There are a variety of causes including genetics, fluctuating hormone levels, stress, high humidity and using oily or greasy personal care products. Acne commonly affects teenagers but can occur at any age.
Though it mainly affects teenagers and young adults undergoing hormonal changes, many people continue struggling with acne into their 20s, 30s and beyond. Some even develop acne for the first time as adults.
Where does acne most commonly occur?
The most common spots where you might have acne are your face, forehead, chest, shoulders and upper back. Oil glands are all over your body, but those are the places where there are the most. The best way to treat acne depends on how severe it is. Acne can be mild (a few occasional pimples) moderate (inflammatory papules) or severe (nodules and cysts).
What are the different types of acne?
Acne can take several forms. They include:
Blackheads: Open bumps on the skin that fill with excess oil and dead skin. They look as if dirt has deposited in the bump, but the dark spots are actually caused by an irregular light reflection off the clogged follicle.
Whiteheads: Bumps that remain closed by oil and dead skin.
Papules: Small red or pink bumps that become inflamed.
Pustules: Pimples containing pus. They look like whiteheads surrounded by red rings. They can cause scarring if picked or scratched.
Fungal acne (pityrosporum folliculitis): This type occurs when an excess of yeast develops in the hair follicles. They can become itchy and inflamed.
Nodules: Solid pimples that are deep in your skin. They are large and painful.
Cysts: Pus-filled pimples. These can cause scars.
All of these forms of acne can affect your self-esteem. It’s best to seek help from your healthcare provider early so they can help determine the best treatment option(s) for you.
Certain things can cause acne and/or make it worse:
1. Fluctuating hormone levels around the time of a woman’s period.
3. Clothing and headgear, like hats and sports helmets.
4. Air pollution and certain weather conditions, especially high humidity.
5. Using oily or greasy personal care products (like heavy lotions, creams or hair pomades and waxes) or working in an area where you routinely come in contact with grease (such as working at a restaurant where there are greasy food surfaces and frying oil).
6. Stress, which increases the hormone cortisol, can also cause acne to flare.
7. Some medications.
8. Genetics.
How is acne treated?
A. Medications applied topically:
1. Benzoyl peroxide is available as an over-the-counter product (such as Clearasil®, Stridex®, PanOxyl®) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin. Irritation (dryness) is a common side effect.
2. Salicylic acid is available over-the-counter for acne, as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.
3. Azelaic acid is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.
4. Retinoids (vitamin A derivatives) such as Retin-A®, Tazorac®, and Differin® (which is now available without a prescription) break up blackheads and whiteheads and help to prevent clogged pores, the first signs of acne. Most patients are candidates for retinoid therapy. These medications are not spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. The most common side effect is irritation, which usually improves with moisturization and time on the medication.
5. Antibiotics (topical types include clindamycin and erythromycin) control surface bacteria that aggravate and often encourage the swelling of acne. Antibiotics are more effective when combined with benzoyl peroxide.
6. Dapzone (Aczone®) is a topical gel, which also has antibacterial properties, can be used for inflamed acne. It’s applied to the skin twice a day.
B. Medications taken orally (by mouth):
1. Antibiotics, especially tetracycline antibiotics such as minocycline and doxycycline, are commonly used to treat moderate to severe acne.
2. Oral contraceptives can help with breakouts associated with menstrual cycles. Three classes of medications have been approved by the FDA for acne patients. Some brand names include Estrostep®, Beyaz®, Ortho Tri-Cyclen® and Yaz ®.
3. Isotretinoin (Amnesteem®, Claravis®, Sotret®), an oral retinoid, is an especially effective drug used only for the most severe cases of acne. Isotretinoin shrinks the size of oil glands, which contributes to acne formation.
Can acne be prevented?
Preventing acne is difficult if not impossible during normal hormonal changes. But some things can help:
1. Wash your face daily with warm water and a mild facial cleanser.
2. Routinely use moisturiser.
3. You don’t have to stop using makeup, but try to use “non-comedogenic” products and remove makeup at the end of each day.
4. Keep your hands away from your face.
Written by Sarah Amah
