Acne 101: Causes, Risk Factors, Types, Treatment & Prevention

Acne is a condition that is most associated with teenagers, but people of all ages have a chance of experiencing the tell-tale outbreak of pimples. Some might joke that they are an inevitable sign of youth, or even that you haven’t been practicing proper hygiene! But what is acne, and what really causes it? In this article we will talk about these as well as how you can prevent and treat acne.

What is Acne?

Acne vulgaris, more commonly known as acne, is a skin condition characterised by several inflamed, painful pimples which secrete pus. Acne is most found on the face but can also occur on the back and chest. Acne can be a long-term skin condition that lasts for months and leaves scars after it heals. While acne is most common in teenagers, older people can also experience the condition.

What causes Acne?

Acne is caused by oil accumulating in and clogging up the pores of our skin, causing them to become inflamed and discharge pus. Our skin naturally produces oils, known as sebum, which moisturise our skin. However, sometimes our faces can produce too much sebum which blocks our pores.

Sebum is secreted by the sebaceous glands on our face, which are concentrated behind the ears and on the face. This explains why acne outbreaks tend to be concentrated in those areas of the face. Our body’s sebum production peaks when we are in our teenage years and begins to slow down around the age of menopause for women, and around the age of 60 to 70 years old for men. Sebum production can also vary between individuals. While some people have oily skin that makes them more likely to experience acne, others have dry skin when their skin produces less sebum than normal.

Acne Symptoms

Acne differs from pimples in that acne refers to a condition while a pimple is one of its symptoms. The term “pimple” is typically used to refer to pustules, which are skin lesions that present themselves as swollen red pustules which ooze pale yellow or white pus from the centre. Acne can present itself as different types of pimples including blackheads, whiteheads, and cysts.

Acne Risk Factors

You are more likely to be at risk for acne if you:

• Are male. Testosterone, a hormone that stimulates the growth of reproductive organs in men, also promotes the production of sebum.
• Live in a humid climate.
• Have a parent with a history of severe acne.
• Have a condition which causes elevated androgen levels. One example is congenital adrenal hypoplasia, a disorder where a woman’s body produces more testosterone than usual.

Types of Acne

There are different types of acne that occur under different conditions. Below we will explain what each type of acne is and how you can distinguish between them:

1. Baby acne

Baby acne refers to acne that can appear on the face of a newborn, typically on the forehead and cheeks. Around forty percent of newborns develop acne when they are around two to three weeks of age. As the pores on an infant’s skin are not fully developed, they are more susceptible to become infected with irritants found in the surrounding environment. Baby acne typically clears up without medical intervention. If you believe that your infant’s rash might be due to another condition like eczema or diaper rash, you should consult a paediatrician.

2. Cystic acne

Cystic acne is one of the most severe types of acne. Cystic acne tends to occur more frequently in people with oily skin. This type of acne tends to develop as large painful nodules that extend deep into the skin. Cystic acne can take months or even years to go away. When cystic acne clears up, it can leave deep scars on the face that require special treatment to remove.

3. Fungal acne

Fungal acne is caused by an overgrowth of yeast in your skin’s pores. Yeast can cause the skin follicles to be inflamed in a condition known as folliculitis. Fungal acne is often itchy but not painful and presents itself as small, regular red bumps in symmetric rows on the forehead and cheeks. Fungal acne can be more common in hot humid weather and aggravated by sweat.

Acne Myths

Several commonly held beliefs about acne that are actually misconceptions about the condition and how it can be treated. Below are some common beliefs about acne that are false:

Acne is a sign of poor hygiene

A common belief is that acne occurs when you don’t wash your face regularly and is a sign of poor hygiene. However, washing your face too often could dry out your skin and make acne worse rather than reduce it.

Acne is caused by emotional stress

Contrary to popular belief, acne is not directly caused by intense stress. However, if you have acne, stress can make it worse. Stress hormones can trigger your sebaceous glands to produce more sebum, making existing acne take longer to subside.  

Acne will go away on its own

Acne will not go away on its own without treatment. Acne is a chronic condition that can last under your skin for years and present itself in repeated outbreaks.

Acne only affects teenagers

Acne is seen as a problem that affects only teenagers. However, the condition can persist far beyond one’s teenage years and older people can also get acne outbreaks.

Blackheads are dirt on the skin that can be removed

Some people believe that blackheads, one of the symptoms of acne, are patches of dirt and may try to scrub them off. Do not try to scrub at your blackheads! Blackheads are pores that are still open but filled with debris. Trying to scrub them away might instead introduce dirt and cause your acne to become worse.

Lemon juice can remedy acne

Lemon juice is also commonly applied to acne in the belief that it will cause acne to subside. The acid in lemon juice might aggravate your acne instead and make it worse.

Squeezing acne pimples is effective

Some say that the most efficient way to get rid of acne is to squeeze the pus out of your pimples as the pimples will become less swollen when the pus has been removed.

Toothpaste can cure acne

Applying toothpaste to your acne pimples is often suggested as a way of remedying acne. The fluoride found in toothpaste could conversely irritate the acne and make it more painful.

Acne Triggers

There are several different factors which can trigger acne. Here are some of the most common triggers:

• Eating certain foods
• Hormonal changes
• Treatment with medicines like antibiotics or steroid medication
• Wearing items that place pressure on a particular area of the skin, like a headband

Acne Complications

Acne can leave long-lasting scars on affected parts of the body. These scars can resemble deep craters (boxcar scars), small deep holes on the face that look as if they had been made with an ice pick (ice pick scars) or scar tissue which gives the face an uneven texture (rolling scars).

Any type of acne can leave scars, especially if you try to poke at or squeeze your pimples. These scars can be a source of shame because they might be unpleasant to look at. The strong feelings of anxiety caused by severe acne scarring can even lead to depression. 

Acne Treatment

There is no cure for acne. However, the condition can be managed with some types of medicine and products that you can buy in the pharmacy:

Using a face wash that contains salicylic acid can help to treat acne on the face. Salicylic acid can help to exfoliate the skin and remove irritants that could contribute to acne.

Doxycycline is also a treatment that is used for moderate to severe acne. Doxycycline is a drug that can be ingested orally and is one of the most commonly prescribed treatments for acne. However, the drug can cause side effects if used long-term. Side effects can range from changes in skin colour to inflammatory bowel disease and even the closing of the digestive tract. Before you take any new medications to control your acne, please consult your doctor to understand whether it is safe for you.  

Milder forms of acne can be controlled by placing hydrocolloid bandages over the affected area. Hydrocolloid bandages can help to absorb pus and oil from the surface of the skin and relieve the swelling in acne. The bandages can also cushion your acne patch and prevent pain when your acne comes into contact with other surfaces, especially if you have acne on your chest or back. Nonetheless, applying hydrocolloid bandages is not a substitute for treatment to control the long-term effects of acne.

Controlled oral contraceptives (COCs) may be prescribed in acne treatment for women. COCs can help to reduce levels of androgens which can cause acne outbreaks in women.

Home Remedies for Acne

Besides medicines there are also some natural substances you can find easily in your house or the supermarket that can help to relieve acne. Here are five home remedies we recommend for acne:

Aloe

The natural gel found inside aloe vera leaves is known for its skin-soothing abilities and can soothe painful patches of acne.

Honey

Honey has long been known for its soothing and antibacterial properties. Manuka honey masks or even pure honey straight from the jar can be applied to acne as a source of relief you can easily find.

Ice

Applying ice to your acne can limit blood flow to the area, causing swollen areas to hurt less. When you ice your acne, do not apply the ice directly to your skin to avoid injury.

Oatmeal

Studies have shown that oatmeal possesses antioxidant and anti-inflammatory properties, making it effective on a variety of skin conditions including viral infections and acne. Using skin masks or creams that contain oatmeal can also help to reduce the severity of your acne.

Tea tree oil

Tea tree oil has anti-inflammatory properties, meaning it can help to reduce acne swelling. A dilute tea tree oil solution can be applied to your acne to reduce the number of bacteria on your skin, which can prevent acne from getting worse. Do not apply tea tree oil directly to your skin.

Acne Scar Removal

Cystic acne can leave unpleasant-looking scars on the face which can cause embarrassment to those who have them. However, these scars can be removed with certain treatment methods.

Dermabrasion is a treatment by which a spinning wheel is moved over the surface where the scar is to remove uneven areas of skin. This type of treatment is meant to alter the surface of the skin by making it appear smoother and more even. If you have other active skin conditions like dermatitis, you need to inform your dermatologist as such conditions can resurface from dermabrasion treatment.  

Laser treatment is a common method by which acne scars can be removed. Small puncture holes are created in the skin with a laser so that the surrounding normal skin grows over the scar tissue. The full effects of skin regrowth will take months to show as the skin gradually repairs itself after the laser treatment.

When to See a Doctor for Acne

Treatments and home remedies can help relieve acne to some degree, but if it becomes more serious medical intervention might be required. You should see a doctor for acne if:

•   Your acne pimples become larger
•   Your acne starts to spread to other areas of your body
•   You do not experience any positive effects from acne treatment

Are you bothered by the red painful pimples you get from acne, and afraid of leaving the house because of how unsightly it is? Instead of going to the doctor, you can arrange a teleconsultation.

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