INTRODUCTION

A common fear that tops everyone’s list is acne. Medically, acne is defined as a skin disease which occurs due to inflammation of hair follicles. This is caused by interaction between skin oils, hormones and bacteria leading to a buildup of dead skin cells causing pimples, blackheads, whiteheads, comedones and sometimes cysts on skin. Acne is equally fearful in all races and ages. 95% people suffer from acne at some point their life and that point mostly being adolescence (14-19 years). (That’s right, when puberty strikes, it strikes hard!). But a striking percent of adult women and men suffer from acne, i.e. 25% and 14% respectively. Naturally, the most common cause of acne is puberty considering the hormonal changes that occur during it. Other things which cause acne are infection due to bacteria, genetic susceptibility, skin irritants, etc. Most treatments for acne include topical medicines, pills and natural remedies. Severe acne can be particularly rough for teenagers, when issue of self esteem is quotidian. It has been linked to depression and anxiety in teens, especially girls. The only good thing that comes to teenagers dealing with acne is Acne scholarship. That’s right! There are scholarships which provide funds to teens with acne like Valeant Dermatology Scholarship, Facing Acne scholarship and Galderma. While having acne is out of our hand, there are cures and preventions for handling this pernicious problem.



 

CAUSES

Simply entering puberty can cause acne. Your hormones will act total whacko. Then there are our genes. We can’t choose our family! Besides these, there are causes which are under our control like stress, diet, habits and environment. Here are these culprits unraveled concisely:

 

  1. Hormonal changes: At the onset of puberty both girls and boys start producing, a set of hormones called androgens. In women, these are dehydroepiandrosterone sulfate (DHEA-S) and progesterone, while in men these are testosterone, DHEA-S, androstenedione and dehydroepiandrosterone (DHEA). Androgens, in addition to estrogen (in women), stimulate oil-producing glands in skin, called sebaceous glands. Oil is trapped inside pores of skin, causing growth of Propionibacterium acnes which digests the oil and release inflammatory by-products. That’s when our body’s immune reaction kicks in causing redness, inflammation and swelling, resulting in pimple. Also, women experience acne often than men because of their menstrual cycle, which cause hormone fluctuations periodically.
     
  2. Genetic: Genes are unpredictable. And Acne is majorly controlled by these erratic genes. Our immune response in acne producing process is fairly genetic. So, you never know if you end up with blackheads or pimples. Also, if one or both parents have acne, your chance of acne is significantly higher than your counterparts who don’t. For example, you may naturally have more oil producing skin, leading to severe acne during puberty. There’s nothing you can do about the fact if you are more prone to acne.
     
  3. Environment: These are the factors you can take in hand and control your acne. Certain environment conditions like pollution, humidity and heat can clog pores which leads to acne. Sun plays paradoxical role in pathogenesis of acne. While Vitamin D and visible light is good for skin, as it sterilizes p.acnes bacteria but excessive exposure to sun leads to blackheads, comedones, whiteheads and pimples.
     
  4. Habits: Personal habits greatly influence acne. Hygiene and cosmetic products like shampoo, soaps, face washes, facial creams, and medications have a significant effect on acne. Artificial tanning severely triggers acne. Excessive scrubbing of face can cause dryness and redness depriving skin of balance. Using too many cosmetic products and makeup can irritate skin. Also, avoiding sunscreen and moisturizers especially in young age stimulates acne and worsening the condition of skin.
     
  5. Diet: Eating foods rich in carbohydrates in large amounts is related to acne development. Carbonated drinks and processed foods can flare up the skin, which cause acne. Certain people may be more sensitive to a food group which causes their skin to react. Even though, there is no empirical evidence for relation between water consumption and acne building but less water, i.e., dehydration can become a reason of skin irritation. (So, drink plenty!) One should also be careful medications which in anyway influence are hormones because erratic hormones cause you to breakout.


     

PREVENTIONS

Now that we know what influences acne, we need to take appropriate measures for our skin so as to not trigger acne or intensify it. Here are the most basic and important precautions:

 

  1. Basic Hygiene: It is the most important thing for keeping away from breakouts. Not only this assists in healing of acne, but also supports chances of it, not coming back.
    • A routinely hygiene regime like, cleansing, exfoliating, toning and moisturizing is chief for acne patients.
    • One should not scrub skin vigorously while cleansing.
    • Cleansing of skin, after sweating is very important to keep skin pores unclogged.
    • To wipe the face, a soft wash cloth should be used. Warm water and gentle face wash should be used for face twice a day.
    • Do not touch your face with hands frequently. Also, keep your hair away from your face.
       
  2. Skin care: Apart from basic cleaning, appropriate skin products should be used. For dry skin, aqueous based moisturizer should be used. This will ensure that the skin gets moisturized well and does not get oily as well. For oily skin, moisturizers can a bane, especially mineral oil based. Sun block is crucial for acne prone skin. It can be the difference between healthy skin and damaged skin.
     
  3. Healthy diet: Although, your cheesy pizza is not the criminal behind your breakout, but staying away from junk and eating healthy can help keep your body healthy, hormones in balance and fight from inflammation. Excessive intake of sugary foods can set-off acne. Then, there are some super foods, which naturally help fight off skin conditions, by being rich in anti-oxidants. These are green tea, berries, nuts and tomatoes. Hydration should be plentiful. Water is important for a supple skin.



     

TREATMENTS

Acne should not be confused with something that you can grow out of. It has to be treated. Be it with home remedies for mild acne or dermatological treatments for severe acne. Acne medications work by reducing inflammation, fastening skin renewal, and fighting off infection. For mild, inflammatory acne, over the counter medications are used whereas for moderate to severe acne, oral antibiotics and topical medicines. Here are the common approaches to treating acne:

 

  1. Topical medications: There are some non-prescription medicines, available for mild to medium acne. These can be used for treating acne which is not recurring. Mostly, these medicines are topical in nature and contain the following active ingredients:
    • Tretinoin:  It belongs to class of retinoids and is most commonly used to treat comedones and mild pimples. It promotes quick healing of pimples and reduces severity of acne.
    • Benzoyl Peroxide:  Most common ingredient in creams, gels and lotions, it helps in fighting infection and helps remove excess oil from the skin. It may not be suitable for sensitive skin, although it is easily adapted on many skin types.
    • Salicylic acid: It is majorly used for unclogging pores and thus helps only with regular use. Salicylic is a favorable option for patients with dry skin, as it less irritating to skin.
    • Sulphur: It is another common ingredient, used mostly in combination with salicylic acid or Benzoyl peroxide.  It works by removing dead skin cells, thus aiding skin renewal. It is active ingredient in regular face washes.
    • Azelaic Acid: A natural, plant derivative of dicarboxylic acid, Azelaic acid has anti bacterial properties. It also helps in reducing excessive oil in skin. When used in combination with other anti-acne products, it helps significantly reduce acne as well as hyperpigmentation.
    • Allantonin: A glyoxylic acid, derived from comfrey plant works actively in oil masks. It function is similar to that of Azelaic acid and is mostly used in combination to other anti-acne products.

      *Not all topical skin creams can be used without prescription or doctor’s advice. There are many topical skin creams, which should not be used without prescription and may not be available over the counter. Generally, they are meant for very severe acne.
       
  2. Oral Medications: For acne, majorly due to hormonal imbalance, it is important to treat the root cause of problem. There are many oral pills and syrups which are used to treat the underlying problem of acne. These should NOT be used without prescription. These pills interact with hormones and heal from the inside.
    • Antibiotics: For severe acne, it is very important that antibiotics be given to fight infection and inflammation. These are mostly tetracyclines like minocyline, limocyline, etc. and others are erythromycin and contrimoxazole.
    • Oral contraceptives (for females): For women and adolescent girls, a combination of hormones which comes in oral contraceptive pills can be given to straighten up imbalance. A combination of estrogen and progesterone helps to heal acne in long term. There can be side effects ,though, like headache, nausea, etc,
    • Androgen-blocking agents: Anti-androgens can be given to block the effect of androgen on sebaceous glands, i.e., stimulation to produce excessive oil. Again, this has serious side effects like breast tenderness, painful and heavy periods, electrolytic imbalance, etc.
    • Isotretinoin: Isotretinoin is only given in case of cystic acne. It is a powerful drug and given only to those, who did not respond to other treatments. Although, it is available in pills, but it is most effective in oral form. It has serious side effects like, high risk of depression, suicide, birth defects, etc.
       
  3. Therapy:  Therapies can be given with other acne treatments. The main purpose of these is to provide quick cure and to avoid discomfort. These can be expensive and everyone might not be able to afford them. Here are some of them:
    • Blue-Light Therapy: This therapy aims at killing bacteria and thus avoiding infection. It can be done in as in-office procedure or through hand-held device. But it is important to take care of the dose and duration of exposure.
    • Extraction of Whiteheads and Blackheads: Dermatologists use some tools to completely extract whiteheads and blackheads. This easy and painless but it leaves scars.
    • Steroids injections: A serious therapy only for cystic acne. In this, a drug is directly injected in the lesion, aiding healing. It has side effects like thinning of skin and more prominent blood vessels on that area.
    • Chemical Peels: Chemicals such as salicylic acid are used as masks on relevant areas and the peeled off. It has to be done repeatedly and can cause skin irritation and permanent discoloration of skin.
       
  4. Home Remedies:  Some commonly available raw materials help to treat mild acne. Agreed, no empirical evidence can support various home remedies but the following have definitely provided significant relief to acne patients.
    • Steam Bath: Steam from mixture of boiling water essential oils can help open skin pores and thus unclog them. Essential oils can cause irritation in some people, but mostly everyone tolerates it well. Rosemary, Lavender, Tea Tree oil and Calendula are the best of all essential oils.
    • Masks for oily skin: Certain ingredients like honey, egg white and lemon have anti-bacterial and astringent properties. A mask of these can be prepared and applied to help with comedones and mild acne.
    • Mint: Known for its cooling effect, mint significantly reduces pain and irritation during acne. Blending the leaves and then using the juice mixed with water, helps relieves burning sensation.
    • Aspirin:  It is quick treatment for a pimple or 2. Just crush tablet, mix with water and apply. This will reduce inflammation and heal significantly overnight.
    • Aloe: Best for any type of skin condition aloe, also helps with acne. A fairly common form to use is aloe gel, which can be directly applied and left overnight.



       

MEDICINES

As mentioned before, some topical and oral medicines are mostly used to treat acne. Mostly, these are common to both boys and girls, while some are only for girls. Here we discuss the most popular ones, common to both sexes:

SKIN CARE PRODUCTS FOR BOYS AND GIRLS

Alongwith medications, it is important to take of skin during acne. There are many beauty products for aiding help in acne treatment. Mostly beauty products are different for both the genders, unlike medicines.
 

FOR GIRLS:

FOR BOYS:

ACNE MYTHS BUSTED

Acne is such a hyped about topic that naturally there are many myths surrounding it. People often end up with worse condition than before due to these myths. Here are the false things corrected about acne:

 

CONCLUSION
The bottom line of the article is to spread awareness about acne, its etiology, pathogenesis and treatment. So, if you or someone you know suffers from acne help them out to achieve the best possible results, knowing the factors involved. Knowledge about such medical condition is very crucial.