Acne is a skin condition that occurs when the hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads, pimples, and if inflamed acne, papules and cysts. Acne is most common among teenagers, though it affects people of all ages. Effective acne treatments are available, but acne can be persistent.
Once you reach your mid-20s, acne often clears up by itself, especially in men. However, for some young people, acne is a serious, ongoing problem that needs medical assistance for the physical and psychological issues acne can sometimes cause.
Acne occurs when a hair follicle and its associated oil (sebaceous) gland become blocked and inflamed. This provides an ideal environment for bacteria (Cutibacterium acnes, formerly known as Propionibacterium acnes) to grow and cause the skin to become irritated, red and tender.
People with acne often have larger sebaceous glands and produce more sebum than people without acne. Sebum is a waxy/oily substance that prevents the hair and skin from drying out.
Blackheads, whiteheads, pimples and cysts tend to develop on the face, neck, back, chest and shoulders, because this is where oil glands are largest and most active.
Acne is a very common skin condition and, because it is caused by hormonal changes resulting in increased oil (sebum) production, it usually begins at puberty.
NON-INFLAMED ACNE (COMEDONAL ACNE)
Comprises of blackheads or whiteheads that result from oil glands becoming blocked. Dermatologists call these 'comedones'. If left untreated, non-inflamed acne can often progress into inflamed acne.
INFLAMED ACNE (INFLAMMATORY ACNE)
Associated with pimples (classified by dermatologists as papules, pustules or cysts, possibly associated with redness of the skin).
Some people will only ever develop mild acne, while others can experience large, deep, painful lumps under their skin, called cysts – a severe form of acne. Unfortunately, cystic acne can lead to permanent scarring, and therefore should be treated as soon as possible.
Acne research is ongoing, and currently there is no cure. Two common (possible) causes for this skin condition are:
Hormones: Puberty is a time when hormone levels increase. Androgens are a group of hormones that are associated with male traits but are present in both males and females. During puberty, androgens cause the oil glands in the skin of the face, neck, back, shoulders and chest to enlarge and produce more oil (sebum).
Girls tend to reach puberty earlier than boys and develop acne at a younger age. Acne can become worse or ‘break out’ at certain times of a girl’s menstrual cycle, usually just before a period.
Stress: Research has shown that increased stress can be linked to new outbreaks or worsening acne. During times of stress, cortisol (the stress hormone) increases oil production which can stimulate acne.
Myths About Blemish Prone & Acne Skin Conditions:
Poor hygiene causes acne. Acne is not caused by poor hygiene. Acne occurs when the pores in the skin become blocked. Hormones cause the oil glands to produce more oil. If the pores are blocked, a build-up of oil results in acne. Keeping your skin clean will help manage acne, however you should not scrub your skin as this can cause irritation and inflammation.
Blackheads are not dirt. They are pores clogged with sebum that are open to the air and oxidize which results in the black appearance. If the skin covers the oil and any pus, this presents as a whitehead (pimple).
Picking and squeezing is ok. Picking and squeezing pimples may remove the core of the pimple, but creates more inflammation, which contributes to scarring. It can also spread the bacteria, which may contribute to further outbreaks.
Diet has no effect on acne. There is increasing evidence a low-glycemic (GI) diet can improve skin. Foods such as fruits, vegetables, nuts and grains help keep levels of blood sugar and insulin down.
A high-sugar/high-fat diet can boost levels of blood sugar and increase sebum production, which is known to trigger acne by making the skin's sebaceous glands produce extra oil. Consumption of dairy products has also been shown to worsen acne.
Cheap make-up and moisturizers can worsen the condition. A high price tag is not necessarily a guarantee of quality. Look for mild 'soap-free' liquid face cleansers with a pH balance at 5.5 or slightly acidic to match that of the skin, but without abrasives, detergents or alcohol. Choose water-based, oil-free, non-comedogenic make-up. If your skin is dry, use an oil-free, non-comedogenic moisturizer (like our Herbal Complex).
Sun exposure improves acne. There’s no link between sun exposure and acne prevention. In fact, sun exposure can cause real damage including premature wrinkles, ageing, skin cancer and melanoma. It is important to protect your skin from the sun’s harmful ultra-violet (UV) rays.
Many ‘oil free’ SPF30+ broad-spectrum sunscreen products containing physical blockers are relatively heavy creams and may worsen acne. Only those broad-spectrum sunscreens that are labelled as ‘non-comedogenic’ are suitable for acne-prone skin.