Acne is an incredibly common chronic inflammatory skin condition that results in unsightly spots on the skin, typically on the face, upper back and chest. Facial acne, in particular, can have a detrimental effect on confidence and self-esteem, and severe outbreaks are often accompanied by depression and anxiety. As well as its unappealing physical appearance, acne can also be itchy or painful. Acne is caused when the sebaceous glands attached to hair follicles (‘pores’) in the skin produce too much sebum, an oily secretion generated to protect and moisturize the skin. The excess sebum mixes with dead skin cells, forming a plug in the hair follicle. If this blocked follicle is near the skin’s surface, it either results in a bulging whitehead or a blackhead. Bacteria that live on the skin can then infect the follicle resulting in a sore, infected pustule. Acne can range from mild (whiteheads and blackheads) and moderate (angry looking pimples) to severe (pus-filled cysts under the skin).
Acne can be hereditary, meaning that if one or both parents have suffered from acne, their children are more likely to develop it. Acne in teenagers is thought to be triggered by the hormone testosterone triggering excessive sebum production as well as its normal function of promoting growth during puberty. Also, acne is more common in women than men due to the increased hormone changes that occur due to menstruation, pregnancy, or polycystic ovary syndrome. Research has shown that certain lifestyle factors can also trigger acne flareups. These include smoking and wearing items such as helmets or headbands that apply pressure to the affected areas. Certain medications can also increase the risk, particularly steroids and drugs prescribed for epilepsy, depression, and bipolar disorder. Cosmetics used to be considered a trigger, but modern cosmetics tend to be non-comedogenic (non-pore blocking). Contrary to popular belief, acne is not caused or worsened by poor diet, dirty skin, or poor hygiene and cannot be ‘caught’, however, stress is known to make it worse. A sudden outbreak of acne in older adults may also be a sign of another underlying condition.
Severe acne breakouts can result in scarring if not treated correctly. Acne scarring can be reduced by dermatological procedures such as chemical peels or microneedling, steroid injections, or topical application of salicylic acid. Some people also swear by home remedies to reduce the appearance of scarring such as applying coconut oil, raw honey, or Aloe vera gel. Although acne scars can be removed, or the appearance of scars improved, prevention is always better than cure. There are four key ways to prevent acne scarring:
- Get acne treatment as soon as the first breakout erupts. Dermatologically recommended acne treatments include topical prescription creams or oral tablets that clear up existing acne and prevent new acne from developing. A dermatologist will create a tailored treatment regimen, given everyone’s skin is different. For some women, changing to a combination contraceptive pill can improve acne.
- Never squeeze or pick at spots, tempting as it is, as this will often cause scarring. Squeezing pimples and picking scabs results in bacteria and pus being pushed deeper into the skin, causing increased inflammation and heightened skin repair with fibrous tissue. The dimpled effect of acne scars is caused by loss of collagen.
- For those who just cannot resist squeezing, disinfecting the area before doing so dries the skin out and reduces the chances of bacterial growth, helping to prevent infection and reduce the likelihood of scarring.
- Use extra sunscreen to protect the skin from burning and sweating, both factors that trigger breakouts. Sunscreen will also need to be applied before going out in the sun for those people using acne treatments that render the skin even more susceptible to UV rays.