What is acne?
Acne is a very common skin disorder that most young people get in early puberty. It is caused by inflammation of the small oil glands that surround the fine hair on the face and chest sometimes in severe cases spreading across the back and arms.
Acne can also cause one or more of the following
- Blackheads (comedones)
- Red or yellow spots
- Greasy skin
- Picking and squeezing the spots may cause further inflammation and scarring
- In women outbreaks may be affected by the hormonal changes that occur during the menstrual cycle
- Excessive production of male hormones such testosterone from conditions such as polycystic ovaries
- Some contraceptive pills can cause acne to be worse
- Some medications can make acne worse but never stop taking medication consult your GP.
- Caffeine causes stress levels to rise which can lead to increased hormone levels
- Wearing of sports helmets or back packs, causing friction.
- Lines & Wrinkles
- Sun damage
- Acne scarring
The diagrams below show firstly a healthy follicle and the second shows one that has become blocked with oil from the sebaceous glands
(diagrams and images are courtesy of the National Institute of Health)
Most people affected by acne are between 12 -25 and is estimated that 9 in 10 teenagers develop some degree of acne 3 in 10 teenagers have acne so severely to need treatment to prevent scarring. Acne tends to go away by the mid 20s however very sensitive people may continue to have the disorder until they reach their mid 40s.
What causes acne?
Acne is caused by the overactivity of the sebacaeous glands that secrete oily substances onto the skin. The subaceous glands of people with acne are especially sensitive to normal blood levels of a hormone called testosterone found naturally in both men and women.
These two effects combined cause a build up of oil in the hair follicles. This causes blackheads and whiteheads to form.
For the majority of people their acne does not progress beyond this stage. However in other people the build up of oil in the hair follicles creates an ideal environment for a bacterium called Propionibacterium acnes to grow.
These bacteria normally live harmlessly on your skin but when this ideal environment is created they feed off the sebum and produce substances that cause a response to the body’s immune system. This inflames the skin and creates the redness associated with spots.
In more severe inflammatory acne, cysts develop beneath the skin surface. These acne cysts can rupture spreading the infection into nearby skin tissue and can therefore result in scarring.
Types of acne
The most common form of acne, with blackheads, whiteheads, papules, pustules, nodules and cysts.
Non inflammatory acne vulgaris
Whiteheads: occur when a pore is completely blocked trapping sebum (oil), bacteria and dead skin cells, to form a hardened white bump on the skin
Diagram and image of a whitehead
Blackheads: occur when the sebum blocks the pore at the surface and melanin (skin pigment) oxidises to turn a brown/black colour. If you squeeze a black head you can make the condition worse as some of the sebum will be pushed back in to the follicle and the pore can become enlarged, It is bet to remove them by gently steaming and using tissues gently ease the blockage out,another excellent method of removal is by microdermabrasion.
Papules occur when the follicular walls break, white blood cells come to the area and the pore becomes enlarged
Diagram and image of a papule
Several days later a Pustule (zit or spot) is formed as at the white blood cells make their way to the surface of the skin, this is when most people would squeeze the spot. Again it is best left alone as squeezing will push some of the inflammation back in to the skin. If you feel you need to remove the pus then gently steam with warm water on a cotton wool pad.
Diagram and image of a Pustule
Pustules may cause the follicle to collapse and break to infect several follicles in the area and cause a nodule or cyst. Where these are present treatment is advised by a dermatologist or doctor.
Isotretinoin may be prescribed to reduce the amount of oil produced, it is typically a 15 – 20 week course, however it cannot be prescribed for women who may get pregnant as it can cause birth defects in the developing foetus. The drug has also been linked to depression so patients are monitored regularly
Image of a nodule
Millia are small bumps created when dead skin cells are trapped in small pockets just below the skin surface. These are very often seen in new born babies, however they disappear quickly. When they occur in adults they are more stubborn and may be persistent. A good way to deal with these is to exfoliate well and microdermabrasion is perfect to remove
What makes acne worse?
There are a number of things that can make acne worse. These include the following
Here is our action plan to help keep your skin healthy and clear
The goal is to treat existing acne and get the condition under control, to keep the skin free from further break outs and to treat any scarring to reduce to a minimum.
1. Eat Fruit and Vegetables
Cut out all processed and high fat foods. Introduce fresh vegetables and fruit where possible, include brazil nuts and pumpkin seeds as the contain selenium which helps to combat acne.
Super foods such as
Drink 2 litres of water per day, to keep the skin hydrated.
3. Cut out refined carbohydrates
Refined sugar, bread, pasta and flour cause a surge of insulin in the blood stream causing increased hormone levels and an increase of sebum allowing for more congestion and bacteria to be formed.
4. Reduce stress levels.
Stress allows for the hormone cortisol to be released, exercise or meditation are great ways to reduce this.
5. Lower caffeine intake
Caffeine is one of the causes of stress in the body, by lowering intake of stimulants the body will be more relaxed.
6.Cleansing and moisturising
Use a water based cleanser and apply a light moisturiser to the skin afterwards, over cleansing can cause the skin to dry out and a crust of hard skin to form. This can actually be detrimental to the skin as it causes more congestion below the hardening. More on products later.
7. If you want to remove blackheads, whiteheads or pustules then make sure that your hands and face are clean, steam gently and wrap tissue around the fingers before gently easing out the lesion. Never squeeze or force.
Acne may cause you considerable emotional distress but there is a range of treatment options to help you tackle the problem. The aim being to prevent new spots forming, improve those already present and to prevent scarring or treat existing scarring.
Congestion and reduction of open pores is essential
Treatments for Open pores
Treatments for reducing outbreaks
Good Cleansing routine
Treatments to reduce scarring
Eos Lotions are natural and have had success in helping to clear the complexion. Formulated from rare herbs and seaweeds outstanding results have been achieved. You can find out more about the products at www.beautybusinessnews.com link
Exposed Acne products have been developed by a team of dermatologists and organic chemistry experts.
This is a common treatments. It has three actions – kills bacteria, reduces inflammation and helps to unclog pores. It works well to clear inflamed spots and helps to clear blackheads and whiteheads. Benzoyl peroxide can be purchased from pharmacies without a prescription. It comes in different brand names and strengths.
Retinoids are a synthetic form of Vitamin A and they are a good treatment in early stages of acne as it works to unblock pores, it also has a effect on reducing inflammation. A prescription is needed for all retinoid treatments.
Isotretinoin is a retinoid and may be prescribed to reduce the amount of oil produced, it is typically a 15 – 20 week course, however it cannot be prescribed for women who may get pregnant as it can cause birth defects in the developing foetus. The drug makes skin light sensitive so a sunblock is essential and it has also been linked to depression so patients are monitored regularly. The most common one used is roaccutane.
They work by reducing the number of bacteria and help with inflammation. However they have little effect if any on unblocking pores and can cause irritation. Good at treating inflamed acne but blackheads and whiteheads will remain. A prescription is needed for topical antibiotics
Work by killing bacteria that contribute to the cause of acne. The most commonly used oxytetracycline, tetracycline, doxycycline, lymecycline and minocycline, these are all antibiotics.
A good treatment to clear and unblock pores. It has some effect on clearing on reducing inflamed acne but not as effective as antibiotics or benzyol peroxide. However it may cause less skin irritation than benzoyl peroxide.
The oral contraceptive pill may help some women if their acne seems to be related to hormone change. It is the oestrogen part of the pill that is thought to help. The pill is available by prescription only.
A chemical peel removes layers of dead skin to reveal healthy new skin cells beneath, they can be used to treat:
There are varying levels of peels from a mild glycolic peel with no down time to CO2 treatment for which you would require a 2 week recovery time. Chemical peeling causes slight trauma to the skin and as it heals an increase in cell renewal occurs giving a more youthful appearance.
A salicylic peel is often used to treat acne, it is also known as Beta Hydroxy acid, it is an anti-inflammatory and a highly effective skin exfoliator. It is often used in acne products and as a peel in a more concentrated version, as it has anti-inflammatory properties it reduces post treatment trauma to a minimum.
Salicylic Peels are recommended for: oily skins, acne, fine lines and wrinkles.
Results: Skin will be less oily, blackheads and whiteheads will be reduced. Fine lines and wrinkles will lessen and the skin will look fresher. The procedure will speed up skin care regimes.
How often? Upon consultation you will be advised as to how many treatments are recommended, typically 6 – 10 treatments.
After Treatment: Skin may be shiny and red for a few hours after treatment, flakiness and itching may occur for the first few days. It is essential that you were a sun block as Salicylic acid will increase sun sensitivity.
TCA Peel (Trichloroacetic Acid)
Trichloroacetic Acid (TCA) is a medium deep peel usually performed in 10 to 355 concentrations. TCA peels may be painful as the skin blanches (Frosts and then turns white) but it is particularly good for certain conditions. Mild pain relief may be given during treatment.
TCA Peels are recommended for: reduction of acne scars, uneven pigmentation fine lines and wrinkles. The treatment isn’t recommended for dark skins, fine or sensitive skins.
Results: Fine lines and wrinkles will reduce, acne scarring and pigmentation will be reduced after a course of treatments
How often? One to three treatments spaced a month apart.
After Treatment: One week recovery time, a protective film of petroleum jelly may be applied to keep the area moist and protected. Skin may peel and it is essential that a sun block is used to protect the skin.
This is the strongest type of peel and will produce the most dramatic effects, it is used for deep wrinkles and acne scarring and takes one to two hours to perform. However spot treatment may be done such as above the top lip and this will take just half an hour to carry out. It is aggressive and this must be considered before undergoing the procedure. Frosting and then whitening of the skin occurs then the skin is neutralised. A layer of petroleum jelly is applied to the skin to protect while a crust forms over to protect.
Phenol Peels are recommended for: Deep wrinkles and lines, deep acne scars, pigmentation and some precancerous lesions. It is not recommended for dark skins and oily complexions. These peels cannot be used on the neck or other parts of the body.
Results: Deep and long lasting with dramatic visual improvements. The skin will always appear paler than untreated skin and it is essential to use a sun block.
How often? One procedure
After Treatment: It is recommended that you allow 2 weeks for recovery, medication may be needed to compensate for swelling and discomfort. The skin will peel to reveal pink new skin below, similar to that in a sun burn.
This treatment uses a small roller, called a derma roller, it is covered with tiny closely spaced needles. As the device rolls along the skin it penetrates to a depth of up to 2 mm. This creates collagen stimulation and allows deeper channels for topical skin care to penetrate more effectively. The mild trauma caused does not create bruising or bleeding it does however create the production of elastin and collagen to plump out the skin and reduce appearance of fine lines and acne scarring.
Micro Needling is recommended for acne scarring and re texturisation of the skin.
Results: Fine lines and acne scarring will appear filled in and the complexion will be much smoother and fresher.
How often? A course of 3 treatments is recommended at 2 week intervals.
After treatment: The skin will probably be red for a day or two, however mineral make up may be worn to cover this.
Stress may be a factor in raising hormone levels and taking baths with camomile and epsom salts may have a twofold action by de stressing but also softening the skin .
Microdermabrasion elevates acne treatment to a powerful level. It activates circulation, deeply exfoliates the skin’s surface, and effectively clarifies pores of trapped oil deposits and other contaminants while diminishing acne scars. There are many different brands of microdermabrasion that use various different abrasion actions such as aluminium oxide crystals, diamond tip and wheat germ to name just a few. There are multiple benefits with microdermabrasion as there is no down time it can be used on all skin types and is relatively painless.
Microdermabrasion treatment is recommended for: Fine lines and wrinkles, acne scarring, skin re texturisation congested skin, enlarged pores, pigmentation problems, scar tissue,.
Results: Fresher younger looking skin, reduced pigmentation and acne scarring, clearer more vibrant with reduced pore size.
How often: A course of 10 is best with one per week and then one per month to maintain results.
After treatment: Little or no down time, mineral make up can be applied immediately after treatment.
Prices range from £25+ per treatments
Intense Pulsed Light
Intense Pulsed Light kills the acne bacteria that causes the infection leading to spots. The light therapy gently heats up the skin around the spots producing collagen that boosts the healing process causing the spots to minimise and prevent scarring.
IPL is recommended for: Fine lines and wrinkles, pigmentation, acne scarring, rosacea and red veins (facial), it is not recommended for dark skins for photo rejuvenation treatments.
Results: Reduction in fine lines and wrinkles, pigmentation and veins. IPL may help to treat acne scarring as it stimulates collagen formation to help to plump up the skin.
LED light is a low level intensity light that works to kill infection and stimulate healing within the skin.
Blue light of around 400 nm wavelength helps to kill the bacteria, P Vulgaris which causes acne, Treatment has shown a 55% improvement of the condition, so while this isn’t a cure, clients have been delighted with the results.
Treatment is painless and results can typically be seen quite quickly with a treatment course of 10 sessions taken up to 3 sessions per week and then a maintenance program of 1 session per month. treatment courses are around £350 for 10 sessions. Correct diagnosis is important though as there is one type of acne that the treatment actually cause a worse reaction rather than improvement.
Nodulocystic acne shows as bumps that are red or purple in colour and may be painful to touch and there may be cysts present which resemble boils. Potentially LED treatment will worsen this condition so it is vital to get a medical check out.
Red LED’s can help to create collagen which is vital in scar healing as are yellow LED’s together they form the perfect combination to help with reducing the occurrence of acne and to reduce scarring. Read about LED treatments
British Association of Dermatologists
HYPERLINK “http://www.bad.org.uk” www.bad.org.uk
Acne Support Group
HYPERLINK “http://www.stopspots.org” www.stopspots.org
This article is a compilation of advice and is accurate at the time of writing, however technical and scientific developments may have produced advancements after this time. The above information is a guide and not all treatments are suitable for everyone so we stress that the book is for general information and medical advice must be sought if you have any questions or concerns and if your skin is not responding to treatment.