Alleviating Acne

My son, D, is going through the rigors of puberty as we speak. He has newfound sense of maturity and independence. But one rite of passage that I’m sure he would get rid of in an instant is acne.

Acne is caused by the plugging of skin follicles or pores, as we call them. During puberty, hormonal changes cause the wall of the pores on the face to thicken, increasing the production of sebum, an oily material that can clog the pores. Oil sludge and shed skin cells form the plug. Every skin follicle comes equipped with an oil gland. Even when the follicle opening is plugged, the gland keeps secreting oil downstream of the plug. The follicle swells and eventually bursts, spewing oil into the adjacent skin. A pimple forms.

According to the American Academy of Dermatology Association, acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. Americans spend nearly $400 million a year on over-the-counter acne treatments.

Acne is most common among teenagers, but it can affect people of all ages. Usually, the condition is mild and leads to breakouts that don’t cause permanent scarring. Teen acne is generally due to hormonal changes, while stress can be more likely a factor for adults.  

For teens, one explanation is that hormones may stimulate oil production. In addition to distending follicles, oil is a favorite meal for skin bacteria that live in the follicle. Bacteria multiplies and adds to the inflammation of the oil spill. This hormone production may continue into the adult years which is why adults are equally susceptible to this condition.

As adults, when you are stressed, your body releases adrenaline and cortisol. When the cortisol levels are too high, they overwhelm the receptors in your oil glands and acne breakouts occur. The difference with stressed induced acne is that it is not concentrated in one area of your body.

If a clogged pore is under the surface of the skin, it forms a whitehead. If it is on the surface, it forms a blackhead. The body reacts to the blackheads and whiteheads by causing inflammation, which results in pimples.

Age may play a role on what areas of the body are affected by acne. Teen acne tends to cluster on the forehead and cheeks, while adult acne is common around the jawline, neck, chest, and back. One common type of acne is T-zone acne where breakouts happen across your forehead, nose, and chin.

For women and girls, breakouts may be connected to their menstrual cycle. In addition, discontinuation of birth control pills may contribute to those hormone changes and eventually, acne.

Acne has nothing to do with personal hygiene. Heredity may determine just whether you get it and just how bad it will be with some assistance from those hormonal fluctuations. It also has nothing to do with diet. There is a possibility that foods high in sodium may cause skin eruptions but it is still very unclear.  

Two standard ingredients used for acne treatment include salicylic acid (to unclog pores) and benzoyl peroxide (to kill bacteria). However, if acne doesn’t clear up in several weeks or is severe (which at times it can be) then see your dermatologist before scarring can become an issue. Whatever you do, try not to pop a pimple because it may result in infection as well as scarring.

Doctors will prescribe an antibiotic, chemical peels, collagen, or retinoids like Retin-A and Accutane (please note this medication has been linked to depression in teens) to prevent scarring. Laser resurfacing can be prescribed in certain cases (keep in mind these treatments may be expensive). Oral antibiotics (take the acne away by reducing the bacteria and inflammatory reaction that occurs) such as tetracycline and erythromycin may also be recommended for some patients with severe acne.

One measure that should be taken to preserve your skin if you are prone to acne is to switch to oil-free products. You may already have excess oil on your skin, so say no to putting additional oil that may clog your pores. Acne might be managed by avoiding heavy oil-based makeup and hair products like mousse and gels around the hairline.

Also there are preventative steps you can take regarding warding off zits. Alpha- and beta-hydroxyl acids are notable treatments. They exfoliate dead skin and normalize dense oil before they cause blockages in your pores. Even more, some doctors recommend sulfur as a good spot treatment for the occasional outbreak by drawing the blockages out of the pores.

Acne can be a struggle to manage but it isn’t forever. Most people do eventually outgrow it. In the meantime, having the right resources can make that struggle a lot less grueling and more positive each day.