It’s easy to recognize that you have acne, but it’s much harder to understand why you’re breaking out and how to prevent pimples in the future. We’re here to break it down for you!
What Is Acne?
Acne Vulgaris, what most of us just call acne, is a chronic skin condition that affects nearly 85% of Americans at some point in their lives. Acne forms when our pores become clogged with dead skin cells, sebum and bacteria.
Why do we get acne?
All of our pores contain a hair follicle and a sebaceous gland, which produces sebum, our skin’s natural oil. The body is constantly regenerating and shedding dead cells, but when those dead skin cells get trapped within the sebum of our skin, they combine to create noninflammatory acne. These are those black and white bumps on your skin — otherwise known as blackheads and whiteheads. If bacteria is present on the skin, it can combine with the dead cells and oil and cause an infection, otherwise known as inflammatory acne.
This type of acne, also called comedones, are simply clogged pores. You probably know them as blackheads and whiteheads, maybe even as the building blocks of acne.
A blackhead is an open comedo, meaning that the clogged pore is open to the surface of the skin, and the air has oxidized the gunk inside, turning it black.
A whitehead is a closed comedo, meaning the dead skin and sebum are unexposed but trapped within the skin.
Propionibacterium Acnes, or P. Acnes for short, is a bacteria that loves to feed on the sebum within our skin. When P. Acnes bacteria gets into clogged pores it reproduces rapidly, causing inflammation. Then your body realizes something is awry, and rushes blood to the scene — causing even more redness and inflammation.
Papules and pustules are the main types of inflammatory acne. Papules are red and hard, and pustules usually have a white head that’s surrounded by red, irritated skin.
The most severe type of acne, however, is cystic acne, which includes nodules and cysts. Cystic acne forms deep under the skin, and is large, red, and painful. This is the type of acne that worries dermatologists most, as it has the highest chances of causing permanent scarring. It’s also the main type of hormonal acne, which is caused by a imbalance of hormones, thanks to your genetics.
What Causes Acne?
There are a multitude of factors that can cause, or make us more susceptible to acne, but the most common causes of acne are:
Genetics: Those with a family history of acne are more prone to breakouts.
Hormones: High levels of types of hormones called androgens can lead to acne. Acne is common in teenagers and pregnant women because of the fluctuating hormones present in their bodies.
Environment. City air that’s filled with pollution can wreak havoc on the skin.
Other Factors: Dietary choices, comedogenic cosmetic products, certain medications, and sitting in tight, sweat-soaked clothing can also lead to acne. Consistent contact with dirty hands, sheets or towels can also lead to pimples.
There are lots of ways to treat different types of acne — at home or at a dermatologist’s office.
Treating Blackheads and Whiteheads
If you have blackheads and whiteheads, the key is to work to unclog your pores and prevent bacteria from infiltrating them. A cleanser with salicylic acid is great for this, as it’s an antibacterial that will reach deep into your pores morning and night — soothing active acne and preventing future breakouts.
Noninflammatory acne is typically responsive to tretinoin, which is available only by prescription. However, Retinol is a less potent form of tretinoin that can be found in over the counter serums. You should only apply retinol at night because it is deactivated by the sun and makes skin more sensitive to the sun’s UVA and UVB rays.
Treating Papules & Pustules
If you have red papules and pustules, that means bacteria is highly involved. To treat this kind of inflammatory acne, a dermatologist might recommend using topical antibiotics to help kill the bacteria on the surface of your skin. They might also prescribe oral antibiotics, which tackle bacteria from the inside out. Ingredients like benzoyl peroxide, combined with a salicylic acid cleanser and a retinol serum are effective in treating this kind of acne. Sulfur is also an effective alternative for those with sensitive skin!
Severe or Cystic Acne
When people have a severe form of acne or cystic lesions, doctors may consider using a treatment called Isotretinoin (more commonly known as Accutane). Because Accutane is such a strong medication however, there is some controversy around it. It can be a very powerful resort for severe or cystic acne — it just needs to be monitored very closely by your physician.
Visiting a Dermatologist
There are many procedures that can be done in a doctor’s office to help combat your acne. Estheticians are able to perform facials or comedone extractions which can help clear up your skin. Many dermatologists will offer cortisone injections, which will also help to significantly decrease inflammation. Heavier, more concentrated chemical peels are also an option for those with severe acne. Dermatologists can prescribe oral and topical medications, and can help put you on a skincare regimen that will help clear up your breakouts or confirm that you are maintaining the right one.