What is Acne?
Acne arises when a pore is blocked by too much sebum and dead skin cells. The skin has a large number of tiny pores or hair follicles. A hair and a sebaceous gland, which has several lobes, are found inside each pore. To lubricate the hair and skin, sebaceous glands secrete an oily material known as sebum, which typically moves up the pore.
Blackheads are created when the dried sebum’s surface is dark, and the pore is partially blocked, but the passage to the skin’s surface is still evident. A pimple is a red, swollen bump filled with pus that forms when the pore’s access to the skin’s surface is limited, causing it to become infected and inflamed. Hard nodules under the skin’s surface, known as cysts, can develop due to more profound and severe infections.
Acne can affect people of any age, and most people have it at some point. Due to an increase in hormone production during adolescence and in conjunction with a woman’s menstrual cycle, acne frequently appears during these times.
Causes of Acne
Inflammation of the hair follicles comes from the combination of hormones, skin oils, and bacteria that causes acne (the pores in the skin where hair grows). Numerous different skin abnormalities define acne (lesions). They differ in size and intensity, and some penetrate the skin more deeply than others:
Blackheads (open comedones)
Whiteheads (closed comedones)
Pimples (inflamed closed comedones)
elevated, firm bumps (papules)
pus-filled spots on the skin (pustules)
more profound, stronger, pus-filled lumps (nodules)
more oversized pus-filled pockets (cysts)
Occasionally, even more prominent, deeper pus-filled pockets (abscesses)
Sebaceous glands
Sebaceous glands are located in the dermis, the middle layer of skin, and secrete sebum, an oily substance. The hair follicles are joined to these glands. Sebum and dead skin cells are transported through the pores from the hair follicle and sebaceous gland to the skin’s surface.
Acne develops when bacteria, dead skin cells, and dried sebum plug hair follicles, preventing sebum from exiting via the pores.
If the blockage is not entirely removed, a blackhead (open comedones) forms.
A whitehead (closed comedones) forms if the blockage is fully developed.
A whitehead that is inflamed is a pimple. Cutibacterium acnes (formerly known as Propionibacterium acnes), typically present in the hair follicle, are encouraged to overgrow by the clogged, sebum-filled hair follicle. This bacterium converts the sebum into irritants for the skin. The ensuing inflammation leads to skin lumps, known as acne pimples. Cysts and occasionally an abscess are caused by deeper inflammation.
Acne Triggers
Most acne cases are caused by elevated hormone levels, particularly androgens (such as testosterone), which activate the sebaceous glands and cause them to produce excessive amounts of sebum during adolescence. By the early to mid-20s, hormone levels have typically dropped to the point where acne reduces or vanishes. Even in their 40s, many women may still have acne.
Acne can also be influenced by other disorders that cause hormonal changes (more on hormones, read here):
- Menstruation or being pregnant
- Ovarian polycystic syndrome
- Certain medications
- Certain skincare products
- Too-tight clothing
- Sweating with high humidity
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a hormone disorder that can disrupt the menstrual cycle and trigger or worsen acne. Acne may occur with each menstrual period in younger women and may clear up or substantially worsen during pregnancy. Certain drugs, particularly corticosteroids and anabolic steroids, can worsen acne or cause acne flare-ups. Certain cosmetics, cleansers, and lotions may worsen acne by clogging the pores. Clothing that is too tight and high humidity and sweating can trigger acne.
Categories of Acne
There are three categories of acne: mild acne, moderate acne, and severe acne.
You can get a few non-inflamed blackheads, whiteheads, or a few pimples if you have mild acne.
If you have moderate acne, you can have more blackheads, whiteheads, pimples, and pustules.
You could acquire a lot of blackheads, whiteheads, pimples, and pustules if you have severe acne.
Scars are not left behind by mild acne. However, repeated scratching and attempting to open them in other ways may leave scars. Because cysts and abscesses erupt during moderate and severe acne, scars remain after the skin has healed.
Conglobata Acne. The scarring from this type of acne is particularly severe.
Acne Fulminans and Pyoderma faciale are uncommon, severe forms of acne that suddenly appear.
How to diagnose Acne
Acne is diagnosed by doctors based on a skin examination. Doctors search for specific symptoms like blackheads or whiteheads to distinguish acne from other skin conditions like rosacea.
Following the diagnosis’s confirmation, the lesions’ number and nature are used to determine if the acne is mild, moderate, or severe.
Treatment of Acne
Acne treatment, in general, is straightforward. Once or twice a day, gently wash the affected areas with a bar of light soap. Alcohol pads, harshly repeated scrubbing or antibacterial or abrasive soaps offer no additional benefit and may aggravate skin irritation.
Because extremely greasy cosmetics might make acne worse, they should be water-based.
Suppose acne treatment is unsuccessful in treating acne in adolescents. In that case, a diet low in simple or processed carbohydrates and sugars (a low glycemic index diet) and moderation of milk consumption may be considered. However, the efficacy of these measures in treating acne is debatable. A balanced, nutritious diet should be consumed (see Nutritional Requirements).
For some people, specific acne treatments are beneficial. For instance, women with acne may be prescribed oral contraceptives. Results from this treatment take longer than six months to appear. Some women may benefit from using spironolactone, a medication that inhibits the effects of the hormone aldosterone. Another drug that blocks the effects of specific hormones is called clascoterone, and patients 12 years of age and older can use it to treat acne. People with inflammation have benefited from a variety of light-based therapy (with pimples or pustules).
Acne treatment is based on how bad the condition is. The most superficial therapy with the fewest side effects is needed for mild acne. Additional treatment is necessary for acne that is more severe or does not respond to first therapy. Education, encouragement, and the most realistic alternative for the patient should always be part of a therapy strategy. A specialist may be needed by the public.
Mild Acne
Tretinoin is the most widely used topical prescription medication for blackheads and whiteheads. Although it is pretty efficient, retinol irritates the skin and increases photosensitivity. As a result, doctors utilize this medication with caution, starting with small doses and occasional administrations that can be gradually raised. Topical adapalene, azelaic acid, and glycolic or salicylic acid are given to people who cannot take tretinoin.
Patients with inflammation (along with pimples or pustules) are prescribed either topical antibiotics, tretinoin coupled with benzoyl peroxide, or both. Clindamycin and erythromycin are the two topical antibiotics that are most frequently administered. Dapsone and minocycline foam are further topical antibiotics. When combined with a retinoid, such as tretinoin, or benzoyl peroxide, topical antibiotics shouldn’t be utilized. It is possible to get benzoyl peroxide with or without a prescription. Although it is no longer frequently used, glycolic acid can be used in place of or in addition to tretinoin.
Moderate Acne
Antibiotics taken orally are typically used to treat moderate acne (orally). Doxycycline, minocycline, tetracycline, and sarecycline are examples of common antibiotics. Other choices include trimethoprim/sulfamethoxazole, erythromycin, and azithromycin. For mild cases of acne, people frequently combine an oral antibiotic with topical therapy. People may take antibiotics for roughly 12 weeks to reap the most significant advantages.
To maintain control, oral antibiotics are avoided whenever possible in favor of topical therapies only. This therapy may need to be continued for months or years. After a brief course of treatment, acne might reappear.
Long-term antibiotic users can experience vaginal yeast infections that may need to be treated.
Oral contraceptives, spironolactone, or both may be administered to women who do not respond to oral antibiotics.
Severe Acne
The only medication that may be able to treat acne is isotretinoin, which is connected to the topical medication tretinoin. Oral isotretinoin is the most effective treatment for the most severe cases of acne when antibiotics are ineffective. Isotretinoin, however, can have some horrible side effects. There could be more, less severe side effects as well. Women taking isotretinoin must use at least two methods of contraception before, during, and after treatment to prevent pregnancy since it can harm a developing fetus.
Usually, 16 to 20 weeks of therapy are required, but sometimes longer.
People with acne conglobata are prescribed oral antibiotics by doctors. Oral isotretinoin and corticosteroids may be prescribed if antibiotics are ineffective.
Doctors provide oral corticosteroids and antibiotics to patients with acne fulminans.
Doctors provide oral corticosteroids and isotretinoin to patients with pyoderma faciale.
Treatment of the scars left
The location, depth, and shape of severe acne scars will determine how they are treated.
Chemical peels, laser therapy, dermabrasion, and/or micro-needling, a more recent procedure, can all be used to heal numerous, tiny, shallow scars. In micro-needling, the skin is pricked with tiny needles, changing the skin’s collagen.
Dermabrasion is a treatment where the top layer of skin is removed by rubbing it with an abrasive metal tool.
Removing certain shallow or deep scars and then seizing the skin back together is possible.
A surgery known as a subcision, in which tiny cuts are performed under the skin to release the scar tissue, can enhance wide, indented scars. Frequently, this process enables the skin to regain its regular contours.
Injections of collagen, fat, or various synthetic materials are occasionally used to treat scars. These compounds might elevate the scarred region to level with the surrounding skin. Injections of temporary fillers must be made regularly, including collagen, hyaluronic acid, and polymethyl methacrylate. Some of the additional injections are long-lasting.
Parting thoughts
If you’re looking for a way to get rid of acne, this is the article for you. We’ve compiled a comprehensive guide with all the information you need to know about how to get rid of acne. From the causes of acne to the best treatments, this guide covers it all. Share this article with anyone you know who is struggling with acne.
Until next time, thank you for reading