Fact: everybody struggles with acne. While it’s common to have breakouts and blemishes during one’s teenage years, acne can happen to anyone at any age. This chronic skin condition appears in various forms and can be quite a challenge to completely eliminate.

If you suffer from acne, this comprehensive guide will give you a better understanding of its causes and help you find different treatments for your particular case.


WHAT IS ACNE?


Acne is a common skin issue that affects many people at some point in their lives. While there are various types of acne, it is typically formed when the pores of your face become clogged with residue from dead skin cells, sebum, or bacteria. This usually manifests in the form of spots or inflammation on the skin. Acne is not inherently dangerous, but it can leave scars if left untreated.

Acne is most commonly associated with pimples and hormonal breakouts, which creates the misconception that it only occurs in teens and adolescents. While it is true that most pre-teens and teenagers are most prone to developing acne, this condition can affect anyone at any age once their sebaceous glands activate.

The severity of acne can also vary depending on many factors that are different for each individual. Some people can get the occasional pimple or two throughout the year, while others are lucky enough to have zit-free skin. However, severe cases of acne can manifest in dozens or even hundreds of pimples all over a person’s face, neck, or back.

SIGNS AND SYMPTOMS OF ACNE

Have you ever noticed some unsightly bumps that happen to appear on your skin, seemingly overnight? This is a common sign that you might have acne. These bumps can show up on different parts of the body and vary in severity, depending on the person. The duration of the breakout can also differ from person to person, although it is possible to shorten its lifespan with proper acne medication.

Two of the most common manifestations of acne are whiteheads and blackheads. Both are mild forms of acne and have a less infected appearance compared to the typical pus-filled pimple. Whiteheads appear as small, white bumps underneath the skin, while blackheads are darker on the surface since the pores containing them have been exposed to air.

Acne that appears in the form of pimples can lead to a more severe condition, and as mentioned, scarring, if left untreated. Pimples are filled with pus and sebum, and they are marked by inflamed skin that can be very painful to the touch.

Apart from the physical discomfort, a person who is dealing with a severe case of acne can also be affected psychologically. The experience can lead to low self-esteem and even depression in some cases. Even when the acne subsides, the noticeable scars left on the skin can affect a person’s overall well-being and quality of life.

Seeing the signs of acne should be a clear warning that something needs to be done about it. However, to truly understand and find effective ways to fight it, you’ll need to learn how acne actually manifests.

CAUSES OF ACNE

So what actually causes acne? Acne is often associated with having dirty skin, and while not washing or cleansing your face properly can lead to bacteria buildup, there are actually many other factors that cause your skin to break out. Here’s a short list of some of the most common causes for acne:

1. Genetics
Genetics play a big role in determining how prone you are to breakouts. If your parents have a history of dealing with acne, it is likely you will have to deal with it as well. Of course, this isn’t a complete guarantee. It’s also possible for a person to experience acne breakouts even if their parents have always had clear, balanced skin.

2. Hormones
There’s a reason why acne typically occurs during the teenage years. This is the time when your sebaceous glands start producing its natural oils, and a hormonal imbalance can increase the production of oil in your body, which can in turn lead to breakouts. Similarly, just before a woman starts menstruating, acne is likely to occur due to the increased hormones during this time of the month.

3. Lifestyle
Your lifestyle can greatly affect the condition of your skin. If you live in a bustling city, where you’re exposed to pollution on a daily basis, your skin can become irritated and have a negative reaction. Stress and sleep deprivation can also lead to the occurrence of acne, since both can cause the body to produce excess sebum as negative stimuli. Ultimately, taking care of yourself and your lifestyle can have a huge effect on the way that your skin is able to maintain its overall condition.

4. Medications and Cosmetic Products
Some medications like corticosteroids have the unfortunate side effect of inducing acne. Similarly, there are certain cosmetic products that are greasy in nature that can also clog the pores. In any case, it’s always a good idea to take a look at the active ingredients of any medication or cosmetic product before you start using them. Products described as “non-comedogenic” are designed not clog the pores.

While you can’t really control your genetics, you can always work on the other factors listed above. Taking care of your skin, managing your stress levels, and observing the products that you use are all things that you can easily control. Doing so will prevent acne on your skin, and help you avoid the problem altogether.

Now let’s take a look at the different types of acne and how they’re classified.

TYPES OF ACNE


NON-INFLAMMATORY ACNE Each pore in our body consists of a hair follicle and a sebaceous gland. As our skin cells continue to shed and replace themselves, some of these dead skin cells become trapped with our skin’s natural oil or sebum. When this happens, non-inflammatory acne or comedones are formed. Non-inflammatory acne can be further grouped into two types.

1. Blackheads
Also known as open comedones, blackheads form when excess oil and dead skin cells are exposed to the oxygen in the air. The oxidation of the oil and skin cells turns the spot black over time, giving it a distinct dark look.

2. Whiteheads
In contrast to blackheads, whiteheads or closed comedones are trapped underneath a layer of dead skin cells and oil, preventing the hair follicle from being exposed. This causes the “whitehead” that forms on the top of these bumps.

INFLAMMATORY ACNE
Propionibacterium Acnes or P. acnes is a type of bacteria that feeds on the sebum in our skin. When this bacteria gets into the clogged pores, inflammatory acne forms. As the body responds to the inflammation, the affected area begins to swell, rushing blood to the spot and causing even further redness and swelling. Inflammatory acne can be categorized into two types.

1. Papules
These closed comedones appear as pink bumps on the surface of the skin and are typically very sensitive to the touch. Because they are triggered by bacteria, popping these bumps will cause more papules to form, as well as lead to heavy scarring. A large concentration of these comedones on the face can be an indicator of a more severe case of acne and should be treated by a dermatologist.

2. Pustules
Pustules can be clearly seen on the surface of the skin. They are characterized by an inflamed pimple with a whitehead that’s surrounded by red, irritated skin. Pustules typically have a buildup of pus around the head. A person with pustules must avoid popping the head, since this can lead to dark scars and leave noticeable marks on the skin.

CYSTIC ACNE The term cystic acne describes more severe cases of acne that form deep beneath the skin. It is marked by a formation of cysts that enclose keratin and sebum in varying degrees. Cystic acne is typically caused by an imbalance of hormones and has a high chance of causing permanent scarring. This type of acne can be divided into two subtypes.

1. Nodules
Nodules are buried fairly deep under the skin and feel like large bumps that are painful to the touch. Compared to other surface pimples, nodules are actually difficult to pop. In fact, trying to squeeze them will only inflame them further and make them look bigger. This type of acne is more resistant to conventional over-the-counter treatments and will need the expertise of a dermatologist to treat.

2. Cysts
Cysts are more pronounced in appearance compared to nodules and resemble boils. They are filled with pus and can be very painful to the touch. Trying to remove them without the help of a dermatologist will only lead to permanent scarring.

OTHER TYPES OF ACNE
There are various types of acne that are categorized based on severity, gender, and age. These include:

1. Acne Vulgaris
This is the medical term used for acne in general. Acne vulgaris is the result of the buildup of pore-clogging sebum and the formation of comedones. It can be categorized into non-inflammatory and inflammatory acne. The former involves plugged-up follicles and a few pimples, while the latter can appear as an eruption of painful pustules, papules, nodules, or cysts. Acne vulgaris usually begins to manifest during puberty and adolescence, when the sebaceous glands become active and begins secreting oil.

2. Acne Conglobata
This is a severe form of acne that almost exclusively occurs in men, especially those who use steroids and testosterone. Acne conglobata appears as numerous inflamed nodules beneath the skin that are interconnected to clusters of other nodules and cysts. It typically shows up in various parts of the body like the chest, neck, and arms.

3. Acne Fulminans
This is a rare type of severe acne that is commonly seen in teenage boys. Acne fulminans shows up as a host of highly inflammatory, pus-filled nodules. Over time, the individual will experience secondary effects from the condition like fever, anemia, weight loss, ulcers, and painful joints.

4. Acne Necrotica Miliaris
Another rare type of acne, acne necrotica miliaris usually affects adults and is concentrated in the scalp area. It appears as a formation of small pustules and can be removed by scratching. A rarer and more severe form of this condition called acne varioliformis can manifest as larger lesions. This can spread down from the scalp all the way down to the brow.

5. Acne Mechanica
Also known as “sports-induced acne,” this mild type of acne is typically caused when sports like caps, helmets, or guards rub against the skin. Friction from the contact combined with sweat can aggravate the skin and result in this type of acne. Fortunately, acne mechanica can be easily treated by cleansing the skin immediately after participating in any kind of sports activity.

Now that you know the different types of acne, let’s take a look at some suggested treatments that can help reduce or eliminate your acne woes.

ACNE TREATMENTS

Once you know the type of acne that you have, it will be much easier to treat. Milder forms of acne can be easily addressed by various over-the-counter medications, as well as changing your diet. On the other hand, more severe cases will need a dermatologist who can prescribe the right medicine for your acne.

In any case, the first step for any kind of acne treatment is properly diagnosing your condition. You’ll need the advice of a licensed skin professional who will ask you some questions and perform the required exams to better understand the severity of your acne. It’s important to undergo this process, so your doctor can rule out any possible health issues that could also be affecting your skin.

There are four grades of acne severity that can assist in categorizing your acne and accurately diagnose your condition:

1. Grade I
This is the mildest form of acne, which is usually characterized as small pimples or plugged-up comedones. There is minimal inflammation on the affected area and any pimples that appear don’t hurt when touched.

2. Grade II
Grade II acne is typically accompanied by a moderate number of breakouts on the skin. It’s possible that the whiteheads and blackheads that appear can develop into more serious papules and pustules as bacteria begin to infect the pimples.

3. Grade III
At this stage, the affected skin is inflamed and tender to the touch. This can cause a degree of discomfort and pain since the resulting papules and pustules can develop nodules that can spread underneath the skin.

4. Grade IV
This is the most severe form of acne that exhibits a large number of papules, pustules, nodules, and cysts. This type of acne can spread all over the body and leave permanent scars if not treated correctly.

Once you’re able to find out the severity of your acne, you can then determine which is the appropriate medication for you. It is important to note, however, any side effects that may occur once you start using acne treatments. Make sure to check for signs like increased acne or residual scarring or marks. Symptoms like these could mean that you need to consult a dermatologist and look for medication that doesn’t have any adverse side effects.

There are several go-to acne medications that many people turn to once a breakout begins. Here are some of the most common treatments for mild acne:

1. Salicylic Acid
Typically one of the most common ways to treat acne, salicylic acid is an over-the-counter medication that has acne-fighting properties that are relatively gentle on the skin. It’s considered a keratolytic, which helps dissolve keratin in the skin and sloughs off dead cells.

It’s also chemically similar to aspirin, reducing redness and swelling from any inflammation on the skin. When applied topically, it opens up the pores by breaking down fatty compounds that clog the pores. Just take note that too much salicylic acid can dry out the skin, so it’s best to stick to only one product that has this active ingredient at a time.

2. Benzoyl Peroxide
Known for its antibacterial ingredients, Benzoyl Peroxide is very effective in killing P. acnes bacteria that feeds on the sebum of your skin. Using products with high concentrations of benzoyl peroxide, however, can be tough on the skin. Those with especially sensitive skin can end up with dried, cracked, and peeling skin. It’s best not to use benzoyl peroxide in conjunction with other acne medication since this can cause excess dryness.

3. Sulfur
Despite the unpleasant smell that some products with sulfur have, it has long been used as an effective way to treat acne. It works directly on the skin by sucking up the skin’s natural oils, drying up pimples and reducing their size. It’s relatively gentler on the skin compared to benzoyl peroxide, but proper care must be taken when applying sulfur to the skin.

Of course, there are cases where the aforementioned acne medications just aren’t enough to treat your acne. For moderate to severe cases of acne, here are some of the more typical treatments that people use:

1. Retinol
Commonly used as a topical cream, retinoid creams are used for their anti-aging and vitamin A properties to help clear up acne breakouts. Retinoids help increase skin cell regeneration, as well as decrease oil, helping your skin slough off excess dead cells. It’s important to note that some people might be allergic to the active ingredients when first applying retinol, so it’s best to always perform a patch test to reduce the risk of possible side effects.

2. Antibiotics
Doctors can prescribe either topical or oral antibiotics for those suffering from inflammatory breakouts. Topical antibiotics can be applied directly onto the infected acne lesions to help suppress the growth of P. acnes bacteria. On the other hand, oral antibiotics like Tetracyclines work quite similarly. Studies, however, have shown that relying too much on antibiotics can make bacteria more resistant, so it’s best not to use them for extended periods of time.

3. Cortisone
This medication is great for those looking for a quick solution to their acne problems. A cortisone shot can work as quickly as 24 to 48 hours to curb any inflammation, making it the ideal treatment for cystic acne. Care needs to be taken when applying this treatment, however, since it can leave a small depression in your skin for as long as eight weeks when done incorrectly.

While these different types of treatments can stem the effects of acne, they can’t necessarily deal with acne scars. For this, you’ll need a different set of treatments.

TREATMENTS FOR ACNE SCARS

Another common problem that many people with acne face is the aftermath of their condition. Up to 95% of acne patients develop some degree of scarring on their skin. Luckily, there are several treatments that can be done to minimize or get rid of these scars. Here are the 6 most common treatments for acne scars.

1. Dermal Injections
This is a popular method of dealing with shallow acne scars. Filler substances are injected into the skin and help decrease the formation of scars. Similarly, dermal fillers increase the production of collagen and can give your skin a smoother appearance. However, it’s important to note that dermal injections only have a temporary effect that last for about three to twelve months.

2. Laser Treatments
This is a non-invasive type of treatment that gets rid of scars in a series of quick procedures with little to no discomfort experienced. Pulses of intense light are shot at the skin to help stimulate collagen production and increase skin growth and renewal. This also helps tighten up the skin that is exposed to moderate amounts of sunlight.

3. Subcutaneous Incisional Surgery
Subcutaneous incisional surgery is a direct type of treatment where the dermatologist removes acne scars using a sharp instrument like a scalpel. By cutting the tension between upper and lower layers of the skin where the scar is located, the tissue binding the scar is carefully removed and extracted.

4. Chemical Peels
This is a simple procedure where a thin layer of acidic material is applied on the surface of the skin. It allows the chemical peel to work on the affected layer of skin, making it renew itself and effectively removing the skin of acne scars.

5. Punch Grafts
When a person is suffering from skin blemishes that have an jagged and irregular look to them, punch grafts are often used to lessen its appearance. Such scars are excised with a sutured closure, which pulls together the separated parts of the dermis and closes the gap between them. Further procedures can be done should there be any residual incision scars that are left over.

6. Dermabrasion
One of the earlier methods of acne scar removal, dermabrasion has seen less popularity in recent years due to the more advanced treatments people tend to prefer these days. The procedure involves the numbing of the skin while a sharp rotary blade sands off the top layer of the skin to remove the skin tissue.

To effectively deal with acne or scarring, you’ll need the help of a certified dermatologist who has the skill and know-how to address your specific skincare needs. Finding such a specialist doesn’t have to be a difficult chore, especially if you know what kind of qualifications to look for.

THINGS TO LOOK FOR IN A DERMATOLOGIST

When facing acne, you can never underestimate the value of a good dermatologist. Aside from providing you with helpful insights regarding your skin condition, a dermatologist can also perform the necessary procedures to help manage or remove your acne or the scars it leaves behind. Finding someone that can cater to all your skin needs need not be a challenge, however. Here are 6 useful qualities to look out for when choosing a dermatologist.

1. Credentials
This is an absolute requirement before consulting with just about any professional. Aside from a medical degree and the required board certifications, it’s best to find a dermatologist that is also certified by a recognized medical organization like the Philippine Dermatological Society. Specialists that are members of a group like this are part of a reliable network of dermatologists that have the skills and experience in treating any type of patient.

2. Good Referrals
A recommendation from a friend or a fellow patient can provide some good insight on whether or not the services provided by a particular dermatologist are any good. Similar to reading reviews for a restaurant or a movie, positive feedback about a doctor’s skills can prove that they are competent and a good fit for solving your skincare problems.

3. Same Gender
While this may sound odd, there are patients who are more open to dermatologists of the same gender. Some people may be shy about sharing details of their acne problems, especially when they start developing in parts of their body they may be embarrassed to talk about. It’s important to be able to talk to someone of the same gender who can dispel much of the awkwardness surrounding the topic. After all, if you can’t give your doctor full disclosure about your skin problem, it will become harder to treat and fully remove your acne.

4. Openness and Communication Skills
Finding someone who can explain the details of your skin condition can be just as important as the medication that they offer to treat your acne. A dermatologist with good communication skills can give you a good grasp of your acne situation and what you need to do to manage it. Instead of simply giving you acne medicine and being done with it, a good dermatologist will impart to you the importance of proper skincare so that you can avoid any future acne problems.

5. Generous with Sample Medications
It’s normal for dermatologists to give out samples of their medication to patients. However, a good dermatologist will always consider other factors like possible allergic reactions and budget considerations that a patient may also have. Before you commit to buying a particular prescription, don’t be shy about asking for alternative medication that can fit your other considerations. If your dermatologist is responsible to your needs, then they won’t hesitate in recommending various samples for you to try out.

6. After Hours Availability
It’s possible that you may have some questions regarding your acne that arise after your doctor’s appointment. Being able to find a dermatologist who can patiently answer these inquiries, even outside your scheduled appointment, can be a huge relief when dealing with the distress of a sudden outbreak. Even if you’re unable to speak with your doctor immediately, if they’re able to get back to you via text or email, then you can rest easy knowing that your dermatologist truly cares for your well-being.

Of course, you don’t always need the help of a dermatologist to handle some of the smaller acne breakouts. In cases like these, you can simply turn to more practical tips on how to manage your skin problems. Below are some helpful guidelines on how you can effectively deal with acne.

TIPS ON HOW TO AVOID ACNE

Ultimately, the best way to avoid acne is prevention. By following good skincare practices, you’ll be able to minimize acne, scarring, and live a relatively zit-free life. There are several ways to prevent or outright avoid developing acne. Here are some easy ways for you to do so.

1. Clean Your Face Regularly
Something as simple as washing your face on a regular basis can do wonders for your skin. The act of washing your face can remove excess oil and dead skin cells from your skin’s surface, reducing the possibility of sebum buildup and clogged pores. Washing your face at least twice a day is recommended.

If you want to be more thorough with your face cleansing ritual, make sure to use a mild soap that doesn’t have any negative reaction to your skin. Being thorough also doesn’t mean that you have to scrub your skin harshly to keep it clean. Making use of an exfoliating glove or sponge is a great way to give your face a thorough cleansing without irritating it.

2. Avoid Popping Your Zits
One surefire way to get pimple scars is by popping the whiteheads or blackheads on your face. Not only will you irritate the inflamed skin by touching it, you’ll also spread the bacteria across your face. As hard as it is to resist popping a zit, you need to be able to restrain yourself until you see your dermatologist, who can do a better job of removing your acne safely.

3. Avoid Stress
Studies have shown that stress is tied to the production of hormones in the body. A stressful lifestyle can lead to an increased amount of oil-stimulating hormones that can affect your skin and lead to acne problems. Be sure to take the time to relax and destress yourself when you feel that your job or your studies are starting to overwhelm you.

4. Moisturize Your Skin When Using Acne Treatment Products
Many acne products tend to dry out the skin, so it’s also important to complement this with a good moisturizer. Try to find a moisturizer that is non-comedogenic. This ensures the product won’t irritate your skin and cause acne. Also, try to find a moisturizer that fits your skin type–pick one that’s good for your oily or dry skin.

5. Choose Your Makeup Wisely
If you’re prone to skin breakouts, it might be a good idea to be mindful of what you put on your face. Some ingredients in makeup can cause skin irritation or clog up your pores. Similar to other skin-related products, make sure to find one that’s non-comedogenic and avoid using makeup that is heavy or greasy.

6. Don’t Stay Out in the Sun for Too Long
While getting some sun can be good for your skin, too much can increase inflammation and redness of any existing acne condition that you may have. It’s best to limit your time under the sun, preferably early to mid-morning, and always wear protective clothing if you expect to be out for the whole day. It’s also a good idea to use sunscreen with at least SPF 30 before going out. Naturally, it’s best to check the label of any sunscreen you plan on using and check if the ingredients are non-comedogenic.

Dealing with acne takes a conscious effort from a person, as well as a lot of patience. Many of these tips and tricks require you to have commitment in following a certain lifestyle. However, if you’re able to integrate these into your daily routine, you’ll realize that having flawless and acne-free skin isn’t that hard at all.

ACNE FAQs

There are many fallacies and myths surrounding acne. Many people who follow some of these assumptions usually end up making their acne worse. This is why it’s important to educate yourself about the how’s and why’s of acne, so that you don’t fall into the trap of following the incorrect practices of treating it.

Here are some of the more commonly asked questions regarding acne and the real deal surrounding them.

If Acne Commonly Affects Teenagers, Why Do Some Adults Still Get It?
Whether you’re a teenager or an adult, everything hinges on the fluctuations in hormones, specifically testosterone. While teens experience some of the most drastic hormonal fluctuations, adults can still experience the same in later stages of their life. For instance, women can have hormonal swings during pregnancy or their menstrual cycles that can result in acne.

It’s also possible for acne to occur due to a side effect of certain medications a person is taking. Anticonvulsants and steroid drugs can affect your hormones and thus induce acne breakouts as a side effect.

Is It Better to Use Pads or Lotions When Treating Acne?
Either type of product is equally effective when treating acne, so it really comes down to personal preference. Take note, however, that pads are better for treating large areas of your skin and can provide a small amount of exfoliating when applied.

Can Acne Be Caused by What You Eat?
In general, this isn’t true. The primary trigger for acne is still hormones, which stimulates the body’s oil glands and produces sebum that can block your pores. Some people tend to mistake an acne breakout with an allergic reaction. When someone says they break out due to a specific kind of food, it might be because they’re allergic to it.

One exception, though, is iodine. Some people tend to break out when they introduce iodine into their system, either through iodine-rich foods or supplements. However, it is important to understand that this only happens when there is a significant amount of iodine built up in the body over time. This doesn’t happen overnight just because you had too much shellfish for dinner.

How Exactly Does Stress Affect Your Skin?
The body reacts to stress by secreting a hormone called cortisone from the adrenal gland. This hormone has the purpose of fighting off and managing stress within the body. Once the adrenal gland produces cortisone, small amounts of testosterone are also produced as a result. As we mentioned, testosterone increases oil production in the body, which can cause acne if the oil blocks up the body’s pores.

Women tend to be affected by this more compared to men due to the normally small amounts of testosterone in their blood. When the adrenal gland starts secreting cortisone, this introduces a significant amount of testosterone into their system that can adversely affect their skin condition.

How Does Sweating Affect My Acne and How Can I Avoid It?
When we work out, sweat that we wipe off can mix with dirt, debris, or oil that’s on our skin and get into our pores. This, as a result, can clog our pores and lead to a breakout. The best way to avoid this is to simply wash our face before and after any strenuous activity where we expect to sweat a lot. Be sure to take off any makeup or other product that you put on your face beforehand as well. This will ensure that any perspiration you wipe off won’t mix with anything that can plug up your pores.

Can I Wear Makeup Even When I Have Acne Problems?
Absolutely. What you need to understand in this case is that people have different skin types and skin chemistries. As such, you need to find the right product that works best with your skin. There are various cosmetic products that are labeled as non-comedogenic or non-acnegenic, which can go well with your skin. Finally, make sure to always be thorough when removing your makeup at the end of the day to avoid any residue that can clog up your pores.

Can Birth Control Medication Really Control Acne?
There are those that attest that birth control medicine can help decrease the frequency of acne breakouts and reduce the number of pimples on the skin. While it’s true that products like Ortho Tri-Cyclen, Estrostep, and YAZ have been found to be effective against acne as a side effect, it’s also important to understand the active ingredients in these products and how they work against acne.

These oral contraceptives contain both progesterone and estrogen as their active ingredients. The combination of these two has the effect of lowering androgens in the body, a hormone that has a high amount of testosterone. Since testosterone affects the production of sebum from the sebaceous glands, decreasing it helps lower the amount of sebum that can possibly clog your pores and cause acne.

And there you have it—your complete guide to acne, and what you can do to prevent it!

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