ACNE

Acne Vulgaris (also called Acne) is a very common skin condition; where the hair follicles and their associated oil glands become blocked and inflamed. It causes spots, oily skin and sometimes skin that is painful to touch. Acne most commonly occurs on the face, neck, back and chest because this is where the oil glands are largest and most active.

Sebaceous glands are tiny glands found near the surface of the skin. The glands are attached to hair follicles, which are small holes from which hair grows. Sebaceous glands produce an oily substance called sebum, which lubricates the hair and the skin. In acne, the glands begin to produce too much sebum, which mixes with dead skin cells and both substances form a plug in the follicle. If the plugged follicle is close to the surface of the skin, it bulges outwards, creating a Whitehead. Alternatively, the plugged follicle can be open to the skin, creating a Blackhead (blackheads and whiteheads are known as comedones). Normally harmless bacteria that live on the skin can then contaminate and infect the plugged follicles, causing Papules, Pustules, Nodules or Cysts.

Causes
Acne is very common in teenagers and younger adults; about 80% of people aged 11 to 30 are affected. Acne often disappears when a person is in their mid-twenties. In some cases, it can continue into adult life; about 5% of women and 1% of men have acne over the age of 25. Acne can also run in families. Many adult women have acne, and this may be caused by the changes in hormone levels at certain times. Some women have a flare-up of acne just before their period.  Others have symptoms of acne during pregnancy; and some women with polycystic ovarian syndrome may develop acne as well. Other possible triggers of acne may include: some cosmetic products, hats/ headbands, backpacks, some medication and smoking.

Treatment
Medication used to treat acne may be of topical (gels, creams, lotions) or tablet form; they aim to unplug pores, reduce the number of comedones, reduce inflammation and prevent discoloration and scarring. Topical solutions may contain salicylic acid, benzoyl peroxide, retinoid, azelaic acid, glycolic acid or a topical antibiotic. In severe forms of acne, oral medication may be used, these may include, antibiotics, isotretinoin and even oral contraceptive pills. (You can find benzoyl peroxide, salicylic acid, or retinol in topical acne products that you can buy without a prescription). Dermatologists may offer other treatments for acne, these include: Light microdermabrasion, chemical peels and Light diathermy. Larger nodules and cysts may be injected with steroids to reduce the inflammation.

Cleansers

Tip#1:

It is important to wash at least twice a day with an appropriate cleanser in order to stop redness, heal the skin and reduce oil production. You should wash once at mornings and then at evenings before bed. Use lukewarm water, as very hot or cold water can make acne worse. Apply the cleanser gently with your fingertips, and use only your fingertips to wash and rinse your face. Gently pat your skin dry with a clean towel.

Tip#2:

Your cleanser should be free of abrasives, detergents and alcohol, and the label should say that it won't clog pores or is "non-comedogenic”. If you have oily skin, look for a cleanser with “high rinsability”, one option is Cetaphil Oil Control Foam Wash. If you have combination, dry, sensitive or irritated skin, look for a “gentle oil-free plus moisturizing” liquid cleanser. Examples include: Cetaphil Gentle Skin Cleanser and Neutrogena Extra Gentle Cleanser.

Exercise and Diet

Tip#3:

Sweat can worsen your acne; you should wash your face whenever you are sweaty. Try showering as soon as possible after exercising. Also, avoid foods that you notice tend to make your acne worse.

Hair

Tip#4:

If acne only appears around your forehead and temples, (pomade acne) your hair products may be the cause. Switch your hair care products, using those that contain water or glycerin instead of oil. Apply hair oil at the ends of your hair (and avoid putting oil at the edges of your scalp).

Tip#5:

Wash your hair often, as well as your hats and pillowcases to prevent build up of sweat, dirt and oil, which may worsen acne. Also, avoid letting your hair fall across your face, as this could also lead to breakouts.

Treatment

Tip#6:

It is best to apply your acne treatment after your skin has completely dried following cleansing. If treatments are applied to moist skin they are more likely to cause irritation. Apply your acne treatment to the entire skin region where you normally develop pimples. A small pea-sized amount is usually all you need to treat the entire face. 

Tip#7:

Acne treatments need time to work; give an acne treatment at least 4 weeks to work. Using a new acne product every few days can worsen acne. If a treatment works for you, you should notice some improvement in 4 to 6 weeks. It can take up to 2 to 3 months or longer to see significant clearing.

Beard

Tip#8:

It is critical to shave beards carefully to in order not to worsen acne. Apply a shaving cream/ gel made for sensitive skin and apply light pressure as you shave. Use double or triple razor blades and shave around the pimples, instead of shaving through them.

Make up

Tip#9:

Avoid using too much make-up and cosmetics, and make sure to completely remove your make-up before going to bed. This will prevent breakouts. Also, do not use heavy, oily makeups to cover dark marks and blemishes. Mineral makeup is much lighter and can do a great job of hiding dark spots. Choose water based make-up products that are described as non-comedogenic.

Natural remedies

Tip #10:

There are several natural remedies that can be used to treat acne. Some persons have reported significant improvement after daily use of 5% Tea Tree oil (gel), however, it may take a few months to show any results compared to other acne treatments. 20% Azelaic acid used twice daily may also result in improvement. 2% green tea extract solution may be useful for treating mild acne as well. As with other acne treatments, these may have side effects such as skin irritation, redness and dryness.

When to see a Doctor

Tip#11:

Acne can cause distress (low self-esteem, depression and anxiety). If your acne is making you feel very unhappy or it cannot be controlled with over-the-counter medication, see your doctor for further treatment.

Also if you develop nodules or cysts, see your doctor, because these need to be treated properly to avoid scarring. (Try to resist the temptation to pick or squeeze your pimples, as this can also lead to permanent scarring.)
 
I hope these tips on ACNE were very useful; Remember, YOUR HEALTH IS INVALUABLE!

By Dr. J. Lawarna Matthew

 
Acknowledgments
American Dermatology Association
Visit
https://www.aad.org/public/diseases/acne-and-rosacea/acne and https://www.acne.org.au/ for more information.