Acne

What is it? (Definition and Overview)

Acne is a common skin condition that occurs when hair follicles become clogged with oil, dead skin cells, and sometimes bacteria. It typically appears on areas of the skin that have the most sebaceous (oil) glands, such as the face, back, chest, and shoulders. Acne primarily affects adolescents due to hormonal changes but can occur at any age. It can manifest in various forms, including pimples, blackheads, whiteheads, cysts, and nodules. Acne is often considered a cosmetic concern but can also have psychological effects, impacting a person’s self-esteem.

What are the signs and symptoms?

• Blackheads: Small, dark spots that occur when pores become clogged with oil and dead skin cells.
• Whiteheads: Small, flesh-colored bumps that occur when pores are clogged but remain closed.
• Pimples (Pustules): Red, inflamed spots with a white or yellow center filled with pus.
• Nodules: Large, painful lumps beneath the skin’s surface that can be firm or tender.
• Cysts: Deep, painful, and pus-filled lumps that are often larger than nodules and may lead to scarring.
• Inflammation: Redness, swelling, and tenderness around the affected area.

What causes it?

• Excess Oil Production: The sebaceous glands in the skin produce oil (sebum) to keep the skin moisturized. When these glands produce too much oil, it can mix with dead skin cells and clog pores.
• Clogged Pores: Dead skin cells, which normally shed from the surface of the skin, may become trapped in hair follicles and mix with sebum to form blockages.
• Bacterial Growth: The bacteria Propionibacterium acnes (P. acnes) naturally live on the skin. When pores are clogged, these bacteria multiply, leading to inflammation and pus.
• Hormonal Changes: Hormonal fluctuations during puberty, menstruation, pregnancy, or while taking birth control pills can trigger acne. Hormones such as androgens increase the size and activity of sebaceous glands, leading to more oil production.
• Diet and Lifestyle: Certain foods, like dairy or high-glycemic foods (sugary or processed foods), can worsen acne for some people. Stress, lack of sleep, and poor hygiene can also contribute to flare-ups.
• Genetics: Family history plays a role in determining the likelihood of developing acne. If your parents had acne, you're more likely to experience it as well.
• Medications: Some medications, including corticosteroids, anabolic steroids, or medications that affect hormone levels, can contribute to acne.

What can you do?

• Proper Skincare: Cleanse your face gently twice a day with a mild soap or acne-specific cleanser to remove excess oil and prevent clogged pores. Avoid harsh scrubbing or over-cleansing.
• Topical Treatments: Over-the-counter products containing ingredients like benzoyl peroxide, salicylic acid, or sulfur can help reduce oil, clear pores, and kill acne-causing bacteria.
• Medications: For more severe cases, dermatologists may prescribe topical or oral antibiotics, retinoids, or hormonal treatments like birth control pills for women. In some cases, oral isotretinoin (Accutane) may be recommended for persistent or severe acne.
• Avoid Picking: Picking at or squeezing pimples can worsen inflammation, cause scarring, and lead to further infection.
• Dietary Adjustments: Reducing the intake of processed foods, sugary snacks, and dairy products may help some individuals reduce acne flare-ups.
• Stay Hydrated and Get Enough Sleep: Drinking plenty of water and managing stress through exercise or relaxation techniques can support overall skin health.

When to see a dermatologist?

• Severe Acne: If your acne includes large cysts, nodules, or deep scarring, a dermatologist can recommend prescription treatments or therapies to control the condition.
• Scarring: If your acne is leading to scarring or hyperpigmentation that doesn't improve, a dermatologist can provide options like chemical peels, laser treatments, or dermabrasion.
• No Improvement with Over-the-Counter Treatments: If your acne doesn't improve with regular over-the-counter products after 4–6 weeks, a dermatologist can suggest stronger treatments or investigate underlying causes.
• Painful Acne: If your acne is painful and inflamed, prescription medications or other treatments may be needed.
• Psychological Impact: Acne can affect your mental health, causing stress or low self-esteem. If it significantly impacts your emotional well-being, a dermatologist can help manage it and offer support.

Seeing a dermatologist early on can help minimize acne’s impact, prevent scarring, and improve both skin health and confidence.