What causes acne?
Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.
Sometimes bacteria that live on our skin, p. acnes, also get inside the clogged pore. Inside the pore, the bacteria have a perfect environment for multiplying very quickly. With loads of bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears – these can often be painful and take a long time to heal.
Acne is usually graded in severity from 1 to 4. Grade 1 being mild acne. Grade 4 is severe acne.
Who gets acne?
If you have a bad case of acne, you may feel that you are the only one. But many people have acne and it is one of the most common skin problems in the world.
Most people who have acne are teenagers or young adults when sebaceous , but acne can occur at any age. Newborn babies can get acne. Men and women get acne. Some women get acne when they reach middle age.
· A growing number of people (mainly woman) are getting acne in their 30's, 40's and beyond. It can be particularly frustrating & for some, can negatively affect their self-esteem. Untreated acne can lead to scarring & dark spots (pigmentation) as the acne lesions heal - leading to further skin problems later on. Acne is very treatable, and with some patience we often see exceptional results.
Signs of acne
Many people think that acne is just pimples. But a person who has acne can have any of these blemishes:
- Blackheads (open comedones)
- Whiteheads (closed comedones)
- Papules
- Pustules (what many people call pimples)
- Cysts
- Nodules
Acne appears mainly on the face, but can appear on other areas of the body. Acne can appear on the back, chest, neck, shoulders, upper arms and buttocks.
Acne symptoms
Acne can cause more than blemishes. Studies show that people who have acne can have:
- Low self-esteem: Many people who have acne say that their acne makes them feel bad about themselves. Because of their acne, they do not want to be with friends. They miss school and work. Grades can slide, and absenteeism can become a problem because of their acne.
- Depression: Many people who have acne suffer from more than low self-esteem. Acne can lead to a medical condition called depression. The depression can be so bad that people think about what it would be like to commit suicide. Many studies have found that teens who believe that they have “bad” acne were likely to think about committing suicide.
- Dark spots on the skin: These spots appear when the acne heals. It can take months or years for dark spots to disappear.
- Scars (permanent): People who get acne cysts and nodules often see scars when the acne clears. You can prevent these scars. Be sure to see a dermatologist for treatment if you get acne early — between 8 and 12 years old. If someone in your family had acne cysts and nodules, you also should see a dermatologist if you get acne. Treating acne before cysts and nodules appear can prevent scars.
How do we treat acne?
Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be controlled.
People who have mild acne have a few blemishes. They may have whiteheads, blackheads, papules, and/or pustules (aka pimples). Often mild to moderate acne can be treated successfully with some good quality skincare used at home, alongside a course of chemical peels &/or microdermabrasion in the clinic. ‘Extractions’ are often necessary to remove the blackhead and whiteheads from the skin then we work on preventing them reforming. We also use ‘high frequency’ which is an anti-bacterial treatment to kill the acne bacteria (p.acnes) & stop it flourishing.
One of the best ingredients to use to curb acne is Retinol. Alpha hydroxyl acids and salycilic acid are also beneficial in the treatment of acne, and have been used successfully for many years.
Know your ingredients:
RETINOL
The discovery that Vitamin A derivatives or molecules that interact with retinoids receptors have beneficial effects in many skin diseases, particularly acne, has been one of the major therapeutic advances in dermal therapy. Retinol is a pro-drug that can be converted to retinoic acid by the skin. Topical retinoids promote the normalization of follicular epithelial desquamation (natural ‘shedding’ of the skin) and reduce cellular cohesion, promoting drainage of existing comedones and preventing the development of microcomedones (the precursor of all acne lesions). Retinoid products are better used at night, when degradation by light is minimal. It is important for patients on retinoids of any kind to apply sunscreen daily, as retinoid use is associated with increased photosensitivity.
AHA’S
AHAs affect the outer layer of skin, the epidermis, causing cells to shed more quickly and certain skin layers to thicken. AHAs work in two basic ways: First, they loosen or dissolve (depending upon the strength) the glue-like substances that hold the outer layer of cells together and to the underlying epidermis. With this loosening effect, the dull, dry stratum corneum is sloughed off, thereby allowing a more smooth texture, refined appearance of pores, the diminished appearance of fine lines and better utilization of skin care products or medications. (Imagine your skin layers as a brick wall, the AHAs work on the “mortar” between the “bricks” of dead cells.) Second, they are known to affect deeper levels of the skin by regenerating collagen and elastin.
SALYCILIC ACID Salicylic Acid is a keratolytic that, in small percentages in a cleanser or moisturizer, can help keep acne-prone skins clear. It also has some anti-inflammatory properties, as well as antiseptic, fungicidal, anti-oxidant and bactericidal properties. It is also a chemical trap for free radicals, and is able to penetrate the pore to exfoliate inside as well as out, similar to the way benzoyl peroxide functions and could be a good substitute for BPO-sensitive patients. It combats oxidative stress, and works well with Vitamin C.
If you are allergic to aspirin, you must not use salicylic acids on them, as they are chemically similar. Salicylic Acid is best on acne-prone and sensitive skin types. The pore-cleansing properties of salicylic acid make it a more effective comedone (blackhead) fighter. Those with sensitive skin who cannot tolerate alpha hydroxy acids may find that they are able to use salicylic acid with good results. As an exfoliant, salicylic acid can actually increase the benefits of other therapies used in conjunction with it. For acne prone skin, retinol makes a good adjunct therapy for salicylic acid.
If you have severe acne, with lots of cysts or nodules, it is recommended you see a dermatologist to discuss medication & stronger topical treatments.
Acne treatment that works throughout the body: A dermatologist may prescribe a medicine that works throughout the body – if you have red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these:
- Antibiotics (helps to kill bacteria and reduce inflammation).
- Birth control pills and other medicine that works on hormones (can be helpful for women).
- Isotretinoin (the only treatment that works on all that causes acne) – used only in severe acne and as a last resort due to it’s strong side effects
Waiting for acne to clear on its own can be frustrating. Without treatment, acne can cause permanent scars, low self-esteem, depression, and anxiety.
To avoid these possible outcomes, we recommend that people treat acne. When the skin clears, treatment should continue. Treatment prevents new breakouts. Your dermal therapist can tell you when you no longer need to treat acne to prevent breakouts. We can refer you to a dermatologist if we feel your acne is severe and requires systemic help.
