Acne is a chronic inflammatory disorder of the sebaceous follicles (the hair follicle and associated sebaceous gland). This is characterised by the presence of papules, pustules and nodules resulting from ruptured comedones. Long-standing acne sufferers may also have scarring and/or areas of hyperpigmentation where old lesions have healed.
The other form of acne can be a non-inflammatory which is characterised by the presence of closed and open comedones (whiteheads and blackheads) but without any signs of inflammation.
It generally affects the face, neck, chest, upper back and upper arms.
There are several factors that contribute to acne development:
- increased sebum secretion
- abnormal follicular differentiation
- bacteria Propionbacterium acne
Acne may also be induced by drugs or through the use of some cosmetic products. It is not TRUE that acne can be caused by eating too much chocolate or chips (however diet plays huge role in cleansing your skin) and acne is not caused by poor hygiene or presence of dirt on the skin.
Interesting! So let me explain what really causes it:
All acne starts with small blockages forming in hair follicles. These blockages are mostly formed from dead skin cells and oil. however sometimes these blockages can be formed from cosmetic products that have become stuck inside a hair follicle, such as make-up, hair wax or moisturizers. This prevents dead skin cells and oil from the sebaceous gland reaching the skin's surface and can result in the onset of acne.
So if you have mild acne there are few steps that you can try first before seeing your GP or reaching for more harsch creams and treatments (please note that it may not work for everyone):
- EXFOLIATION - removes small blockages in hair follicles that can develop into acne. Chemical exfoliation tends to be more effective than mechanical but whichever you use keep exfoliating even when acne lesions are not present. Don't scrub too harshly as it can micro damage your skin.
- SKIN CLEANSING - gently cleansing your skin daily can remove cosmetic products before they make their way down into hair follicles and become stuck. Cleansing skin with harsh cleansing products will not help and can irritate the skin
- AVOIDANCE OF FRICTION AND TIGHT CLOTHING - this helps with acne developed on your back and chest
- DIET - there is no strong evidence that connects diet and acne but as a great believer that food is our medicine I will strongly encourage you to change poorly eating habits and this way cleanse the body from toxic substances. Not only your skin may improve but also your general health and wellbeing.
- STRESS - again, no strong research-based evidence is present that connects stress with acne however stress can cause inflammation in the body in general (including skin). The one type of acne called acne excoriee is most common in depressed and obsessional young people who squeeze and pick the spots. Therefore reducing your stress level is good for your general health.
I am very much aware how acne can make you feel distressed and affect your self esteem or mood.... (i've been there myself). You may want to hide and withdraw from your social life, you may feel embarrased..
The above mentioned options may not work for you (but still good to include then into your daily habits). If your acne is moderate or severe your GP may be able to prescribe you one of the following:
- BENZYL PEROXIDE - gels,creams, lotions, washes - it is an oxidising agent that is bactericidal for P. acne and also have some anti-comedogenic activity. Start with low dose and increase if necessary (dose-related irritation like redness, dryness, stinging or scaling may occur). Also available OTC in your pharmacy.
- RETINOIDS (tretinoin, isotretinoin, adapalene) - these are the most effective topical comedolytic agents. They inhibit the formation of and reduce the number of microcomedones. These creams tacle the condition in an early stage. But you also may experience dose-related side effects like redness, peeeling and burning. You will also have to hide from the sun and it may take 3-4 months for the maximum benefits to be seen. Also very IMPORTANT: not for pregnant ladies or those who intend to become pregnant!
- AZELAIC ACID - antimicrobial and anti-comedogenic agent but may have less local adverse effects than those mentioned above
- TOPICAL ANTIBIOTICS - mainly used in mild-to-moderate inflammatory acne but have little effect on non-inflammatory comedones. Erythromycin and Clindamycin are the most common
- NICOTINAMIDE - vit B3 derivative is useful for some people with mild inflammatory acne. There are some anti acne products that contain this vitamin.
With moderate-to-severe acne your doctor will probably prescribe you some oral antibiotics or oral isotretinoin or some anti-androgenic agents (for acne that appears to be related to hormonal events)
Whichever product you decide to choose there is no such a cure that will make acne dissapear in the space of one week... The effects of treatment may take 2 weeks to become apparent and treatment should be continued for at least 2 months.
Hope I could help you to choose what is best for your skin, you can always message me for more advice as these are just general informations about treatment options and prevention.
1. CPPE - The managment and treatment of skin conditions 2007
2. Acne support 2018