What Is Acne?
Bangalore Baptist Hospital
Hebbal, Bengaluru Feb 9, 2017
What Is Acne?
Acne is an inflammatory disease that involves the sebaceous (oil producing) glands of the skin. These glands are connected to the skin surface via hair follicular canals. Sebum, an oily liquid, is produced by these glands. The sebum carries dead skin cells through the follicles to the surface of the skin. Pimples are formed when these follicles get blocked and infected. It usually occurs on the face, but can also affect the arms, back and chest. Acne occurs most commonly during adolescence, and often continues into adulthood.
What Causes Acne?
There are many factors that cause acne. Acne occurs when the sebaceous glands attached to the hair follicles are stimulated at the time of puberty by elevated levels of male hormones (androgen). Rising androgen levels make the oil glands under the skin grow; the enlarged gland produces more oil (sebum). The dead cells and sebum form a plug at the outlet of the hair follicle which appears just below the skin as a whitish elevation – the whitehead. As the gland enlarges, the wall may rupture, allowing bacterial access into the deeper layers of the skin, ultimately leading to inflammation. This leads to the formation of pimples.
How Does Acne Appear?
- Acne appears on the skin as:
- Comedones – These are the blocked pores known as blackheads or whiteheads
- Papules – Visible on the surface of the skin as small red bumps
- Pustules – These are red at their base and have pus at the top
- Nodules/ Cysts – They are painful large pimples that are embedded deep in the skin
What Can Make Acne Worse?
- Menstrual cycle – acne tend to get worse one week before menstruation. This is probably due to hormonal changes
- Anxiety and stress – mental stress can affect levels of some hormones (cortisol and adrenaline) which can make acne worse
- Hot and humid climate – this increases sweating and can make the acne worse
- Cosmetics – greasy cosmetics and skin care products that are pore clogging (comedogenic) aggravate acne
- Greasy hair – some hair products are very greasy and might have the same effect as oil based makeup
- Squeezing the pimples – this makes the acne worse and increases the risk of scarring
- Facial/ Massage/ Clean ups – can flare up the inflammation
- Certain drugs cause acne – some medications may cause or worsen acne, especially steroids, anticonvulsants, hormonal preparations, etc. Topical steroids applied on the face can trigger acne after it is withdrawn
- Occlusion – pressure from helmets, chin straps, collars, suspenders and veils can aggravate acne
- Genetic – susceptibility to acne could also be genetic
- Diet – high caloric food like milk products and pure chocolate can trigger or exacerbate acne. Having healthy food habits and eating a lot of fresh fruits, vegetables, salads & drinking a lot of water helps to keep the skin clear
- Occupations – exposure to industrial and oily products may aggravate acne
Why Should Acne Be Treated At All?
- Acne can produce pustules & cysts, which can lead to permanent disfiguring scars if left untreated
- Acne can scar not only the skin but also the psyche. It can cause low self-esteem, self-consciousness, anxiety, depression and an introvert personality
- Clear skin helps in boosting the self-confidence of an individual
When Should You Start Acne Treatment?
Treating acne in the early stages prevents further spread and scars.
What Is The Treatment For Acne?
If your acne is uncontrolled, you must consult a dermatologist. The goal of treatment is the prevention of scarring (not a flawless complexion) so that after the condition resolves there is no lasting sign of the affliction. Your doctor will access the severity of acne, your skin type and discuss the options of treatment available.
- Treatment will help:
- Unclog pores – By using a good cleansing lotion
- Kill bacteria – Topical or oral antibiotics are given that are effective and fight against the bacteria causing acne
- Minimize sebum – Severe acne needs other drugs to control the hormonal secretions
The above options will only help treat/ control the acne. Scars developed from previous untreated acne require surgical/ cosmetic procedures to elevate deep, depressed acne scars and resurfacing procedure to smooth out shallow acne scars. Your doctor will advise you on treatments available for marks & scars like chemical peeling, microdermabrasion, microneedling with dermaroller and laser resurfacing.
What Are The Precautions For Acne?
- Wash your face thrice daily. Use warm water and a mild soap made especially for acne prone skin. Do not scrub the skin. Use a gentle astringent to wipe away oil
- Don’t try to burst the pimples. This results in further infection, more blockage and increased inflammation, ultimately causing scarring
- Use makeup that does not clog up the pores. Don’t go to sleep with makeup on
- Hair collects sebum and skin residue. Keep hair clean and away from your face
- Protect skin from over exposure to sun; too much sun can cause your skin to produce more sebum
- Males are advised to shave their face carefully and under hygienic conditions
- Drink plenty of water (eight glasses/day)