Acne is a disorder of the glands which lie at the base of hair follicles. We all have these glands but some people’s glands release oily substances more than others. For most people this is a constant battle, while for others thankfully acne disappears when the teens are passed. What is good to know is that there are many things that you can try to keep this under control so that it does not affect your life.
Research is constantly going on to find causes and cures, and other less invasive ways of treating this. What is important is that you realise that other people also suffer from acne. You are not alone in the quest to find a solution to this.
What is acne?
Acne is a very common skin condition, sometimes affecting face, while at other times affecting back, shoulders and even the chest.
Acne is very common in adolescence and can vary in severity from just a few spots to far worse blemishes. It affects mostly people between the ages of 11 and 30, although it can very occasionally stay with a person in later life. Boys are affected more than girls and severity can range from very mild to severe.
Acne is not contagious or infectious, you can never pass it on to other people. The main problem with acne is that it affects your skin, and most people are very self-conscious about that.
Although it is not contagious or infectious, acne is classed as a disease which affects the skin. The pores in your skin are right next to the oil glands which lie under the skin. It is the job of the glands to produce an oil substance called sebum. The glands are connected to the pores by the canal called a follicle. The follicle is the method whereby the oil carries the dead skin cells to the surface of the skin. It is also the place where a single strand of hair grows. When the follicle gets clogged with oil, it does not bring the dead skin cells to the surface, and a pimple forms.
Acne is not a serious disease, but it may cause scars, if pimples are squeezed or scratched. Acne can last up to five years, although it may carry on longer on some people.
Anyone who develops acne will have it on the face. More than half of the people with acne will have it on their backs, and 15% will have it on their chests.
The causes of acne include clogged pores, oil production, dead skin cells and bacteria.
Foods that fight acne
Some foods have long histories of being good for certain ailments and acne is one condition which the right foods can help to eliminate. Combining them with a good skin care regime and exercise will make a great difference to your skin.
Avoid processed foods as much as possible, and also foods that contain a lot of sugar. Junk foods fall into this category.
Drinking water will help to detoxify your body and purify the skin so make sure that you drink an adequate amount of this through the day.
- Low glycemic index: this category includes foods such as brown rice, sweet potatoes, chickpeas, apples, cauliflower, lentils, cabbage, and cherries.
- Omit dairy: dairy products are harder to digest and therefore stay in your system for longer. This increases the toxin build up which then affects your skin. If you do not have a nut allergy, then almond milk is a great substitute for regular milk.
- Anti-inflammatory foods: try adding fatty fish and nuts – if you have no allergies to them. Mackerel, salmon, walnuts, chai seeds and tuna are all good sources of anti-inflammatory foods.
- Water: water not only benefits your skin, but also your entire body. It is the way our bodies remove toxins. If we do not drink enough water, then our kidneys cannot eliminate toxins and the job is left to the skin to do it. To work out how much water you need to drink, you must weigh yourself in ounces and divide by 2. This will give you the amount of water you should drink per day.
- Superfoods: this is a category of foods that contain more than normal amounts of vitamins and minerals. Foods in this group include blueberries, kiwi fruit, apples, broccoli, walnuts, and legumes.
- Omega 3: this category of foods contains anti-inflammatory products which will help fight infection. Sardines, salmon, trout, and walnuts.
- Omit wheat and gluten: wheat, rye, barley, beer, ice cream and even pizza contain gluten. You should look for products that are labelled gluten-free.
Essential lifestyle changes
- Exercise: increases the flow of blood to the surface of your skin. It helps to flush out toxins, relieve stress and tone up your body.
- Sleep: try to eat several hours before you go to bed, and aim for 7u – 8 hours a night. It is also a good idea to keep non-sleep related things out of your bedroom, so that the room is only used to sleep in.
- Alcohol: limit your alcohol, it is not necessary that you omit it altogether. Be aware that drinks like tequila and vodka do not contain sugar so should not affect your skin. Red wine is also good in moderation. Mixed drinks will always contain large amounts of sugar which may make your acne worse.
- Smoking: there is no way to look at smoking, other than it is bad for you and your skin.
- Stress: this triggers a reaction in your body which then produces more stress hormones. Subsequently, your skin will pay the price for this. Some good forms of stress relief are yoga and meditation, aromatherapy, and massage, stretching and acupressure, and finally – good old fashioned walking in a peaceful place such as the beach or countryside.
Daily skincare regime
- Cleanse: you should wash your face at least twice a day, without using soap. There are cleansers available which contain benzoyl peroxide which work better with acne.
- Exfoliate: healthy skin normally exfoliates itself every 28 days, but with acne this process is far less, so you need to exfoliate. You should do this gently with a mild exfoliating agent. Any vigorous scrubbing will remove the tops of pimples and may cause an infection.
- Moisturise: this should be an essential part of your skin routine. Water based products work well, as does glycerine. Jojoba oil is very good for acne.
- Sunscreen: be sure to apply some factor SPF 30 or above every time you go out into the sun. Some products used for acne can cause the skin to be extra sensitive, and this is the reason you should protect it from the sun’s rays.
- Toners: avoid alcohol toners as they will dry your skin. A toner that contains salicylic acid will work well for a skin with acne.
- Overnight treatment: if you leave any substance on your face, make sure that you have a thin layer of it just where you need it. If your skin shows any sign of irritability, remove it at once and wash with warm water. It is important that you let any broken skin heal first, before using any overnight treatment.
- Correct hygiene: wash your hands before touching your face, but, if at all possible, keep your hands away from your face. Change your pillowcases and bedding often, and replace your makeup brushes every few weeks. Remember never to share washcloths or towels and to wash them after every use.
What makes acne worse?
- Contraceptive pill: if you take the progestogen-only pill, your acne may worsen.
- Monthly periods: this is not always the case, but with some women, this will make acne more severe.
- Thick make up: you may notice that thick, greasy make up brings out a fresh set of pimples. Most make up, if it is light enough will not affect acne and there is some makeup which you can use to cover mild spots. Oil free products are best for this.
- Squeezing spots: you should avoid picking and squeezing spots because this will make the inflammation worse and possibly cause scarring. Opening up pimples can also spread infection.
- Very humid conditions: sweating profusely and humid conditions may make acne worsen. Some people have bad reactions if they work in hot, humid kitchens. The humidity is thought to block the pores.
- Tight clothes: friction and excess sweating due to tight clothing is thought to add to the discomfort. Avoid things like tight bra straps, headbands and tight fitting necklines.
- Some medications: phenytoin (which is used for epilepsy), and some steroid creams (used for eczema) are thought to bring out acne. If you suspect a medication to be worsening your acne, do not stop it until you have spoken to your doctor. He may be able to give you a different type of medication.
- Anabolic steroids: it is very common to see bodybuilders who take these develop serious acne.
The thought from researchers is that while the exact cause of acne is still not known, there are suggestions that it may be both genetic and environmentally caused. Certainly, family history plays a part, and sometimes an environmental factor may trigger of a reaction. You may be aware that certain things in your daily life seem to bring on a spurt of pimples and cause a flare up. Triggers are different for every person, but it is important that you keep a record of data every time your acne worsens. This will give you an idea of what causes your personal flare up, and you will be able to avoid as best you can.
Medical research is constantly looking for ways that new drugs can be made to treat acne. As with most bacterial infections, the problem is that over a period of time, bacteria become drug resistant and certain antibiotics will no longer work. There is research work going on to see how effective the use of probiotics is in the struggle with acne.
In this article by AAD they state that combining more than one treatment is the best way for most patients.
Bacteria on the skin will release a fatty acid which in turn triggers inflammation.
How is acne treated?
If you suffer from acne and feel that you need further treatment, you should only go to someone who is qualified in treating this. You should be careful to check out the reviews and recommendations as if acne is not treated by someone who is qualified, you may end up with more scars and blemishes, and possibly a skin infection.
Acne treatment is designed to:
- heal existing pimples
- prevent more pimples from forming
- prevent any scarring
The best way to prevent scarring is to treat acne early. Primarily your doctor may recommend over the counter drugs, or even some prescription drugs. There are some medications which are applied onto the skin and others are in tablet form to swallow. You may be started with just one form, or given more than one, depending on how severe your acne is, and what the doctor thinks best for you.
Do not believe people who tell you that acne is caused by poor personal hygiene. This is not true, in fact extra washing does not make any difference to acne at all. You should wash the area no more than twice a day with a very mild soap or unperfumed cleanser and water. Avoid wearing lots of makeup. If you do wear makeup, you must make sure you remove it all at night.
Try to be gentle when you wash the area and if you use any exfoliating care products. Excess rubbing and friction will cause your pimples to leak and make matters worse. Some types of acne cause very dry skin and for this you can use a fragrance free, water based moisturiser.
Antibacterial treatments such as benzoyl peroxide – which can be bought over the counter – will reduce the bacteria on your skin and may ease acne. However, there is no conclusive proof that they really do work. They may irritate your skin at first but this tends to settle down after a few usages. If you are going to see an improvement, it will take some weeks before it becomes noticeable. Take care not to get any on your clothing as it will make colours fade.
Lotions, gels and creams:
There are several different types of lotions and gels available, often over the counter, and others by prescription only.
- Benzyol peroxide: comes in a cream and gel.
- Antibiotic creams and gels: will help to reduce inflammation and swelling by controlling the natural levels of bacteria on your skin.
- Azelaic acid: this is often prescribed instead of benzoyl peroxide as it is kinder to your skin and will not leave it red or peeling.
- Retinoids: these are topically applied and it may take a while before you notice the effects. They may also be slightly irritating to your skin. These should not be used if you are pregnant as there is a great risk of harming the baby.
- Sunscreen: over time you might find that you become more sensitive to the sun. be sure to apply plenty of sunscreen, and also stay out of the sun as much as possible.
Antibiotics: There are some antibiotics which your GP may prescribe if you have moderate to severe acne. These are oxytetracycline, doxycycline and erythromycin. Normally these will take up to six months to work. Your doctor will explain how often you should take an antibiotic tablet, and he may also give you a cream to apply while you take them.
Oral Contraceptives: because contraceptives suppress the male hormone testosterone, it therefore increases the production of sebum. Your doctor may have you take the oral pill for this. Normally this makes your skin less oily, and often you will need to take them combined with other treatments.
In cases of severe acne there is a medicine called co-cyprindiol which also works as a contraceptive, and your doctor might recommend this. It also serves to reduce testosterone levels and therefore dry your skin. One of the risks is that it does increase the risk of blood clots, and your doctor will discuss this issue with you.
Isotretininoin: this may be another option in severe cases of acne. Your doctor will prescribe this to be taken orally. One of the downsides to this is that your acne will worsen before it improves. This medication is known to cause dry skin, headaches and often nose bleeds. Some people notice an ache in their joints when taking this. One point to consider is that this may cause more serious medical conditions such as liver problems and higher cholesterol levels. If you suffer from depression, then you should also let your doctor know before you start any treatment with this. Occasionally people will have an allergic reaction to this and you will also need to have regular blood tests to ensure your cholesterol levels are within the acceptable limits.
If you are trying to start a family, then you should not take this medication as it can affect your unborn baby, so using contraception is essential if you choose to take this.
This is one of the medications that you will need to have a frank discussion with your doctor before starting on.
Using lights: normally any form of light treatment is not offered by doctors because they are not sure how well it works. Research is continuing for this. There are people who believe that using a sunbed dries up their acne, but again, there is no scientific proof to this claim. The best person to speak to about this, is your dermatologist.
- Wash with pH balanced cleanser: wash your face twice a day with a good quality cleanser which has a pH of 5.5. Make this a part of your daily routine, especially if you wear makeup. You must be sure to remove it all before bed.
- Wash with oils: you may find that using oils such as rapeseed and olive oil are far more gentle ways to cleanse your skin.
- Exfoliate: it is important that you slough off the dead skin. Konjac sponges are soft enough so that they will not harm your skin, but firm enough to be effective. Oatmeal mixed with honey is another way to remove dead skin gently.
- Apply essential oils: there are anti-bacterial properties in tea tree oil which destroy the bacteria that causes acne. You should read the label and dilute it to the recommended proportions.
- Use products with benzoyl peroxide: you should look for products that contain less than 3% to avoid irritating the sensitive areas of your face and body.
- Clay masks: you should look for masks that contain sulphur as this assists in acne treatment.
- Toner after cleansing: toning helps to close the pores in your skin so that less dirt becomes trapped. Witch hazel and apple cider vinegar are excellent toners for anyone with acne.
- Moisturiser: after you have performed your routine, the final part is to moisturise your skin. You should do this gently every morning and evening.
Skin care and acne
It is important to have a skin routine which works for you, and then to stick to it.
- Be gentle: you may want to use a mild cleanser twice a day, in the morning and evening. You should add another wash after a heavy workout, where you have sweated a lot. Do not be tempted to scrub your skin. This does not work and will only increase your problem.
- No touching: no picking, squeezing or pinching pimples! This will not improve your acne, and will eventually leave you with scars on your face. It is a quick way to spread infection from your skin into open wounds and make your pimples even worse.
- Take care when shaving: experiment with both hand and electric razors to see which one is kinder to your skin. You may want to soften your beard with soap and water before adding shaving cream. Try to shave as lightly as possible and only when you have to.
- Resist the sun: your medication will likely cause you to burn even more. Added to that, being in the sun for extended periods of time will make your skin wrinkle and leather-like, and raise the risk of skin cancer.
- Be selective with makeup: look for oil free makeup, with ‘noncomedogenic’ on the list of ingredients. This product helps towards keeping your pores open. Occasionally people will still get acne, even using this product.
- Try an antiseptic wash: you may find this eases your acne. Take care not to use any abrasions such as cleansing granules and exfoliating scrubs. Wash with a soft cloth and your fingers, and do it softly so as not to scratch the pimples open.
- Leave blackheads alone: if you tart squeezing and poking them, you will only spread infection to other parts of your face. Wash as you normally would, and leave them to your dermatologist.
- Try topical treatments: some of these make the skin dry, and if this is your case, then use a light moisturiser. Avoid oil based creams as they will clog your pores.
The goal of any acne treatment must be to clear as many spots, and to leave as little scarring on your face as possible. Your doctor or dermatologist will advise you of the best treatment and together you can work out a routine. This will depend on the severity of your acne. You may need treatments which are applied directly to your skin, or others which you take internally.
Mild acne is a very common thing and goes away in time, normally without any scarring. If you start to develop red spots, pustules or rashes, it is advisable to start treatment as early as you can, to prevent the acne worsening. Treatment will eventually clear your acne it if is used correctly, however you may always have a breakout due to outside influences.
Natural ways to treat acne
Sometimes people are not happy with using chemicals on their skin to reduce and clear acne. There are alternative ways that you can use, which are all natural and chemical free.
- Ice: place a piece of cloth around an ice cube and place it on the red area for a few seconds. Remove, wait a few seconds, and repeat. You can do this as many times as you deed through the day. This is for pimples that are not infected.
- Lemon juice: extract the juice from fresh lemons and use a cotton swab to dab the juice onto the pimple before bed. Citrus works as a germicide and attacks microscopic germs. Adding a sprinkle of cinnamon may work for pimples which do not respond to pure juice, although do not use this if you have very sensitive skin.
- Toothpaste: use white toothpaste here and not gel. Dab a little on each pimple before going to bed. Wash off with cool water in the morning. Toothpaste should stay on the spot longer than thirty minutes. Stop using toothpaste if your skin becomes irritated by it.
- Honey: you can make a thick paste of honey and cinnamon, or you may use the honey on its own. Use a clean swab to dab onto pimples and leave overnight. Wash off in the morning with cool water. Honey is a natural disinfectant with known healing properties.
- Tea tree oil: this contains antibacterial properties and works well for the treatment of acne. Dab a little onto each pimple and leave for no longer than thirty minutes before rinsing off. Aloe Vera gel is a cooling agent and may be added to the tea tree oil. Leave this on for no longer than twenty minutes before washing off in cool water. If your skin is very sensitive, then avoid using tea tree oil.
- Steam: steam has the ability to open up the pores and then flush out the dead skin which clogs them. Fill a bowl with warm water, have your face over the bowl with a towel over your head so that you feel the steam on your face. Do not touch the hot water. If you can stay there for thirty minutes, then do so, after which you should apply your usual moisturiser.
- Garlic: it is a well-known fact that garlic has antibacterial properties. It is the sulphur content of the garlic which does the work. Slice a clove of garlic in half and rub the cut end onto the pimple. Leave this on for no longer than five minutes before washing it off with warm water. You may repeat this several times each day.
- Cucumber: slice a cucumber and soak in a little water for an hour. Strain the water and discard the solids, keeping the liquid. Use this to wash your face. You may also prepare a face mask using cucumber, by liquidising it and applying it to your face. Leave it on for fifteen minutes and rinse off in warm water.
- Baking soda: this acts as a mild exfoliant to remove dead skin cells which may be infected. Blend one teaspoon of baking soda with either water or lemon juice so that it is a thick paste. Wash your skin and then apply a coat of the baking soda and leave it to dry. Leave this on for another five minutes and wash off in warm water. You can repeat this up to three times a day. Do not keep the past on for longer than five minutes as it will dry your skin out.
- Papaya: choose a ripe fruit and mash the pulp into a smooth paste. Papaya has natural compounds that sooth your skin and reduce inflammation. Apply the pulp to your pimples and wait ten minutes before washing off in warm water. You can do this twice a day.
- Apple cider vinegar: wash you face and towel dry lightly. Make up a solution of one part vinegar to three parts water, dip a cotton swab in this and dab on pimples. Leave on for no less than ten minutes, preferably overnight if possible. Wash off in the morning with tepid water.
- Aspirin: crush one aspirin finely and make up to a smooth paste with water. Using a cotton swab, dab onto pimples and leave for thirty minutes. You will notice the mixture dries and cracks and is ready to remove. Wash off in warm water. Use this only once a day as it dries out your skin.
- Yogurt: use plain yogurt and add a little lemon juice. Mix well and using your hands, apply to your skin. Leave on for fifteen minutes and wash off with warm water. You should repeat this twice a day.
- Olive oil: this contains anti-oxidants and has a calming effect on inflamed skin. Gently rub some good quality olive oil on your pimples before bed. In a gentle rubbing action, massage the oil into your skin. Now take a clean towel and soak in warm water and place on your face for a few minutes. Gently wipe away the excess oil. Be careful not to rub too hard. After this you may wash your face with warm water.
Go to a Dermatologist or Spa
- Facials: most spas are equipped to give facials to people with acne. This includes cleansers and masks and occasionally the use of tools to reduce acne. Your dermatologist is also able to do this.
- Peeling: this consists of using an acid based gel to remove dead skin and bacteria. Done regularly, these can help to get rid of acne.
- Microdermabrasion: this is literally when the skin is sanded away from your face, removing all the dead skin, and stimulating new growth. This is an effective way once a week over several months.
- Laser treatment: strong bursts of light are targeted at bacteria cells to kill them. This is unfortunately a painful thing, but it is very effective, with a 50% success rate.
- Light treatment: some colours of lights such as reds and blues, have been proven to reduce acne. These are milder than laser and not at all painful.
- Prescription drugs: thought should be given when using these, because, as with most drugs, there are side effects. You should discuss the drug and the effects with your dermatologist before agreeing to this method.
Myths about acne
There are many myths that surround acne, and no doubt you have heard some of them. There are also a good deal of ‘old wives tales’ about the condition, which may or may not have an element of truth to them. It is never a good idea to rely on these myths or old wives’ tales, rather you should speak to your doctor or dermatologist about any queries you have.
- Poor hygiene causes acne: no, it does not! The truth is that excessive washing will make your acne worse.
- Chocolate causes pimples: no, it does not! This has never been proven to conclusion. You may want to limit it because it adds calories, but it does not cause acne.
- Stress does not cause acne: wrong! Stress does play a part in acne, learning to relax and not get stressed is always recommended.
- Acne is a simple skin problem: wrong! Acne is a very complex condition of follicles becoming clogged with oil and being unable to bring dead cells to the skin surface.
- Acne is contagious: no, it is not! You cannot catch acne, neither can you pass it on to anyone. By using someone else’s towels, you can spread their bacteria to your face and aggravate your acne.
- Drinking water cures acne: no, it does not. Whilst drinking water is good for your body, it does not prevent acne, neither will it get rid of it.
- Sunbathing gets rid of acne: no, this has never been proven to be true. There is always a risk that you burn as your skin is more sensitive than most.
- Medical treatment does not help: wrong, medical treatment will work if it is used and followed correctly.
Although acne is the most common skin condition to be treated in the USA, it is still difficult to understand why it happens. Often it happens to women in their 30’s to 50’s and dermatologists are still unsure as to the reason. However, the important thing is that you start any treatment as soon as possible to reduce the possibility of scaring. Be patient, learn to relax and not be too stressed out. Follow your treatment regime and you will see an improvement.