Skin Condition Series, Acne
Acne, medically referred to as Acne Vulgaris is a disease of the skin that occurs due to plugging of hair follicles with dead skin cells and oil or sebum. Acne is most commonly found in teenagers and according to reports approximately 70-80% teenagers develop acne. Increasingly acne is affecting younger children as well.
What is Acne?
The word acne is derived from the word acme meaning “the highest point”, which originated from Greek word akme meaning “spot” or “point”. In simple terms, dead skin cells, hair and sebum can form a plug after clumping together. When bacteria infect this plug, it results in a swelling referred to as acne.
What are the symptoms of Acne?
The symptoms and signs of acne differ depending upon the severity of the condition:
- Whiteheads are plugged skin pores that are closed.
- Blackheads are plugged skin pores that are open. On being exposed to air the oil turns brown in colour.
- Small tender, red bumps or papules.
- Pimples also called pustules, which refer to papules with pus present at their tips.
- Nodules or large, painful, solid lump formed under the skin surface.
- Cystic lesions or painful lumps, which are filled with pus formed under the skin surface.
What are the causes of Acne?
Acne is caused by 4 main factors:
- Production of oil
- Dead skin cells
- Plugged or clogged skin pores
- Infection by bacteria
Acne typically occurs on your neck, face, back, chest and shoulders as most oil or sebaceous glands are present in these areas. Acne appears when there is clogging of hair follicles with dead skin cells and oil.
Hair follicles and oil glands are connected to each other. Oil glands secrete sebum, which is an oily substance, to lubricate the skin and hair. Normally sebum moves along the shafts of the hair and via the hair follicle openings to the skin surface.
When excessive amount of dead skin cells and sebum are produced by your body, then these two substances can get accumulated in the hair follicles. A soft plug is formed of them and an environment is created for bacteria to thrive. Inflammation results if the plugged or clogged skin pores get infected with bacteria. The excessive and abnormal collection of sebum converts the usually harmless bacteria of the skin P. Acnes into aggressive and harmful bacteria causing pus and inflammation.
The wall of the follicle may bulge by the clogged pore producing a whitehead. A blackhead may appear if the plug is open on the surface and darkens. A blackhead may appear as if dirt is stuck in the pores. But actually there is congestion of the pore with oil and bacteria. The oil turns brown on being exposed to the air.
Pimples are papules with a white tip that develop when inflammation or infection occurs of the blocked hair follicles. Inflammation and blockages that form deep in the hair follicles form cystic lumps under the skin surface.
Acne may be aggravated by the following factors
Hormones: Acne is commonly present during puberty. It is the time when the oil (sebaceous) glands become active-these glands are stimulated by androgens (male hormones) secreted by the adrenal glands in both females and males. Hormonal changes occurring in females during pregnancy or menstrual cycle can also produce acne.
Some medicines: Acne can be aggravated by drugs containing androgens, corticosteroids or lithium.
Stress: Acne can become worse by stress.
Diet: According to studies, certain foods such as foods rich in carbohydrates such as bagels, bread and chips and dairy products may act as acne triggers. Chocolate has also been found to make acne worse.
What are the risk factors for Acne?
The following are the risk factors for acne:
Hormonal changes: Changes in hormonal levels are common in females and girls, teenagers and individuals using medicines containing androgens, corticosteroids and lithium.
Family history: Heredity plays a role in the occurrence of acne. If both of your parents suffered from acne then it is very likely that you will also have it.
Oily or greasy substances: Acne may occur when you apply oily or greasy substances to your skin such as oily creams or lotions.
Pressure or friction on your skin: This can result from items including cell phones, telephones, tight collars, helmets and backpacks.
Stress: Acne is not produced by stress but it can make acne worse.
U.K. Statistics of Acne
It is believed that acne affects about 8 out of 10 people aged between 11 and 30 years in the UK. It is most commonly present in the age group of 14-17 years in girls and in the age group of 16-19 years in boys. 5% of females and 1% of males can suffer from acne as an adult.
Lifestyle changes to improve Acne
Mild acne can be prevented or controlled by using non-prescription products, practicing good skin care and other good self-care techniques:
Use gentle cleanser to wash affected areas: Wash you face with a gentle cleanser and warm water two times a day. If acne occurs around your hairline, you should shampoo your hair regularly. Avoid products including scrubs, masks and astringents as they are skin irritants and can worsen your acne. Excessive scrubbing and washing can also cause skin irritation and should be avoided. While shaving the affected skin area, do it gently.
Avoid irritants: Avoid greasy or oily cosmetic products, hairstyling products, sunscreens or acne concealers. Always use products that are labelled non-comedogenic or water-based as their chances of causing acne are less likely. You can use an OTC lotion that contains benzoyl peroxide.
Use a non-oily (non-comedogenic) moisturizer that contains sunscreen: Sun’s rays may worsen your acne. Moreover, some medicines used for acne make you more susceptible to the rays of the sun. Ask your doctor about your medicine. If your medicine is one of these, avoid sun as much as possible. Use an oil-free moisturizer containing sunscreen regularly.
Don’t squeeze or pick pimples: Avoid picking or squeezing your pimples as it may cause scarring or infection.
Watch what comes in contact with your skin: Keep your hair off your face and wash them regularly. Avoid resting objects such as telephone and even your hands on your face. Hats or tight clothing can also cause problem, particularly if you are in a hot and humid climate and sweating. Oils and sweat can cause acne.
Wash your hands regularly: Keep them clean. Always wash them before you touch your face. This includes even before applying creams, lotions or makeup.
Clean your glasses regularly: Glasses should be cleaned regularly as they collect skin residue and sebum.
Always clean your makeup before going to sleep.
Wear loose clothing: If your acne lesions are on your chest, back or shoulders, wear loose clothing. Avoid tight garments including caps, headbands and scarves.
Vitamins and Supplements for Acne
Zinc is a trace element that is present in the majority of the cells of the body. It acts as a vital co-factor of many enzymes. Zinc is present in foods including organ meats, red meat, whole grains, yeast, and eggs. Zinc has antioxidant properties. It is used in beauty products due to its effectiveness in the maintenance of the health of skin, nails and hair. According to a study published in the Journal of the American Academy of Dermatology, application of terythromycin/zinc liquid and erythromycin/zinc gel showed significantly better results in acne patients in comparison to placebo.
A fat soluble vitamin, vitamin A is predominantly stored in the liver. In nature, different structures of vitamin A are found-Retinol, which is only found in animal sources of food and carotenoids, which are found only in plant based foods. Food sources of retinol are cod liver oils, butter, egg yolks, oily fish, and whole milk. Food sources of carotenoids are peppers, dark leafy vegetables, broccoli, sweet potato, parsley, kale and carrots. According to a study published in the International Journal of Dermatology, administration of oral retinol has been found valuable for treating stubborn, severe inflammatory acne vulgaris. According to another study published in the British Journal of Dermatology, topical application of retinoic acid was found useful in acne vulgaris in comparison to placebo.
Selenium is an essential trace element required for multiple functions in the human body. Foods rich in selenium are Brazil nuts, mushrooms, eggs, garlic, brown rice, Swiss chard or any plant grown or animal grazed on Selenite rich soils. Selenium has antioxidant properties; hence, it helps in the protection of other antioxidants including vitamin E. According to a study published in the Journal Europe PMC, a good result was obtained with selenium in patients with pustular acne. According to research, selenium deficiency may play a vital role in inflammatory disorders including acne, psoriasis and eczema.
Omega-3 fatty acids have been found to reduce inflammation and acne is characterized by inflammation. Omega oils also have a positive effect on the immune system of the body. There are 3 kinds of omega-3 fatty acids: Eicosapentaenoic acid (EPA), Alpha-linolenic acid and Docosahexaenoic acid (DHA). According to a study published in the journal Bio Med Central, there is some evidence that supplementation with fish oil is associated with an improvement in overall acne severity, particularly in persons with moderate to severe acne. In another study published in the journal Acta Dermato-Venereologica, supplementation with omega-3 fatty acids and Gamma-linolenic acid proved to be beneficial for patients suffering from inflammatory and non-inflammatory acne.
Maca is native Peruvian root extract from the plant, Lepidium Meyenii. Maca is considered as a nutritional powerhouse, it is rich in all macronutrients along with iron and iodine. Maca treats acne by correcting imbalance of hormones.
There are various types of B vitamins and each has its own function. However, when used in conjunction the primary benefits are maintenance of- normal energy metabolism, nervous system function, skin, vision, mucous membranes, growth of hair etc. They also prevent oxidative stress as they act as antioxidants. According to a study published in the International Journal of Dermatology, nicotinamide gel provides potent anti-inflammatory activity without the risk of inducing bacterial resistance.
Astaxanthin has multiple sources including shrimp, krill, crustaceans and microalgae. Astaxanthin is rich in carotenoids, which is a derivative of vitamin A. Astaxanthin is also known as “the King of the Antioxidants” as it contains high level of active antioxidants. A study conducted in the year 2002 in Japan demonstrated that only 2 weeks of oral supplementation of astaxanthin with Vitamin E produced improvement in almost every attribute of skin. Some of the benefits were decrease in fine lines and acne, increased elasticity of skin, less freckles etc.
Acne is a skin disorder that is characterized by clogging of hair follicles by dead skin cells and oil. It usually occurs in the teenagers; however, it can also continue into adulthood. There are various causes and risk factors for acne. You can practice multiple good skin care and self care techniques to relieve your acne. There are various supplements available such as omega oils, maca, B vitamins, selenium, zinc, astaxanthin etc, which can be used to relieve acne.
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