Whether you suffered from acne as a teenager or knew a friend plagued by frequent breakouts, chances are you’ve been affected by acne at some point. Over the years, many patients have shared stories —tales of skipped proms, missed dates, or painful recollections—that have one common theme: Acne can have a devastating effect on self-confidence that lasts a lifetime.
We’ve helped many patients gain control of their acne problems by sharing education, guidance, and when necessary, an aggressive treatment plan. While no two acne cases are alike and there can be many underlying causes of acne, we’ve broken down some basic information to help you better understand the causes of—and treatments for—various types of acne.
Let help with understanding acne symptoms to determine the best course of treatment.
WHAT ARE THE TYPES OF ACNE?
Also known as open comedones, blackheads have a somewhat misleading name, as they may also appear yellowish in color. Blackheads form when a hair follicle becomes filled with a combination of oil, dead skin, makeup or other pore-clogging skin care products that plug the opening. Without layers of skin to cover this accumulated matter, it oxidizes and turns darker.
Blackheads are often the first stage of acne. Many people notice blackheads beginning to appear at the onset of puberty, when hormones rage and oil production goes into overdrive. They can also appear later in life with the use of certain products (like moisturizers, serums or sunscreens) that are comedogenic, or pore clogging.
Unlike blackheads, whiteheads form under the surface of a closed pore and present as raised bumps with—you guessed it—a white head at the top. When a pore becomes clogged, oil production builds up behind the blockage, while bacteria that live in your pore begin to feed off of oil secretions, leading to inflammation. White blood cells come to the rescue and that’s the stuff you see when you finally extract a whitehead.
Though milia are not whiteheads, the two are easily confused. Milia are small, white balls that develop when keratin (the protein found in hair, nails and skin) becomes trapped under the skin. While milia are not typically painful, they do require professional extraction to avoid scarring.
The most severe form of acne, cystic acne, may start as small, painful bumps before growing into painful nodules, which feel like a marble under the skin and can last for several weeks to even months.
Many women experience random cyclical cysts that pop up due to hormonal fluctuations. Unfortunately, however, some people have multiple cystic acne lesions that are always present. In the latter case, it’s best to see a dermatologist who can prescribe an oral and/or topical mode of treatment.
WHY IS ACNE CAUSED?
While myths abound as to the dietary causes of acne (including eating fatty foods and chocolate), we do know that overindulging in a high sugar/high fat diet can increase sebum production and promote the inflammatory response in the body that leads to acne.
Some studies point to a connection between consuming certain dairy products and acne. A direct link has not been established; however, information published by the American Academy of Dermatology suggests that the hormones and growth factors found in traditional (non-organic) milk may contribute to some cases of acne. Talk to your skin care specialist if you notice a correlation between the two.
You may notice that when you feel stressed, your skin reacts accordingly. While the current school of thought suggests that stress doesn’t trigger new cases of acne, it may worsen existing acne.
We know that the cells that produce sebum have receptors for stress hormones. When the body is under a lot of stress, these oil-producing cells undergo a process called upregulation, or an increased cellular response to stimuli. And with increased oil production comes an increased chance for clogged pores. Also, when we feel stressed or anxious, we tend to inadvertently pick the skin, which only makes blemishes worse.
Stripping the Acid Mantle
Whenever we feel oily or experience a breakout, it seems that the common first inclination is to scrub the skin until it feels squeaky-clean—in fact, this is a common misconception that I see on a daily basis with my patients!
Enter the acid mantle, a fine, slightly acidic film on the skin’s surface produced by the sebaceous glands. Scrubbing the skin too aggressively—aka when it feels tight or overly dry—can strip the skin of its acid mantle, creating a chain reaction that actually makes the skin oilier.
Follow along with me: The skin is our first line of defense, and its acid mantle acts as a barrier to bacteria, viruses and contaminants that might otherwise penetrate the skin and contribute to infection. When stripped of this defense system, the skin reacts by instinctively producing even more oil—the precursor to clogged pores and blemishes.
Therefore, it’s important not to over-cleanse; washing more than twice a day will strip the skin. Even oily skins need the acid mantle for hydration and protection.
HOW: TREATING ACNE
Cleanse: Correct, proper cleansing is important for acne patients. We don’t care what cleanser you use as long as you use the right cleanser and use it the right way.
Oily or acneic skin types should stick to a foaming or gel cleanser. Cleanse at night to remove makeup and anything you may have been exposed to during the day, and in the morning to rid the skin of toxins that the skin purges during sleep.
We also recommend investing in a Clarisonic facial brush. Not only does the brush head vibrate for superficial exfoliation, but it also utilizes sonic technology to help dislodge oil and debris in the pores, making it an excellent choice for oily and acne-prone skin.
When choosing a scrub, look for one with spherical scrubbing beads, versus scrubs that utilize rough particles to exfoliate, such as apricot scrubs. When you roll the scrub between your fingers, it should feel smooth—not sharp or jagged.
Use a Retinol
Dermatologist favorite vitamin A, or retinol, helps to unclog pores encouraging skin cell turnover. Furthermore, retinol is a proven anti-ager, making it perfect for women suffering from adult acne who also want to fight the signs of aging.
When using a retinol, it may take two to eight weeks of consistent nightly use to see an improvement in the appearance of acne. However, this product should not be stopped once your acne starts clearing up, as the mechanism of action continues to prevent new lesions from popping up.
Using blue light helps clear blemishes. Blue light technology attacks P. acne causing bacteria to help clear existing spots and prevent new ones from forming.
Elōs™ Acne Treatment is the first and only technology that uses the combination of bi-polar radio frequency (RF) and light energies to effectively and gently resolve active acne by treating it at its source. The combined energies of Elōs enable highly selective targeting of the sebaceous glands and acne bacteria. Infrared and RF energies reduce sebaceous gland activity while blue light simultaneously destroys active acne. Abloom Med Spa offers Elos Therapy and you can find out more.
This is just the tip of the acne-advice iceberg, but I hope it gives you a place to start on your journey to clearer skin. As always, consult your skin care professional to determine what course of treatment is right for you.