What is acne?

Acne occurs when the pores of your skin become clogged, most often on the face, neck, back, and chest. No one knows exactly why this happens, but we do know that testosterone plays a part, as does heredity.1-5

Once a pore becomes clogged, it traps skin oil inside. Bacteria grows in this oil and can cause an inflammatory response in the skin. Acne lesions can be small and hardly noticeable, have a small white or black head, or can appear red with a white/yellow center. Sometimes a clogged pore will become so inflamed that it can lead to larger, more painful lesions called nodules or cysts, which can ultimately scar. Almost no one escapes some clogged pores and pimples, especially during adolescence–a fragile time when self-esteem and confidence is just emerging.9-10 Acne afflicts people of all ethnicities and is treated the same regardless.† 11-15

Our skin is healthiest and clearest when it is in balance. The more irritation your skin experiences, the more likely it is to break out. Conversely, the less irritation your skin experiences, the better it is able to remain clear. Sources of irritationinclude anything which rubs, scratches, or comes into prolonged contact with your skin, as well as anything which sends your skin out of balance such as overdryness, sunburns, shaving the face with irritating razors, and pore-cloggingcosmetics. To best clear acne, try to keep your skin as untouched as possible. Acne is not caused by dirt, and washing your face, while it is fine to do up to twice per day, is going to do little to help with your acne.
Finally, popping pimples is not off limits. None of us likes to walk around with puss filled pimples. Done correctly, properly popping can actually help hasten healing. However, whatever you do, do not pick at your skin.6-8

Often, bacteria called Propionibacterium acnes (P. acnes), can be present too, which can contribute to the redness, swelling and pus that can accompany lesions. The visible result is acne, which is the term used to describe blackheads, whiteheads, pimples, and cysts. Acne usually appears on the face and neck but it can include shoulders, back, and arms.

Who gets acne and when?
Everyone gets a pimple somewhere on their body sometime in their lifetime.
Acne often starts around puberty, and it may last about 5-10 years or it can continue into adulthood. Even some babies develop acne shortly after birth.
It can usually be treated with topical over-the counter (OTC) products if mild to moderate. For more severe, stubborn and/or widespread acne, however, it is recommended that you see your family doctor or a dermatologist, so s/he can prescribe something stronger.

What causes acne?
Overactive sebaceous (oil-producing) glands that start producing more sebum, usually at puberty. In some people, the excess sebum clogs pores, which leads to the inflammation (redness and swelling) often associated with acne.

Heredity (your genes) is another factor that can determine who gets acne and how severe. If either or both of your parents had acne, you are more likely to develop the skin condition too.

Stages of acne
There are various terms that describe different forms of acne, such as comedones, papules, pustules, nodules, and cysts. Basically, comedones (plural for comedo) are the name given to plugged follicles: an open comedo is called a blackhead because the surface is visible and turns “black” when it’s exposed to air. A closed comedo is a whitehead, which is like a blackhead, but is closed at the surface. Plugged follicles can become irritated and swollen enough to burst, thus affecting surrounding tissues. If a plugged follicle erupts above the skin’s surface, it becomes a pimple; when it erupts below the surface, it forms a red lump, such as a nodule or cyst.


How bad can acne get?
There are basically three levels of severity:
● Mild acne consists of a few lesions that are close to the surface, and not deep or inflamed.
● Moderate acne is marked by deeper nodular lesions and some redness.
● Severe acne involves many lesions, multiple cysts, and a great deal of redness and inflammation.

What can trigger acne flare-ups?
There are a number of factors that can make acne flare up or lead to “breakouts”, although triggers can vary from person to person. Avoiding the things that you notice may make your acne worse is a good way to help control your acne. For example,

Make-up and hair care products can clog pores. When shopping, look for the following acne-friendly terms on product labels: “oil-free”, “non-comedogenic”, or “non-acnegenic”.
Physical pressure
Pressure due to a chin strap, phone receiver, sports helmet, headband, guitar strap, bra strap and other tight clothing can lead to localized acne that develops at the point of skin contact.

Sweating can worsen acne in some people. Most likely, it is because sweating helps to clog pores, especially if trapped under clothing.

Washing your face twice a day with a mild cleanser is recommended for acne-prone skin. Cleaning it more often, scrubbing/exfoliating, or using strong cleansers or astringent products (i.e. toners with alcohol) can actually strip the skin and irritate it, which can lead to more acne.

Certain medications can cause acne to flare up, such as oral corticosteroids, some contraceptive pills (progestin only), and anti-convulsives, to name a few.
Menstrual cycle
Many girls and women may notice that their acne flares up as they are nearing their monthly period.

Picking or squeezing
Touching acne lesions can make them worse and raise the risk of permanent scarring. Squeezing or popping pimples can cause an eruption of sebum and bacteria into surrounding skin tissues leading to more swelling and redness and possibly infection.

Actually, no study has yet proven that any specific foods or dietary habits can cause or worsen acne. However, if you find that a certain kind of food seems to aggravate your acne, try removing it from your diet. Removing entire food groups from your diet, though, is not healthy so is not recommended.