Acne
Acne, the medical term known as acne vulgaris, is a skin condition characterized by pimples (pustules or papules), comedones (whiteheads, blackheads), and greasy skin with or without scarring.
Acne not only involves the skin of the face, but can also affect skin on other parts of the body including shoulders, chest, and back.
Acne itself isn’t a serious disease, however the cosmetic disfigurements can result in reduced self-esteem, anxiety, and depression in the patients.
Causes of Acne Vulgaris
Acne is mostly associated with teenagers at the age of puberty since acne can be a result of hormonal changes that lead to an increased production of sebum and a greater proliferation of the cells of the skin. However, acne isn’t confined only to teenagers. There are various other factors that lead to acne too, including genetics and many others.
Several causes of acne include:
- Hormonal changes related to:
- Puberty
- Menstrual cycle
- Birth control
- Pregnancy
- Hormone therapy
- Stress
- Cosmetics of greasy and occlusive nature like lotions and cleansers
- Tight and irritating clothing
- Sweating and high humidity levels
- Chemicals and drugs worsening acne or resulting in acne like eruptions, including:
- Corticosteroids
- Phenytoin
- Isoniazid
- Lithium
When treating acne, it’s important to figure out the cause of acne so that disease progression can be stopped and proper acne treatment can be started accordingly.
Types of Acne Vulgaris
Acne is classified into various types, based on the underlying cause for the development of the disease. Treatment usually varies based on the type of acne too.
4 Main types of acne are:
Comedo refers to a clogged pore on the skin. Pores get clogged more in patients with oily skin, giving an appearance of bumps around the skin. These comedo are often more concentrated in the T-zone of the facial skin.
A comedo, clogged hair follicle, occurs when the skin debris, called keratin, combines with the oil on the skin and blocks the hair follicle. It can be either open (blackhead) or closed by skin (whitehead).
Note that a comedo can occur with or without acne.
Clogged skin pores play a role in inflammatory acne too, however, the main role is played by the body’s inflammatory response to the clogged comedo in the pore.
Inflammatory acne is more common in males because of more oil production in the skin due to higher levels of testosterone.
Inflammatory acne usually seems to be random and without any obvious reason. E.g., a pimple might simply pop up one day, however there is an underlying clogging of a hair follicle’s pore, resulting in an inflammatory response in some patients due to the irritation caused by oils and waxes in the clogged hair follicle, resulting in acne.
Cystic acne involves deep inflammation in the skin. It’s the most severe form of acne and can result in scarring. However, it affects very few people, nearly 0.2%, while general acne affects 7% of the population.
It’s important to start treating cystic acne as early as possible to avoid scarring. The cosmetic disfigurement caused by cystic acne has a huge impact on the emotional and social life of the patient.
As a result of bacterial infection (P. acnes) of the hair follicle, the papules occur. When the infection is also associated with inflammatory response, it results in pustules, leading to red and swollen bumps on the skin.
If left untreated, the inflammation can result in the rupture of the hair follicle, releasing the contents of the pustule to the surrounding skin. This material triggers inflammation in the surrounding follicles and results in a wider, deeper, and painful cyst.
Remember that some strains of acne causing bacteria are found to be generally helpful for the skin; therefore using a strong antiseptic soap is not recommended. Seek an expert’s advice before using any strong chemical on your skin.
Hormonal acne occurs in females in and around 30 years of age. These women usually don’t have acne earlier in their life.
The reason for hormonal acne is considered to be a drop in estrogen levels in these women, resulting in acne.
Hormonal acne mostly involves the lower third of the face, forming a U-shaped pattern. Pimples usually erupt just before, during, or after the menstrual cycle.
Acne Treatment
Treatment of acne varies based on the underlying cause and the type of acne. If you’re suffering from acne, consult a doctor to diagnose the type you have so that the best treatment can be given, specific to your condition.
Common acne treatment options are as follow:
Self-care, natural ways to prevent, and how to get rid of acne
Measures to prevent and help in the management of mild to severe acne include:
- Wash your face twice daily:
- Don’t wash too often, twice is enough
- Don’t use high potency antiseptic soaps, cleansing granules, exfoliating agents, abrasive soaps etc.
- Mild soaps or cleansers with lukewarm water are enough
- Don’t scrub harshly
- Don’t pick or squeeze the pimples, it’s likely to worsen the acne
- Avoid heavy makeup
- Prefer using non-comodogenic and water-based formulations
- Avoid oil based formulations
- Remove makeup as soon as possible, particularly before bed
Several medicines are available for the treatment of acne. Consult a doctor to confirm if a particular drug is useful in your type of acne and is safe for you, as they have their own side effects, especially during pregnancy.
Drugs include:
- Retinoids
- Isoretinoin
- Adult Hormonal Acne Medication
- Spironolactone
- Birth control pills, as they suppress sebum production, but have their own side effects
- Estrogen
- Progesterone
Remember, drugs and medications don’t affect only the skin but also have various effects all over the body including heart and shouldn’t be used without an expert’s advice.
Surgical excision of a cyst
A dermatologist may sometimes excise and remove the cyst surgically by making a small cut in the skin. This is not to be tried by the patients themselves as it may lead to scarring, spread or recurrence of the cyst.
If you’re experiencing acne, don’t panic, don’t try to scratch the pimples, and don’t self-medicate. Go to an expert and they will suggest the best acne treatment for you, and help you get rid of your acne.