Acne is one of the most common skin conditions in the world, affecting up to 80% of the world population aged between 11 to 30.
It is a chronic, inflammatory condition skin condition that causes spots and pimples to appear on the face, shoulder, back, and chest.
Process of Acne
Our skin has pores that connect to oil glands under the skin. Follicles connect the oil glands to the pores. These glands produce an oily liquid called sebum. Sebum carries dead skin cells through the pore to the surface of the skin.
During puberty, much larger amounts of sebum is being produced by the skin. The natural shedding of skin cells is al slowed down by the sebum. The skin cells and sebum and micro follicles clump together to form a plug, forming a comedone. The comedone can appear as a blackhead or white head. The oily environment within the skin allows bacteria to infect the comedones, causing to swell and become a pimple.
Causes of Acne
The number one cause of acne is hormonal, specifically a rise in androgen levels. Androgen is a type of hormone which is produced in high quantities during puberty and teenage years. A rise in androgen cause the effect of increase sebum production and also increase the likelihood of the clogging of pores, encouraging bacteria to grow.
While it is still debatable if emotional stress directly causes acne, studies have shown that emotional stress can worsen current acne conditions.
High glycemic index foods like cakes, sweets, and nutritional supplements containing whey protein have all been associated with and risk of acne.
Wrong use of cosmetic products
Powder foundation, concealer, etc, can contain ingredients that irritate the skin and clog our skin pores.
Wrong use of skincare products
Skincare products can contain comedogenic ingredients that can stimulate our sebaceous glands to produce more sebum.
Some medications containing androgen and lithium can cause acne.
Grades of Acne
Grade 1: Mild (Comedones)
Grade 1 acne is characterized by the appearance of open comedones, or blackheads. These blemishes occur when pores are clogged by an excess of waxy sebum, which is an oily substance secreted to lubricate skin.
Grade 2: Moderate
In moderate acne, blemishes appear in greater numbers. With Grade 2 acne, there will also be occasional papules and pustule, which are the types of blemishes that most people associate with acne.
Papules are raised red bumps caused by bacteria that have damaged the pore with no fluid inside.
Pustules are also raised red bumps, but present as white at the top due to an accumulation of white blood cells and debris.
While papules and pustules indicate the presence of bacteria, the inflammation is actually due to the immune system’s response to the infection.
Grade 3: Severe
Acne moves to Grade 3 when blemishes occur in larger numbers and inflammation is more pronounced. When it reaches this point, the skin’s structure is compromised, and the risk of acne scarring is very high.
With a greater incidence of papules and pustules comes a greater temptation to eliminate them by squeezing or popping. Unfortunately, this can serve to spread the bacteria and multiply breakouts.
Grade 4: Cystic
In Grade 4, cystic acne is characterized by large, angry-looking blemishes on the face and jaw line which can also affect the upper body, neck, arms, shoulders and back.
Grade 4 acne often results in cysts, which are deep blemishes more than 5 mm in diameter. Nodules are hard, painful bumps that are similar to cysts but contain no pus or other fluids. They can last for weeks or months and even go dormant only to reappear later on.
Why We Treat Acne
While there is no permanent cure for acne, treating acne early has its benefits:
- Prevent formation of deep pitted acne scars
The more severe the acne, the worse the resulting scars. If we can control the acne condition, we can limit the destruction of the dermis.
- Early treatment, early recovery
A few discrete blackheads and mild pimples will respond to treatment and resolve faster than a full-blown breakouts of acne papules, pustules and cysts.
- Reduce development of post inflammation hyperpigmentation (PIH)
Most people consider acne PIH worse than acne itself, because PIH can linger for months. Timely treatment of acne can help reduce the severity of PIH.
- Improve emotional well being
One thing that is seldom addressed is the psychological and emotional state of acne sufferers. In these people, their self esteem and confidence can take a hit, especially if acne occurs during their teenage years. Good acne control can return good quality of life for these patients.