Acne

Have you ever looked in the mirror and felt frustrated by those spots on your face? Acne affects millions of people worldwide, causing both physical discomfort and emotional distress. This common dermatological condition occurs when hair follicles become clogged with oil & dead skin cells, leading to various types of blemishes. In this comprehensive blog, let's explore the different types of acne, their symptoms, and the underlying causes. 

What is Acne? 

Acne is one of the most common skin conditions that affects all ages, though it is most prevalent among teenagers. It occurs when hair follicles become choked with oil (sebum) & dead skin cells. This obstruction leads to the formation of various types of blemishes, including whiteheads, blackheads, and pimples. Acne mostly becomes visible on the face, forehead, chest, upper back, and shoulders. 

Types of Acne 

• Acne vulgaris, the most common form of acne, presents various types of lesions. These include Superficial lesions such as open and closed comedones (blackheads and whiteheads), papules (small, tender red bumps), and pustules (white or yellow "squeezable" spots). Deeper lesions comprise nodules (large painful red lumps) and pseudocysts (cyst-like fluctuant swellings). 
• Secondary lesions may also occur, including excoriations, erythematous macules, and pigmented macules. 
• Other types of acne include fungal acne, caused by yeast buildup in hair follicles, and hormonal acne, affecting adults with excess sebum production. 
• Cystic and nodular acne are severe forms that can lead to scarring. Early treatment by a healthcare provider is crucial to determine the best options and prevent permanent skin damage. 

Symptoms of Acne 

Acne manifests in various forms, each with distinct characteristics. Common symptoms include: 

• Whiteheads (closed plugged pores) and blackheads (open plugged pores) 
• Small red, tender bumps called papules may appear, while pustules are papules with pus at their tips. 
• In more severe cases, individuals may experience painful, large, solid lumps under the skin, known as nodules or painful, pus-filled lumps called cystic lesions. 
• Other skin changes associated with acne include crusting of skin bumps, redness around eruptions, and potential scarring. 
• Acne typically affects the face, forehead, chest, upper back, and shoulders. However, it can also occur on the trunk, arms, legs, and buttocks. 

Causes of Acne

Acne develops when hair follicles get obstructed with oil (sebum) and dead skin cells. This blockage creates an environment where bacteria thrive, leading to inflammation and infection. The main factors contributing to acne include excess sebum production, clogged hair follicles, bacteria, and inflammation. 

Diagnosis of Acne 

Dermatologists diagnose acne through a combination of methods. They examine the skin, looking for different types of spots such as blackheads, whiteheads, papules, and pustules on the face, chest, or back. They also ask about family history, symptoms, and current medications. For women, questions about menstrual cycles are common. 

Doctors sometimes perform lab tests to rule out other conditions causing acne-like symptoms. 

Treatment for Acne 

• Acne treatment aims to stop new pimples from forming and heal existing blemishes. 
• Topical medications, such as retinoids, antibiotics, and azelaic acid, are applied directly to the skin. 
• Oral medications, including antibiotics and isotretinoin, target acne from within. 
• For stubborn cases, doctors may suggest therapies like steroids, lasers, and chemical peels. 
• Over-the-counter products (benzoyl peroxide or salicylic acid) can help with mild acne. 

Risk Factors for Acne 

Several factors contribute to the development of acne, such as: 

• Age plays a significant role, with teenagers being most susceptible. 
• Hormonal changes, particularly during puberty or pregnancy, can trigger acne outbreaks. 
• Family history also influences acne risk; if both parents have acne, their children are more likely to develop it. 
• External factors like greasy substances, friction, or pressure on the skin can exacerbate acne. 
• Items like oily lotions, tight collars, helmets, and backpacks may contribute to breakouts. 

Complications of Acne 

Acne can lead to various complications, affecting both physical and emotional well- being, such as: 

• Scarring is a common issue, with pitted skin and thick scars (keloids) potentially remaining long after acne has cleared. 
• People with darker skin are more susceptible to experiencing skin changes, including hyperpigmentation or hypopigmentation of affected areas. 
• Psychological effects are significant, with many individuals developing depression, anxiety, and low self-esteem. 
• In severe cases, acne fulminans may occur, characterised by acute inflammatory nodules and systemic symptoms, particularly in male adolescents. 

When to See a Doctor 

Individuals should consult a dermatologist if over-the-counter treatments prove ineffective after four to six weeks. Persistent or severe acne, mainly when it affects the chest, back, and shoulders, may require systemic therapy. 

Home Remedies for Acne 

Several natural remedies may help manage acne symptoms. 

• Tea tree oil, widely recognised for its antibacterial properties, can potentially reduce inflammation and kill acne-causing bacteria. 
• Apple cider vinegar is a popular treatment. 
• Aloe vera gel contains salicylic acid and sulphur, which are commonly used in acne treatments. 
• Due to its antioxidant properties, green tea may help reduce sebum production and inflammation when applied topically. 
• Honey, with its antibacterial properties, could help clear clogged pores. 

Prevention 

• Preventing acne involves maintaining good skincare habits. Washing the face twice daily with gentle, sulphate-free cleansers helps remove excess oil and dirt. 
• Moisturizing is crucial, but choose noncomedogenic products to avoid clogging pores. 
• Staying hydrated by drinking an optimal amount of water supports skin health. 
• Avoid touching the face frequently and use noncomedogenic makeup. 
• Sun protection is essential, as excessive sun exposure can worsen acne. 
• A balanced diet, stress management & regular exercise also contribute to healthier skin and may help prevent acne breakouts. 

Conclusion 

Understanding acne and its underlying factors is crucial to develop an effective management strategy. By maintaining good skincare habits, staying informed about treatment options, and seeking timely medical advice, individuals can take control of their acne and work towards clearer, healthier skin. Remember, while acne can be frustrating, with patience and the right approach, it's possible to achieve significant improvements in skin health & overall well-being. 

FAQ's 

1. Who does acne affect? 

Acne affects all at some point in life. It's most common among teenagers and young adults, with up to 95% of adolescents experiencing it. However, acne can occur at any age, including in babies and adults. Women tend to experience adult acne more frequently than men, with 26% of women aged 31-40 and 12% of women aged 41-50 suffering from clinical acne. 

2. How common is acne? 

Acne is extremely common, affecting about 80% of people aged 11 to 30. 

3. Where on my body will I have acne? 

They commonly appear on the face, forehead, chest, shoulders, and upper back. These areas have the most oil glands. However, acne can also occur on the trunk, arms, legs, and buttocks. 

4. What is the leading cause of acne? 

The formation of acne can be attributed to various factors such as excess sebum production, clogged hair follicles, bacteria, and inflammation. Hormonal changes, particularly during puberty, stimulate sebaceous glands to produce more oil. Genetics also play a significant role, as acne tends to run in families. Stress and certain medications can exacerbate acne as well. 

5. What foods cause acne? 

While the relationship between diet & acne remains controversial, some studies suggest certain food items may contribute to acne development. High glycemic load diets, which include foods like white bread, cornflakes, and sugary drinks, may worsen acne. Some research also links dairy consumption, particularly skim milk, to increased acne risk. 

6. At what age is acne the worst? 

Acne typically peaks during adolescence and early adulthood, between 12 and 24. For many, acne is worse during the teenage years, often starting between ages 10 and 13. 

Dr. Shradhha Mahalle

CARE Medical Team

5