Acne, this unpleasant and upsetting condition is nearly universal in humans, and yet, it is still often misunderstood. It is an ailment which affects upwards of 80% of the population to some degree; ranging from mild cases of spots that clear up quickly, to chronic pustules which can leave the sufferer permanently scarred. There is an awful lot to cover on this subject so I want to break it down into three categories for ease of digestion.
Before we go into the symptoms of acne, it is important to explain exactly how it forms and why. Acne happens when pores in the skin are blocked off and filled with sebum (a natural oil produced by the skin). The blockage causes a build-up of sebum which then leads to the spots we associate with acne. Pores are most commonly blocked by dead skin cells which have not been shed fast enough which is often a symptom of oily skin. This can also be the result of inflammation which narrows pores, making them more susceptible to blockage. Sebum production is another important part of how acne forms. There are many different factors which affect the production levels of sebum. The most significant are androgen hormones such as testosterone which can increase production drastically, especially during puberty. These blockages lead to the formation of structures called comedones, these are the fully formed spots seen in acne breakouts.
Bacteria also plays an important role in the formation of acne, the strain P. Acne is largely responsible for the effects and spread of spots on the skin. This bacteria is always present on the skin of humans, although it always wants to move into the pores as it feeds on sebum and breeds rapidly deep within the pores. This bacteria is also is often responsible for acne which spreads across the face and body, as the swelling bursts it spreads the bacteria to more pores worsening the acne. It is also partially responsible for chronic acne as the bacteria can form clumps called biofilms which are linked to long term infection.
Acne can appear almost anywhere on the skin of the body, however, it most commonly occurs on the face. Almost all cases of acne include the formation of spots on the face although they also commonly occur on the back and the chest to a lesser degree. Acne in these last two areas can commonly be mistaken for folliculitis or other potentially more serious infections of the hair follicle. Check to see if the spots are centred on hairs, if they are then it is likely folliculitis rather than simple acne.
There are six types of spots which can be caused by acne.
1. Whiteheads The best know form of acne, this is the infamous white and red spots which we commonly associate with acne. They are small comedones which form close to the skin, pushing outwards.
2. Blackheads The most common and least serious of the spots which can occur on the skin. They are known for their black colour which comes from oxidized sebum, not dirt as is commonly thought. They are also different in that they are the only open comedones which form; oxidized sebum, not dead skin cells make up the blockage.
3. Papules These are larger comedones formed when a pore is irritated and damaged to the point that the sebum breaks through its walls, expanding further. This form of acne is red or pink and hard to the touch. Papules are a more severe form of normal acne and should be treated immediately as if left alone, they can lead to scarring.
4. Pustules Much like papules, these commodes form when the pore can no longer contain its contents. However, these structures form closer to the skin and are red with yellow or white pus. This form of acne can be seriously upsetting to those who suffer from it; also, as the pustules are prone to bursting they can easily spread the bacteria across the skin making the acne worse. The constant damage they do to the skin can be very serious and often leaves scars which can last for life. For these reasons it is important to take serious steps to treat acne pustules.
5. Nodules These comedones are similar to papules but much, much larger and more serious. Nodules are very tender, painful and extremely swollen, feeling almost solid under the skin. They are very displeasing and can even lead to scarring if left untreated. If suffering from nodules, then you should certainly go to a doctor as over the counter treatment will likely be unable to adequately manage nodular acne.
6. Cysts Cystic acne is the most severe type which a person can suffer from, these large, soft comedones are painful and aesthetically unpleasing, often causing major distress for those who have them. They are also very likely to cause scarring as they burst, often permanently damaging the skin.
There are as many, so called “solutions” for acne, as there are stars in the sky. Everyone has a different idea on how to prevent and reduce the appearance of acne, with people swearing by anything from basil to ice and toothpaste to honey. However, not all treatments are created equal and some commonly used solutions can even harm the skin, making acne worse.
Firstly, we should dispel some common myths surrounding acne treatment which persist to this day.
MYTH - Diet doesn’t influence acne: Thanks to a pair of flawed studies conducted in the ‘60s and ‘70s which suggested that chocolate and other similarly sugary foods had no impact on acne, people wholesale accepted the premise that diet had no impact on acne. As a result, very little research was done on the topic for over forty years after the fact.
However, newer research would suggest that consuming too much sugar, dairy and bad fats all contribute to the formation of moderate to severe acne.
Myth-Toothpaste can put a stop to spots
This common myth comes from a place of truth, toothpaste does contain a variety of ingredients which can dry out pimples; causing the spots to reduce in size and appearance. However, toothpaste is not designed for the skin and the drying out and irritation which it causes can lead to more acne in the long term. As the skin dries, more sebum is produced to re-lubricate the skin, leading to worse spots than before.
Natural sun is a natural solution
If used correctly this method of prevention can really help with fighting spots, although it can also lead to outbreaks as well. Sunlight has been shown to reduce inflammation in the short term and so it can help to prevent acne for a while. However, UV damage leads to the release of free radicals which cause huge inflammation in the skin. This damage also breaks down collagen fibres, leading to pre-mature ageing of the skin. To prevent excess damage, pop in for an LED light therapy Mask treatment that has all the benefits without the UV damage.
Going for a swim
Similar to toothpaste, chlorine does dry out pimples which reduces their size and can get rid of them in the short term. However, it also dries out the skin which forces the body to produce more sebum to lubricate the skin. Drying out the skin works in the short term, but it only leads to worse acne over time.
Benzoyl Peroxide is completely safe
As is a common theme with these myths, benzoyl peroxide can actually reduce acne in the short term. Unfortunately, as is also a common theme, it can be disastrous for the skin and spots in the long term if precautions are not taken. BP works in two ways, firstly, it dries out and causes the skin to exfoliate which reduces the size of spots while also unplugging blocked pores. As we have already discussed, this may work for a time, but the damaged skin will stimulate greater production of sebum to re-lubricate its dry surface. As BP is a peroxide, it contains a large number of oxygen molecules which are then introduced to the pores. As P. Acnes needs an environment low in oxygen to properly replicate, the peroxide effectively smothers it, preventing the bacteria from growing further. However the end product of benzoyl peroxide is a phenyl radical which causes oxidative stress. For these reasons, it is very important to use a light weight moisturiser and take plenty of antioxidants while using Benzoyl Peroxide. Most BP products are now only available by Prescription only.
So, what do I recommend to fight off acne and keep your skin looking lovely?
First of all, it is an awful lot easier to prevent acne from forming in the first place than to treat a breakout in full swing.
It is essential to use a sunscreen that will prevent oxidative damage which leads to inflammation, just be sure that the product you choose is non-comedogenic (does not cause the formation of acne).
Consuming antioxidants will also help to fight inflammation, inflamed pores are much more prone to becoming blocked by dead skin. We have some amazing antioxidant drinks you can take daily - Skinade and Yana.
Gentle exfoliation can also help to reduce the chance of pores becoming blocked off by dead skin, just be careful not to exfoliate harshly as this can lead to increased sebum production and more spots. The Vital C masque by Image Skincare is great for this.
In the same vein, using a lightweight, non-comedogenic moisturiser can prevent dry skin, keeping sebum production levels in check. The oil free SPF 32+ moisturiser by Image skincare is great for acne skins.
Increasing the amount of Omega 3 fatty acids in your diet from sources like salmon or flaxseed oil has been shown to control levels of molecules which can increase sebum production. Skinade contains these ingredients.
Lastly, it is important to lead a healthy lifestyle, getting enough sleep and exercising decreases stress which has been shown to make outbreaks more frequent. Studies also suggest that reducing the amount of sugar and dairy in your diet can prevent acne from forming.
However, if you are already suffering from spots the challenge of removing them is much more difficult. The most important thing you can do is avoid the urge to pop or pick at your spots. This method only damages the pore and irritates the skin, spots which are not left alone can take months to heal and disappear. Not only is it ineffective but it can make your acne worse by spreading spots causing bacteria across the skin without removing all the bacteria from the pore.
Use a product with salicylic acid which effectively unplug pores and kill off spot forming bacteria. As we have already covered, be sure to eat plenty of antioxidant foods and use a low weight moisturiser after the acne treatment has dried to prevent damage to the skin and keep the acne from reappearing. If you have sensitive skin or an intolerance of traditional ingredients, some essential oils have been shown to reduce acne effectively. Tea tree, lavender, clary sage and juniper berry oils are great for the skin, fighting both inflammation and bacterial infection.
As you can see acne is a complicated and heavy subject with many misconceptions. We hope that we have managed to clear up a few of these issues and explain how best to prevent and treat acne in a healthy and effective manner.
If you need any more advice or information please book yourself in for a complimentary consultation with one of our skincare specialists on 01708 922 205 Romford Essex
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