ACNE – Causes, Symptoms, Risks & Treatment

Overview

Can acne affect your self-confidence? It is not just an inconvenient embarrassment. Even if you agree or not, it can affect your mental health as well. The American Academy of Dermatology Acne Reports, “Acne often causes significant physical and psychological problems such as permanent scarring, poor self-image, depression, and anxiety.” Knowing the causes of acne formation can help you keep it at bay. So, continue reading to know the causes and the various measures to heal these stubborn breakouts. I, Dr. Sandeep Bhasin, am the author of the article, which will discuss the causes, symptoms, and treatments of acne.

What are the differences between acne and pimples?

Your skin normally has many tiny holes called pores. Dirt, excess oil, dead cells, or bacteria can block these pores. Hence, bacteria will start growing in these blocked pores. Moreover, the oil cannot escape. All these problems result in pimple formation. You may have acne if your skin suffers from various skin lesions, like pimples, blackheads, whiteheads, etc., regularly.

Acne:

1. Skin conditions affecting hair follicles and oil glands.
2. Caused by the clumping of sebum and dead skin cells in follicles, leading to inflammation.
3. It can affect various parts of the body.
4. Can range from mild to severe, with different types.
5. Requires comprehensive treatment, including topical creams and oral medications.

Pimples:

1. The symptoms of acne appear as red bumps on the skin.
2. The result is bacterial inflammation within plugged hair follicles.
3. Typically, it appears on the face but can occur elsewhere.
4. Often mild and temporary.
5. Can be treated with over-the-counter topical treatments.

What are the types of acne?

There are two types of acne, namely, non-inflammatory and inflammatory.

Non-inflammatory

• Blackheads: These occur when follicles are clogged, but they’re open and exposed to air. The dark color isn’t dirt; it’s due to the sebum reacting with air.
• Whiteheads: When follicles get plugged, these look like little bumps under the skin’s surface. They look white because they don’t have any air around them.

Inflammatory

• Papules: These are small, pink bumps on the skin that are inflamed and tender to the touch.
• Pustules or Pimples: Papules that develop white or yellow pus-filled tops. They’re red at the base and can be painful.
• Nodules: These are large, solid, painful lesions deep within the skin.
• Severe Nodular Acne (Cystic Acne): This is the most severe form, with deep, painful, pus-filled lesions.

Every type looks different. So, let us next go through their features.

Read this article too to learn: more about acne types.

What are the symptoms of acne?

You will notice the following common symptoms if you have acne:

• Pimples: Pimples are persistent red spots on the skin filled with pus.
• Blackheads: Due to oxygen in the air, blackheads open at the skin’s surface, giving them a black appearance.
• Whiteheads: Whiteheads remain closed under the skin surface, giving them a white appearance.
• Pustules: Pustules are small, red-colored pimples with pus at their tips.
• Papules: Papules are small, raised bumps that appear red in color.
• Nodules: Nodules are solid, painful lumps that appear under the skin’s surface.
• Cysts: Cysts are large, painful lumps that contain pus. They appear under your skin.

Furthermore, acne is divided into three grades according to its severity:

1. Mild acne: You will find a few blackheads, whiteheads, mildly irritated small pustules, or pimples. However, there won’t be a proper pimple mark.
2. Moderate acne: Compared to mild acne, you will find more whiteheads, blackheads, pimples, and pustules on your face. You may get a pimple mark.
3. Severe acne: In this case, you will find a large number of whiteheads, blackheads, pimples, pustules, and painful nodules on your skin. You will get pimple marks as well.

Henceforth, you can easily determine the grade of acne by noticing the symptoms.

How do I know what type of acne I have?

Did you get a breakout? Know what type of acne it is so that you can select the right treatment at the right time.

• Blackheads: Blackheads will look small, dark, and common.
• Whiteheads: Whiteheads will appear as small, yellowish, or white bumps. There won’t be any redness.
• Milia: Milia is usually mistaken for whiteheads. It looks white in color. But unlike whiteheads, it appears as small and hard bumps.
• Papules: Papules look red or pinkish. But there is no visible opening or pus formation.
• Pustules: Pustules are also mistaken for whiteheads. But they appear as red or pink bumps. They are filled with pus and have yellow or white tops.
• Nodules: As nodules contain pustules and papules, they appear swollen and bumpy. They are red in color.
• Cyst: Cysts look single and not clustered. They appear large and widespread, with no visible pus.

Now that you have understood how to identify the acne type, let’s understand its causes to select the right treatment.

What causes acne? Do medical conditions cause acne?

As mentioned already, acne develops if the skin pores get blocked with dead skin, excess oil, or bacteria. These three factors become the major causes of acne.

Other causes may include:

• Hormonal changes, especially androgens, during puberty or pregnancy
• Excess sweating
• Medications like birth control pills, iodide, lithium, bromide, chemicals having dioxins, and steroids
• A diet rich in carbohydrates like chips or bread
• Insufficient water intake
• Refined sugar consumption
• Heredity
• Weather changes
• Humidity
• Stress is not the cause. However, if you have acne, stress may worsen it.
• Excess use of beauty products
• Smoking and alcohol consumption
• Dandruff causes acne on your forehead
• Air pollution
• Over-washing your face can worsen your acne

However, diet, lack of hygiene, masturbation, greasy hair over the face, and lack of exercise do not contribute to acne development.

Moreover, the consumption of chocolates and non-oily cosmetics has no effect on acne formation.

What causes sudden acne? 

Sudden acne, as the name implies, occurs all of a sudden due to the following reasons:

• Stress
• Overconsumption of fried, fat, or processed foods
• Medications like hormonal pills, steroids, or anticonvulsants
• Excess sebum production
• Sleep irregularities
• Hormonal imbalance 
• During periods of puberty
• Being overweight
• Health disorders
• Underlying endocrine disorders such as PCOD (polycystic ovarian disease), Cushing syndrome, acromegaly, and thyroid
• Nonendocrine diseases such as Apert syndrome, Behcet’s syndrome, and PAPA (Pyogenic Arthritis, Pyoderma gangrenosum, and Acne) syndrome

Keep checking if you get sudden acne recurrently. If so, you should consult a doctor as soon as possible.

What are the risk factors that can contribute to the development of acne?

There are a few risk factors that can lead to acne development:

1. Age: Though acne is common for people of all ages, it’s more common among teenagers
2. Hormonal changes during pregnancy and puberty
3. Heredity: If your parents had acne, you may also develop acne
4. Greasy substances: The use of greasy creams or lotions can cause acne
5. Friction on your skin due to the use of mobile phones, backpacks, tight collars, and helmets
6. Unwashed skin
7. High-glycemic foods rich in sugar and carbohydrates, such as french fries, white bread, potato chips, and soda

However, remember that hormonal acne (acne development during puberty) may subside by the time you reach adulthood.

Which parts of the body develop acne?

Acne can develop anywhere in your body. However, it mostly develops on the face, forehead, neck, back, chest, and shoulders. The reason is that these areas have the most oil glands.

Can acne be a sign of a serious illness?

You can get acne at any age. Most of the time, it’s not a serious sign. However, several researchers think there is a connection between acne and cancer.

People with severe acne are more likely to be at a huge risk of breast cancer and skin cancer.

Dr. Brian Horvath, a dermatologist in Pittsburgh said, “When you have excess acne, you probably have excess hormones as well.” Hence, Allison Santhouse, a physician assistant at New York Dermatology Center explained, “We already know the more moles somebody has the higher risk they are of developing melanoma in the future. So young women who have a history of acne may already have an increased number of moles and that is most likely the link.”

Is acne a sign of a weak immune system?

Yes. Usually, stress causes a hormonal imbalance where there is an increase in the androgen level in your blood. Hence, this increase in androgen leads to suppression of the immune system.

If your immunity is weak, you may not be able to fight off microbes, thereby leading to acne development. That’s why you will more likely notice breakouts whenever you contract a fever or cold.

What is the best treatment to prevent acne?

There are various home remedies if you get acne. If that doesn’t work, consult a doctor and take your medications. Along with this, we are going to tell you about six such approved methods by which you can also treat your acne scars.

DIY acne treatment: Home remedies

• Mix one part apple cider vinegar or tea tree oil with three parts water and apply it to the affected area. After 20 seconds, rinse with water. Repeat this step two times a day.
• Prepare a honey and cinnamon paste and apply it as a mask to your face. After 15 minutes, remove the mask.
• Try cool green tea using a cotton ball
• Use aloe vera gel either alone or in combination with tea tree oil 
• Rub your skin gently with coconut oil and salt (or sugar) mixture and rinse well

Medications

Your doctor may prescribe either topical medications or oral medications for acne removal.

The common topical medications include:

• Antibiotics (erythromycin or clindamycin with benzoyl peroxide)
• Drugs containing tretinoin or retinoic acids
• 20% Salicylic acid and azelaic acid
• 5% Dapsone

Oral medications include:

• Antibiotics (macrolide or tetracycline) with benzoyl peroxide
• Combinational oral contraceptives (a combination of estrogen and progesterone)
• Anti-androgen medications: spironolactone
• Vitamin A derivatives like isotretinoin

If there is no improvement with medications alone, your doctor may recommend steroid injections, chemical peel, light therapy, or drainage and extraction.

Acne prevention diet

However, if you want to prevent acne development, do follow the below listed best diet for acne.

• Consume a high-protein diet that can control your blood sugar level. So, avoid foods like sugary cereals, white bread, pastries, pasta, sweets, ice cream, and candy.
• Reduce the consumption of processed foods, dairy products, and whey protein
• Always, prefer to eat nutrient-dense foods such as chia seeds, canola, fatty fish, and soybean oils.
• Include fruits, whole grains, vegetables, legumes (kidney beans, chickpeas, etc.), and spices (cinnamon, garlic, black pepper, turmeric, etc.) in your diet.
• Include foods rich in zinc (quinoa, cashews, pumpkin seeds, etc.), fish oil, B vitamins, and probiotics.
• Don’t miss out on consuming unsweetened beverages such as lemon water, green tea, hibiscus tea, and water.

Pretty simple acne prevention diets, aren’t they? Try them for around three months, and you can easily make out the difference in your skin.

What should you do first when you get acne?

Here are the nine things you should do once you notice acne:

• Wash your face only two times per day with mild soap and warm water. Don’t wash excessively.
• Never scrub your face or use a washcloth that may irritate your skin.
• Avoid using oily products, astringents, alcohol, exfoliants, or toners.
• Be careful while shaving the face
• Don’t forget to wash your face after sweating
• Remove your makeup before going to bed
• Wear a wide-brimmed hat while going out to prevent direct exposure to sunlight
• Wear breathable and soft fabrics if you find a break out on your chest or back
• Apply sunscreen while going out
• Stop using the skin products if you are getting any side effect
• Use a warm compress on whiteheads. For any swelling or blemishes, use ice.
• Reduce your makeup to the lowest level. Avoid using a heavy foundation.
• Never pop your pimples, as they may increase inflammation.
• Avoid touching the acne portion. Even if you touch it unknowingly, wash your hands.

Above all, consult a doctor in case you are getting acne repeatedly and you find it painful. Only the doctor can diagnose the underlying cause of acne development and recommend the right treatment.

Conclusion

Treating acne is a personalized process for every person. Thanks to the medical field, it is possible to treat every case of acne successfully. Stop breaking your head with recurrent breakouts! Talk to your doctor and find out how to say goodbye to them once and for all. It’s ultimately you who should take matters into your own hands to get rid of acne.

References:

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4. Dinulos JGH. Acne, rosacea, and related disorders. Habif’s Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 6, 2020.
5. Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/acne. Accessed July 9, 2020.
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