What is acne?

We have all woken up to find that we’ve got an unsightly spot or two. But for many people, pimples are a daily fact of life, often covering large parts of the face and body. Acne vulgaris, often known just as “acne” is a common skin disease that causes spots, blemishes or pimples to develop on the skin, which don’t clear up on their own.

The types of spots people experience with acne can include the more common blackheads and whiteheads, to larger and sometimes painful pus-filled pustules and cysts. Those who suffer from acne usually find these spots developing on their face, neck, chest and back.

Although acne can be unpleasant, often affecting sufferers’ self esteem, acne is a common skin complaint. In fact, it will affect most of us at some point in our lives, usually during puberty. Statistics show that acne affects 3 in every 4 people aged 11 to 30 years. While it is not considered harmful or a sign of poor health, it can leave skin scars in severe cases, and it can affect your quality of life. ¹

The good news is that acne is treatable. For most, treatment consists of topical medications and treatments. For some, oral medication is needed. Improvement is usually noted gradually, over several weeks, as new, healthier skin cells emerge to the skin surface, while inflammation and redness improves.

Symptoms of acne

Acne can happen almost anywhere on your body. But it most commonly develops on the face, back, neck, chest, and shoulders.

If you suffer from acne, you’ll typically notice various types of lesions on your skin. Noninflammatory lesions include “whiteheads” and “blackheads”, for which the medical term is comedones. Comedones are the result of blocked hair follicles and sebaceous ducts that form the base of hair follicles.

There are other types of inflammatory skin lesions that occur in acne. Inflammatory lesions cause redness, irritation, discomfort, and sometimes even drainage from the skin lesions. Inflammatory lesions include:

• Papules - small, red, raised bumps. These are caused by inflamed or infected hair follicles.
• Pustules - are small red pimples with pus at their tips.
• Nodules - solid and sometimes painful lumps beneath the surface of the skin.
• Cysts - are large lumps found beneath the skin. They contain pus and are usually painful.

Acne causes and risk factors

Acne occurs when tiny holes (or “pores”) on the surface of the skin become clogged. These pores open downward to a hair follicle, which contains a hair and an oil gland. The oil released by the gland (called sebum) helps remove old skin cells and keeps your skin soft. However, sometimes there is a buildup of sebum and skin cells that block the pores-contributing to acne. Additionally, bacteria may become trapped in the plug, causing inflammatory lesions--like papules, pustules, and cysts.

Acne is usually triggered by normal changes in the body’s hormone levels and genetic factors. This is why acne is very common amongst teenagers. During teenage years, levels of androgens are at their highest. Androgens are the group of hormones that trigger sebum production from the pores. When sebum production is high, the sebum and skin cells are more likely to clog the pores and become inflamed.

Adult acne is also fairly common. Factors that can affect hormone levels and lead to acne include menstruation, smoking, pregnancy, obesity, and periods of stress. It is also thought that acne has genetic causes, meaning that if one or both of your parents suffered from acne then you are more likely to also experience it. Usually, no specific testing is needed to identify causes of acne, and it is diagnosed based on the appearance of the lesions and clogged pores.

Acne treatment

Fortunately, there are a wide range of options available for treating acne. These include topical washes, creams,lotions and specific antibiotics.

For those with mild acne, the best place to start is usually a pharmacy or drugstore. Mild acne can be treated with over-the-counter (OTC) medications, such as gels, soaps, pads, creams, cleansers and lotions, that are applied to the skin once or twice daily.

OTC acne remedies may contain the following active ingredients:

• Resorcinol: helps break down blackheads and whiteheads
• Benzoyl peroxide: kills bacteria, accelerates the replacement of skin, and slows the production of sebum
• Salicylic acid: assists the breakdown of blackheads and whiteheads and helps reduce inflammation and swelling
• Retin-A: helps unblock pores through promoting cell turnover

It is advisable to start with the lowest strengths, as some preparations can cause skin irritation, redness, or burning on first use.

However, for many people, OTC options do not work effectively. Many cases of acne can be treated by a primary care provider in a clinic or online setting. Sometimes, more complicated or severe cases are referred to a dermatologist, or skin specialist. A telehealth provider can view your skin online during the consult.

Providers may prescribe a gel or cream similar to OTC medications but stronger. Sometimes they also prescribe oral or topical antibiotics. Retinoids, are prescription medications that promote cell turnover, to generate more healthy skin cells in the place of clogged or inflamed skin lesions. For some women, oral contraceptives (“birth control”) can also help control acne. Contraceptives contain hormones and certain contraceptives can improve acne, while others can worsen it. Speaking with your health care provider about your acne concerns can help him or her identify the right contraceptive for you.

References

1 Acne: Causes, treatment, and tips

The information provided is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of a doctor with any questions you may have regarding a medical condition. Never delay seeking or disregard professional medical advice because of something you have read here.