Acne

Acne is a vexing chronic inflammatory skin condition that occurs when hair follicles become clogged with oil (sebum), dead skin cells, and sometimes bacteria. These clogged follicles can develop into different types of blemishes, including blackheads, whiteheads, papules, pustules, nodules, and cysts. Acne most commonly appears on the face, but can also affect the chest, back, shoulders, and neck.

It typically appears during puberty when hormonal changes cause an increase in oil production. However, many adults continue to experience acne well into their 30s, 40s, and beyond. The appearance and persistence of acne can create psychological stress and lead to long-term skin concerns such as scarring and hyperpigmentation if left untreated.

Acne presents in several forms, each varying in severity and treatment approach. Understanding the different types can help guide more effective management:

• Comedonal acne includes non-inflammatory lesions such as blackheads (open comedones) and whiteheads (closed comedones). These occur when hair follicles are blocked by oil and dead skin but without significant inflammation.
• Inflammatory acne includes papules (small, red bumps) and pustules (similar to papules but filled with pus). These lesions are red, swollen, and may be tender to the touch.
• Nodulocystic acne is a more severe form of acne involving deep, painful nodules and cysts under the skin. This type is more likely to lead to scarring and often requires more intensive treatment.
• Hormonal acne is typically seen in adult women and may appear as deep, painful pimples along the jawline or chin. It often flares with the menstrual cycle and is linked to hormonal fluctuations.

Acne is caused by a combination of factors, including:

• Excess oil production: The sebaceous glands produce too much oil, which can clog pores.
• Clogged hair follicles: Dead skin cells that are not properly shed can combine with oil and block hair follicles.
• Bacteria: Cutibacterium acnes (formerly Propionibacterium acnes) is a bacteria that normally lives on the skin but can multiply in clogged pores, leading to inflammation.
• Hormonal changes: Hormones, particularly androgens, stimulate oil production. Hormonal shifts during puberty, menstruation, pregnancy, or due to medical conditions like polycystic ovarian syndrome (PCOS) can contribute to acne.
• Genetics: A family history of acne can increase the likelihood of developing it.
• Diet and lifestyle: While not a direct cause, certain dietary factors such as high glycemic index foods and dairy may contribute to acne in some individuals. Stress, sleep deprivation, and poor skincare habits can also exacerbate breakouts.
• Shaving: Improper shaving can lead to or worsen several types of acne in men, particularly in areas like the beard, neck, and jawline, and may lead to skin trauma and scarring.

While not all acne is preventable, there are several steps individuals can take to minimize breakouts and maintain healthier skin:

• Use non-comedogenic skincare products that won’t clog pores.
• Cleanse gently twice daily and after sweating. Avoid scrubbing, which can irritate the skin and worsen acne.
• Avoid picking or popping pimples, which can lead to scarring and further inflammation.
• Maintain a balanced diet and stay hydrated. Consider limiting foods that may trigger breakouts.
• Manage stress through exercise, meditation, or other relaxation techniques.
• Remove makeup thoroughly before bed and clean makeup brushes regularly.