Acne: Types, Causes, Treatment and Prevention Tips

Acne occurs due to inflammation of the skin. The problem with acne is that the skin texture gets affected in severe breakouts, and it can also be painful. Imagine worrying every time you want to wear your best outfit, and you feel the acne is stopping you from feeling your best. It not only makes one look unkempt, but it also affects one’s confidence level. Therefore, in an ideal world, one should pay attention to acne breakout, whether young or adult, at the very onset. 

There may the several underlying causes for it. Some common causes include hormonal changes and medications. It generally begins during puberty and continues in adulthood. Both adolescent and adult acne have similar reasons. Also, one may not have acne during puberty and may develop them in adult age. Adult acne can occur due to hormonal changes, stress factors, life stages like childbirth, menopause etc. 

Acne generally appears on the face, shoulders, back, chest, and neck. It can occur in both men and women. However, women typically have higher chances of developing acne. Almost 20% of affected people have residual acne scars. Moreover, massaging, stress and anxiety may worsen acne.

What is acne, and why is it happening to me?

Acne is a common skin condition that arises when hair follicles become clogged under the skin with sebum, dirt, and dead cells. As a result, it causes cysts, pimples, and pigmented spots. It usually occurs when the body experiences increased hormone production. As the sebum or facial oil mixes with dead skin cells and hair, they clump together to burst open the skin. Acne is not the same as pimples. They may be used interchangeably but have different meanings and nature. Acne is the condition itself, whereas pimples are one of its symptoms. You can call pimples a less severe form of inflammatory acne. 

Acne develops in each person differently. The severity of acne is worse during adolescence. However, acne may occur on and off till 30 to even more advancing years. Therefore, before deciding on treatment, it is essential to find the cause of your acne. 

What kind of acne do I have?

You may notice that the acne present in your face is not always similar to those you meet. In reality, there are different types of acne with distinct appearances, symptoms, and treatments. Knowing the kind of acne helps in choosing what’s best for you. 

1. Blackheads 

Blackheads are skin bumps or comedones caused by acne. Open comedones contain excessive oil and dead skin cells. It is not dirt that makes the spot look black; the dark colour results from the uneven reflection of light from clogged hair follicles. The debris present inside the blackheads often gets oxidised. 

2. Whiteheads 

Whiteheads remain completely plugged or closed at the skin’s surface. As a result, they do not expose themselves to the air. This skin condition occurs when oil and skin cells obstruct the opening of a clogged hair follicle. As a result, it usually appears as white or skin-coloured bumps. 

3. Papules

Papules are inflammatory and appear as tiny red or pink bumps on the skin. This sort of pimple may be touch-sensitive. Picking or squeezing can aggravate the inflammation and cause scars. The presence of a considerable number of papules may suggest moderate to severe acne. However, it is usually devoid of white pus. 

4. Pustules

Pustules are another type of inflammatory pimple. They have a whitehead-like appearance with a red ring around the bump. Typically, the lump is full of white or yellow pus. Picking or squeezing pustules can result in scars or dark patches.

5. Fungal Acne (Pityrosporum folliculitis)

This type of acne can occur by an overgrowth of yeast in the hair follicles. As a result, they are prone to becoming itchy and irritated.

6. Nodules

Nodules are prominent, inflammatory pimples with a firm texture. They penetrate deep beneath the skin and are typically painful. It is a severe form of acne. 

7. Cysts

Cysts are prominent, pus-filled lesions that resemble boils in appearance. They look like nodules, can be painful and should be treated by a dermatologist due to the possibility of scarring. Individuals who develop nodules and cysts are typically diagnosed with a severe form of acne.

Is my acne severe?

You’re having a severe case of acne if you’re experiencing too many breakouts that may cover your back, chest, face, neck, and jawline. Sometimes, it develops on the buttocks. Unlike mild or moderate acne, severe acne extends deep into your skin to cause painful breakouts. Instead of minor blemishes, you’re more likely to have scars after the acne clears.

Anyone with severe acne can notice many whiteheads, blackheads, and pimples on their skin. They tend to be stubborn and don’t respond to most acne treatments. People with this condition might notice slight swelling, reddened or inflamed skin, and cysts. In addition, to make it worse, a single cyst or pimple stays on for months.

How to treat acne?

Primary or mild acne stage

If you find 1 or 2 large pimples on your otherwise clear face, it’s the primary or mild acne stage. Luckily, the initial acne phases cure home remedies and drugstore creams for most people. Try not to pop, squeeze, or pick pimples. Treating the first sign of acne may also prevent scars. You may stop the spreading of acne when they first start appearing by following any of these treatment strategies:

Some DIY Treatments

1. Green Tea

When used topically, the flavonoids and tannins in green tea prevent inflammation and acne-causing germs. In addition, multiple studies demonstrate that applying a 2–3% green tea extract to the skin reduces sebum production and pimples in acne sufferers.

How to use green tea for acne

• Dip green tea bags for 3–4 minutes in boiling water.
• Allow the tea to cool.
• Use a cotton ball to apply it to your face, or use a spray bottle. 
• Let sit on your face for 10 minutes and then rinse it off with water.
• Apply 1–2 times daily, as necessary.

2. Essential Oils

With antibacterial and anti-inflammatory qualities, essential oils can aid in the rapid resolution of pimples. For example, 5% tea tree oil gel is nearly six times more successful at lowering acne severity. In addition, a thorough scientific review discovered that tea tree, cinnamon, rose, lavender, and clove essential oils effectively work against acne-causing bacteria. However, most essential oils are concentrated. As a result, one should dilute it with a carrier oil before use.

3. Over-the-Counter Medications

Most mild to moderate acne cases can be treated with Benzoyl peroxide cream. It eliminates microorganisms, speeds up skin repair, and reduces sebum production. In addition, you can buy a face wash infused with salicylic acid to clear up the blackheads and whiteheads. It can also reduce inflammation and irritation. Another topical acid called azelaic acid strengthens the follicular lining cells, decreases bacterial growth, and eliminates sebum eruptions. 

4. Aloe Vera

Aloe vera includes lupeol, salicylic acid, urea nitrogen, cinnamic acid, phenols, and sulphur, which prevent pimple-causing microorganisms. According to a study, combining 50% aloe vera gel with tretinoin cream was more successful at clearing up pimples than tretinoin cream alone. Tretinoin cream is an acne medication made from vitamin A.

Secondary Acne Stage

A qualified medical professional should treat severe cases of acne. You can not clear it by home remedies or using pimple treatment cream from local stores. When you have severe acne, usually one of the following treatments work:

1. Isotretinoin

A potent oral retinoid used to treat severe cystic acne and acne that has failed to respond to previous drugs and therapies. It works by decreasing sebum production. However, you may see noticeable differences only after 1-2 months. Isotretinoin capsules are taken twice a day for 15-20 weeks. Most people can stop taking this drug after two months. However, the second course of treatment starts if the severe cane returns. 

Isotretinoin is a carefully regulated drug that may have adverse effects. Therefore, the patient must sign a consent form acknowledging the potential side effects. Possible side effects are dry skin, chapped lips, nosebleeds, foetal abnormalities, and mood changes. In addition, patients using isotretinoin must avoid Vitamin A supplements, as they may cause vitamin A toxicity.

2. Oral Antibiotics

Patients with severe acne may be prescribed oral antibiotics for six months. Religiously following the drug course brings down the P. Acnes bacteria population. First, the dose will be high. Then it gradually decreases as the acne clears. Antibiotics can stop germs’ growth and lessen inflammation. In addition, routine severe acne treatment is possible with antibiotics. The effective antibiotics are erythromycin and tetracycline.

3. Injection of Corticosteroids

An inflamed cyst may be treated with a diluted corticosteroid injection by a specialist. A severe acne cyst can explode and cause deep scarring. Therefore the injection can aid in reducing scarring and inflammation of severe acne. It may also speed up the healing process, and within a few days, the cyst will dissolve.

4. Topical Antimicrobials and Retinoids

Topical antimicrobials also diminish P. acnes in individuals suffering from mild to severe acne. Clindamycin and sodium sulfacetamide are two examples.

Topical retinoids are vitamin A derivatives. The dermatologist may prescribe a topical retinoid. This treatment may clear the pores and prevent the formation of whiteheads and blackheads. Adapalene, tazarotene, and tretinoin are examples of topical retinoids.

Tertiary Acne Stage and Cosmetic Treatments

After the complexion clears and you finally manage to break free from acne, you’ll find there are remains of the breakouts. Unfortunately, acne scars and acne marks are often left behind. Most of the time, those pigmented spots and blemishes fade away without any treatment. The acne scars, however, are permanent. You can improve the skin texture and make scars look less noticeable, but they won’t entirely go away. 

1. Fillers

Dermatologists can improve depressed acne scars by filling them with collagen or fat. It gives temporary results that last between 6-18 months. In addition, fillers rich in hyaluronic acid improve the skin texture. However, you may need filler injections every few months to have lasting effects. 

2. Chemical Peeling

Chemical peeling comes under resurfacing procedures that diminish the acne appearance by removing skin layers. By doing so, you’ll be allowing the body to produce new skin cells. It is unsuitable for deep acne scars as chemical peeling removes only the top skin layer. However, you may go for this treatment if you suffer from nearly flat scars. 

3. Micro-Needling

A needle-studded roller is manually moved across the depressed acne scars and punctures the skin. As the ki heals, more collagen production occurs that later covers up the scars. As a result, you may notice gradual changes in scar appearance within nine months.

Factors Leading to Acne

1. Excess Androgens

During puberty, our body starts making elevated amounts of androgen hormone that stimulates the oil glands, making them more prominent. As a result, sebum production is increased by the enlarged gland. Excess sebum clogs the pores and hair follicles. It may cause blackheads or whiteheads. For the most part, the Propionibacterium acnes (P. acnes) bacteria feed on the sebum, triggering infection and inflammation. 

2. Unhealthy Diet

Consuming foods high in simple sugars may trigger acne. Studies suggest that a high glycemic index may worsen acne. In addition, these foods cause increased insulin secretion. Insulin, in turn, triggers androgen production. Therefore, an increase in androgen secretion results in oilier skin.

Consequently, it is vital to have sweets like chocolates and mithais and ready to eat snacks in moderation. Including vitamin-rich foods may help in reducing infection. They may also reduce skin inflammation.

3. Menstruation

Hormonal changes during the menstrual cycle cause acne flare-ups a few days before periods. During the middle of your menstrual cycle, the increased progesterone levels stimulate sebum production. It, in turn, will clog the pores. Moreover, testosterone hormone levels tend to be high during the monthly cycle. It also contributes to sebaceous gland sensitivity. 

4. Medications

Systemic drugs and medications trigger acne. Some of them are antituberculosis, antidepressants, antibiotics, and corticosteroids. 

In some people, intake of oral corticosteroids increases yeast proliferation within the hair follicles. As a result, the pores become clogged with yeast and oil, leading to fungal acne. Severe acne in athletes is often a result of injecting anabolic steroids. These are nandrolone, stanozolol, and danazol. You may even develop acne during the initial few months of taking oral contraceptives. 

5. Lifestyle

Your lifestyle impacts the onset, duration, and severity of acne. It includes erratic sleep patterns, lack of exercise, alcohol consumption, greasy cosmetics, and smoking. A study shows that smokers are more likely to have acne than non-smokers. Furthermore, increased stress from a busy lifestyle intensifies the severity of existing acne. Anxiety and stress cause an increase in the production of cortisol and adrenaline, both of which aggravate acne, so try and avoid it.

What do I need to do about it?

Always consider that your acne management journey is not limited to one identical step. It depends on the severity, cause, and persistence of acne. Here’s the guide on what to do before, during, and after acne.

Primordial Acne Management

Prevention is always better than cure. So keep your skin healthy to stop acne from happening in the first place. Simply put, you can start now by lowering the possibility for acne through these simple steps:

You may prevent or reduce acne by identifying the cause. In addition, identifying the triggers may help in reducing the severity. However, it is essential to care for skin health from the inside out. If you use acids or active particles to prevent or cure acne, ensure that you use them in moderation. An excess may harm the skin barrier.

Diet and Hormones

Hormones can play a significant role in the development of acne. Keeping your hormones in check may help in managing acne. Hormones are affected by several factors. Diet and PCOD are some of the commonly known causes. Changes in fat composition may also contribute to hormonal changes.

Additionally, consuming an excess of simple sugars and fatty foods may worsen acne. However, this is because these food items are instrumental in increasing the production of insulin and androgens. As a result, oil or sebum secretion increases leading to acne. Therefore, it is crucial to consume a healthy diet. 

Foods rich in antioxidants like vitamin C may reduce acne thanks to their antioxidant and anti-inflammatory properties. Additionally, omega-3 fats and fibre may also contribute to reducing acne. However, in some people, certain foods may trigger inflammation. Studies show that such inflammatory foods may worsen acne. These foods include dairy, gluten-rich foods, oily foods and simple sugars. Therefore, it is advisable to consult your physician to rule out any possible triggers.

Stress and Sleep

Stress and lack of sleep have a significant impact on acne. Studies suggest that stress may increase cortisol levels. Therefore, this may trigger the immune system and cause inflammation. The simple solution is to manage stress and get adequate sleep.

Medications

Studies show that certain medicines may worsen acne. Few of these include antibiotics, vitamin B12, birth control pills. Before starting on hormonal medications such as birth control pills, talk to a doctor to prevent possible side effects.

Sun Protection

Always wear sunscreen while stepping out. It should have a high sun protection factor. It is good to go for a mild and oil-free product in a humid environment. Also, make sure to use non-comedogenic skincare products. Non-comedogenic products allow the skin to breathe and stay hydrated. Talk to your dermatologist and find out which products suit your skin best.

The Bottom Line

Acne is an inflammatory skin disease. It occurs both at puberty and adulthood. Mostly, it happens when the pores and hair follicles become clogged with bacteria, oil, and dead skin cells. As a result, acne appears as cysts, nodules, pimples, blackheads, and whiteheads. Touching or popping the pimples leads to secondary infection and scarring. In extreme cases, the acne lasts for months and spreads rapidly. It is an indicator of severe acne. The scars formed as a result of severe acne is permanent. However, you may go for fillers, chemical peeling, or micro-needling treatments. 

Following a healthy and balanced diet may help reduce the severity of acne. However, it is also essential to identify the possible triggers that vary from person to person. Therefore, when in doubt, it is best to consult a dermatologist. In addition, personally-tailored skin treatment may help in managing acne.