs. When the plug begins to break down, a pimple develops.
Bacteria located on the skin and contribute to pimples infection is named Propionibacterium acnes (P. acnes).
Research suggests that the severity and commonness of acne depend on the strain of bacteria. Not all acne bacteria trigger pimples. One strain helps keep the skin pimple-free.
Increased androgen levels are thought to be the leading cause of acne, although several factors cause acne.
Androgen is a hormone whose levels increase with the onset of puberty. In women, it is converted into estrogen.
The rising androgen level causes the oil glands under the skin to grow. The enlarged glands produce more sebum. Extra sebum can break down the cell walls in the pores, allowing bacteria to grow.
Other possible triggers
There are suggestions, by some studies, that some genetic factors can increase the risk.
Other causes may include:
- Emotional stress
- Hormonal changes
- Some medications that contain androgen and lithium
- A cosmetic that is greasy
Many people believe that chocolate or fries contribute to acne due to several myths about acne. While these claims are not scientifically proven, there are certain risk factors for developing acne. These include:
- hormonal changes caused by pregnancy or puberty
- specific medications such as particular birth control pills or corticosteroids
- a diet rich in refined sugars or carbohydrates such as bread and chips
- having parents who had acne.
The highest risk of developing acne is during puberty. During this time, your body goes through hormonal changes. These changes can stimulate oil production, leading to an increased risk of acne. Hormonal acne related to puberty usually subsides or at least improves by the time you reach adulthood.
Types of Acne
Acne Vulgaris is a common medical term for acne – the presence of blackheads, whiteheads, and other types of acne on the skin. The most common places for breakouts are the face, chest, shoulders, and back. Mild acne may improve with over-the-counter remedies, but a dermatologist should treat more severe forms.
Comedo or primary acne lesion is a hair follicle clogged with oil and dead skin cells. Comedones (plural of comedo) can develop into whites and blackheads nodules. Products that can trigger comedones are called “comedogenic” also, makeup labeled “non-comedogenic” is less likely to clog pores and less likely to contribute to acne.
Blackheads are open comedones on the skin surface. They are full of extra oil and dead skin cells. It is not the dirt that turns the blackheads black. The black coloring is caused by the irregular reflection of light coming from clogged hair follicles. Blackheads can often be treated with over-the-counter medications.
Whiteheads are comedones that are left closed on the surface of the skin. This is caused when oil and skin cells prevent a clogged hair follicle from opening. Many of the over-the-counter medications that treat blackheads are also effective against whiteheads.
Papules are comedones that form small red or pink bumps on the skin and become inflamed. This type of pimple can feel tender. Picking or squeezing can worsen inflammation and may lead to scarring. Moderate to severe acne may be indicated with a large number of papules.
Pustules are another form of inflamed pimples. They look like a white head with a red ring around the bump. Avoid nibbling or squeezing pimples. Picking can cause scarring or dark spots on the skin.
Nodules– Nodules are large, inflamed pimples that feel firm. They form deep in the skin and are often painful. A dermatologist should treat nodules because they can scar. Treatments that aren’t prescribed may not be strong enough to get rid of them, but prescription medications can be effective.
Cysts– Cysts are large, pus-filled lesions that resemble a boil. Cysts can be painful such as nodules and should be treated by a dermatologist, as they can also leave a scar. It is believed that people who develop nodules and cysts have a more severe form of acne.
Mild Acne– “Mild” category of acne is if you have less than 20 blackheads or whiteheads, fewer than 30 lesions total, or fewer than 15 inflamed bumps. Mild acne is usually treated with medications without prescriptions. It may take up to eight weeks before you see significant improvement.
Moderate Acne– If you have 20-100 blackheads or whiteheads, 15-50 inflamed bumps, or 30-125 lesions total, your acne is considered moderate. Dermatologists usually recommend prescription medications for moderate to severe acne. It may take a few weeks until you notice improvement, and your acne may seem to get worse before it gets better.
Severe Nodulocystic Acne– People dealing with intense nodulocystic acne have multiple inflamed nodules and cysts. The acne may turn red or purple, and also it can often leave scars. Timely treatment by a dermatologist can reduce the formation of scars. In some cases, your doctor may inject corticosteroids directly into the nodules and cysts to reduce the size and painful inflammation.
Acne Conglobata– Acne conglobata is one of the most painful forms of acne. It involves multiple inflamed nodules associated with other nodules under the skin. It can affect the neck, arms, chest, and buttocks, and also it can often leave scars. This kind of acne is more common in men and is sometimes caused by steroid or testosterone use. Timely treatment by a dermatologist is essential.
Acne Mechanica– Acne Mechanica is caused by heat, friction, and pressure on the skin, often due to wearing sports equipment such as helmets or baseball caps. It is sometimes called “sports-induced acne” because it usually occurs in athletes. Showering immediately after exercise & wearing an absorbent material under sports equipment can prevent getting this kind of acne.
When to see a doctor
If your acne does not go away with self-treatment remedies, you should see your family doctor. They may prescribe stronger medications for you. If the acne persists or is severe, you should seek treatment from a doctor who specializes in the skin (dermatologist or pediatric dermatologist).
Acne can persist for decades in many women, with flare-ups often occurring a week before menstruation. In women who use contraceptives, this type of acne usually disappears without treatment.
In older adults, the sudden appearance of severe acne may indicate an underlying condition that needs medical attention.
How is acne diagnosed?
If you have any symptoms of acne, your doctor may make a diagnosis by examining your skin. Your doctor will determine the type of lesions and their severity to determine the best treatment.
People with darker skin types are at higher risk for the following acne complications than people with lighter skin:
- Dimples (acne scars) and thick imperfections (keloids) can persist long after the acne has healed.
- Skin changes. After acne has cleared, the affected skin may be darker (hyperpigmented) or lighter (hypopigmented) than before the condition appeared.
Treatment depends on how intense and persistent the acne is.
Mild acne can be treated with over-the-counter medications (OTC) such as gels, creams, soaps, pads, and lotions that are applied to the skin.
For sensitive skin, the best solutions are creams and lotion. Alcohol-based gels dry out the skin and are better for oily skin.
OTC acne preparations may contain the following active ingredients:
- Resorcinol: helps break down blackheads and whiteheads.
- Benzoyl peroxide: kills bacteria, accelerates skin renewal, and slows sebum production.
- Salicylic acid: will help with the breakdown of whiteheads and blackheads and helps reduce inflammation and swelling.
- Sulfur: the exact mode of action is unknown.
- Retin-A: helps unclog pores through cell turnover.
- Azelaic acid: strengthens the cells lining the follicles, stops sebaceous eruptions, and reduces bacterial growth. There is a cream for acne, but other forms are used for rosacea.
It is advisable to start with the lowest strengths as some preparations may cause skin irritation, redness, or burning when first applied. These side effects usually decrease with continued usage. If not, consult a doctor.
Treatment of moderate to severe acne
A dermatologist or skin specialist can treat more severe cases.
May prescribe a gel or cream that works similarly to the medications from OTC but is stronger or an oral or topical antibiotic.
When an acne cyst becomes severely inflamed, it can rupture and can lead to scarring.
A specialist can treat an inflamed cyst by injecting a diluted corticosteroid.
Corticosteroids are helpful with reducing inflammation, preventing scarring, and speeding healing. The cyst will resolve within a few days.
Oral antibiotics may be prescribed for up to 6 months in moderate to severe acne patients.
These aim to reduce the population of P. Acnes. The dosage is high initially and is reduced as the acne subsides.
- acnes may become resistant to the antibiotic over time, requiring another antibiotic. It is more likely that acne will become immune to topical antibiotics than oral antibiotics.
Antibiotics can reduce inflammation and fight the growth of bacteria.
Erythromycin and tetracycline are commonly prescribed for acne.
Oral contraceptives– Oral contraceptives can help control acne in females by repressing overactive glands. They are often used for the long-term treatment of acne.
They may not be suitable for women who:
Have a blood clotting disorder, smoke, have a history of migraines, are over 35 years old.
It is essential to check with your gynecologist first.
For patients dealing with moderate to severe acne, topical antimicrobial medicine will reduce P. acne. Some of examples are clindamycin and sodium sulfacetamide.
The dermatologist may prescribe a topical retinoid which is a derivative of vitamin A. They clog pores and prevent the formation of blackheads and whiteheads.
Examples of topical retinoids prescribed in the United States include adapalene, tazarotene, and tretinoin.
This potent oral retinoid is used to treat severe acne and cystic acne that has not responded to other medications or treatments.
It is a tightly controlled medication with potentially serious side effects. Patients must sign a consent form acknowledging that they understand the risks.
Adverse effects include nosebleeds, dry skin, dry lips, fetal abnormalities if taken during pregnancy, and mood swings.
Patients taking isotretinoin must avoid vitamin A supplements as they may cause vitamin A toxicity.
Always remember that all of these medications have side effects, so be aware of them.
Tips for prevention and treatment
Here is some advice for skincare that is acne-prone or acne-prone.
- Clean your face no more than twice a day with warm water and mild soap specially formulated for acne.
- Do not scrub the skin or squeeze out the pimples, as this can drive the infection down further, causing more blockage, swelling, and redness.
- Avoid touching the face.
- Wash your hands often, mainly before applying lotions, creams, or makeup.
- Remove makeup before going to bed.
- Use makeup for sensitive skin and avoid oil-based products.
- Don’t pop pimples, as this encourages scarring.
- A specialist can treat a pimple that needs to be removed for cosmetic reasons.
- Hold the phone away from the face when talking, as it is likely to contain sebum and skin debris.
- Clean your glasses regularly, as they collect sebum and skin debris.
- If you have acne on your back, shoulders, or chest, wear loose clothing to allow the skin to breathe. Avoid tight clothing such as headbands, hats, and scarves, or wash them regularly if you wear them.
- Use an electric razor or a sharp safety razor when shaving. Soften the skin and beard with warm and soapy water before applying shaving cream.
- Keep your hair clean as sebum and skin debris will collect in it.
- Try not to use greasy hair products, such as those containing cocoa butter.
- Various acne medications increase the risk of sunburn.
- Avoid anxiety and stress, as this can increase the production of cortisol and adrenaline, which aggravate acne.
- Avoid excessive sun exposure because that can cause the skin to produce more sebum.
- Try to stay cool and dry in hot and humid climates to avoid sweating.
- Acne is a common problem. It can be not very pleasant, but there are treatment options that are effective in many cases.
Home remedy for acne
Apple cider vinegar
Like other kinds of vinegar, it fights many bacteria and fungi.
Apple cider vinegar includes organic acids, like citric acid, which have been shown to kill P. acnes.
Studies have shown that succinic acid, another organic acid, suppresses inflammation caused by P. acnes, preventing scarring. Another acid in apple cider vinegar is Lactic acid which can improve the appearance of acne scars.
It’s important to know that using apple cider vinegar on your skin can cause burning and irritation. If you want to try this method, use it in small amounts and dilute it with water.
Take a zinc supplement
Studies show that individuals with acne tend to have lower blood zinc levels than people with clear skin.
Several studies have also shown that orally taking zinc can help reduce acne.
Taking too much zinc can cause adverse effects such as stomach pain and intestinal irritation.
It is also necessary to note that applying zinc to the skin is inadequate. Because zinc is not effectively absorbed through the skin.
Make a mask of honey and cinnamon.
Honey and cinnamon are perfect for fighting bacteria and reducing inflammation, two factors that trigger acne.
A 2017 study found that combining honey and cinnamon bark extract has an antibacterial effect against P. acnes.
Other research has found that honey alone can inhibit the growth of P. acnes or
Regardless, this conclusion does not necessarily indicate that honey effectively treats acne.
Spot treat with tea tree oil
Tea tree oil is a vital oil found from the leaves of Melaleuca alternifolia, a small tree native to Australia.
It is known for its ability to fight bacteria and soothe skin inflammation. In addition, several studies have found that applying tea tree oil to the skin can reduce acne. Another small study found that participants who used tea tree oil ointment for acne had less dry skin and minor skin irritation compared to benzoyl peroxide. They also felt more pleased with the treatment.
Apply green tea to your skin
Green tea is rich in antioxidants and can promote health if you drink it.
It can also help reduce acne because the polyphenols in green tea fight bacteria and reduce inflammation, two major causes of acne. There is not yet much research exploring the benefits of green tea for acne, and more studies are needed.
Apply witch hazel
Witch hazel is obtained from the bark and leaves of the North American witch hazel shrub Hamamelis virginiana. It contains tannins that have strong antibacterial and anti-inflammatory properties. Therefore, it treats various skin conditions, including dandruff, eczema, varicose veins, burns, bruises, insect bites, and acne.
Currently, there seems to be very little research on the ability of witch hazel to treat acne specifically.
Moisturize your skin with aloe vera
Aloe vera is a tropical plant whose leaves are full of clear gel. That gel is often added to creams, lotions, soaps, and ointments.
Typical usage of that plant is to treat bruises, rashes, burns, and other skin conditions. Aloe vera gel can help heal injuries, treat burns, and fight inflammation with applying to the skin. Salicylic acid and sulfur are found in Aloe vera, and they are commonly used to treat acne. The studies show that applying salicylic acid to the skin reduces acne.
Take a fish oil supplement
Omega-3 fatty acids are healthy fats that provide a variety of health benefits.
It would be best to get these fats in your diet, but research shows that many people who consume a standard Western diet do not get enough of them.
Fish oils contain two primary omega-3 fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
High levels of EPA and DHA have been shown to reduce inflammatory factors, reducing the risk of acne.
Exfoliation means that you are removing the top layer of dead skin cells. You can use chemicals to do this or perform mechanical exfoliation with a brush or scrub to remove the cells physically.
Exfoliation can improve acne by removing skin cells that clog pores.
It can also increase the effectiveness of acne treatments for the skin, as they can penetrate deeper after removing the top layer of skin.
Currently, research on exfoliation and its ability to treat acne is limited.
Remember, mechanical exfoliation, such as harsh scrubs or brushes, can irritate and damage the skin. Therefore, some dermatologists recommend gentle chemical exfoliation with products based on salicylic acid or glycolic acid.
Be sure to eat a diet with a low glycemic load
For years, there has been a debate about the relationship between diet and acne.
Research indicates that dietary factors such as insulin and the glycemic index may be associated with acne.
The glycemic index of a food (GI) measures how quickly it spikes your blood sugar.
Eating foods with a high GI causes insulin levels to rise, which likely increases sebum production. Therefore, foods with a high GI may directly impact the development and severity of acne.
Processed foods that contain a high glycemic index include foods such as:
- white bread
- sugary soft drinks
- sugary breakfast cereals
Foods with a low glycemic index include:
- whole or minimally processed grains
Refrain from dairy products
The link between dairy products and acne is very controversial.
Milk and dairy products contain hormones such as IGF-1, which has been linked to acne. Other hormones in milk can cause hormonal changes and lead to acne.
The connection between acne and stress is still not completely understood. The hormones released in stressful situations can increase sebum production and inflammation, worsening acne.
Stress is also one reason that can affect gut bacteria and cause inflammation throughout the body, which could be associated with acne. In addition, stress can slow wound healing, delaying the healing of acne lesions.
Several studies have found a link between stress and acne.
Still, more research is needed because each of these studies was relatively small.
Ways to reduce stress
- by getting more sleep
- engage in physical activity
- take deep breaths
- practice yoga
There is not a lot of research on the effects of exercise on acne. Nevertheless, exercise affects bodily functions in ways that may help improve acne.
For example, exercise promotes healthy blood circulation. The high blood flow helps nourish skin cells, which can help prevent and heal acne.
Exercise also plays a role in regulating hormone levels.
Several studies suggest that exercise can reduce stress and anxiety, both factors that can contribute to the development of acne.
Homeopathic medicines may be helpful as a sole treatment for severe acne vulgaris. A case series showed a more than 80% remission rate with individual homeopathic treatment. The treatment remained effective long after cessation and is not associated with significant side effects.
Some limited studies support the home remedies listed in this article as the most effective, natural methods for reducing pimples.
However, applying various essential oils, green tea, and aloe vera to the skin seems the fastest way to get rid of pimples. At the same time, dietary supplements may require longer-term use, according to some limited research.
The remedies in this article may not be for everyone but are worth a try.
If you suffer from severe acne, you should still consult a dermatologist.