Acne Overview: Spotting the Truth
Acne is a complicated skin condition to live with. There are many different kinds of acne, inflammatory and not, all with different causes and combinations of causes. Some people are just predisposed to developing acne, or you might just be unlucky enough to develop it anyway. Most people will get pimples at various points in their lives, but these are different from acne due to its chronic and prolific nature. At Not Just Skincare we understand the mental toll visible acne can have on your life, and we fundamentally feel like understanding a condition is the first step to treating it and making the space for yourself to break away from that shame. Acne is not a curse, and it doesn’t make you less loveable and important: your skin is just reacting to the signals it receives. So let’s break it down.
All acne related skin conditions coincide with excess sebum production. Normal sebum production and secretion = no acne. As with all good and terrible things however, it is never just that simple. Other causes and concurrent events include the growth and proliferation of bacteria; inflammation; excess keratin production and changes in the way the skin cells behave. Certain demographics are more predisposed to developing acne, e.g. adolescent males and people with PCOS, but it can still affect anyone at any age. Hormonal changes also play a significant role in certain acne pathologies, because some people are extremely sensitive to their body’s natural production of testosterone and its derivatives, which leads to inflammation and excess sebum production. It is important to note that men produce testosterone throughout their lives, and this picks up greatly during puberty, conversely women produce testosterone in different levels at different points in their cycle. This is why some women will have breakouts right before menstruating,
What’s the pattern? An acne lesion (fancy word for pimple, pustule, blackhead etc.) starts when excess sebum accumulates in the pilosebaceous unit (the hair follicle + sebaceous gland) along with keratin, dead skin cells and often bacteria such as Propionibacterium acnes. This terrible combo continues to accumulate either with an open pore/ opening, known as a blackhead or open comedone, or with a closed pore, known as a whitehead or closed comedone. Whiteheads, pustules, nodules (closed comedones) are more closely correlated to painful, red, inflammatory acne, due to the inside walls of the comedone/ pimple rupturing, causing the body’s inflammatory system to react. Blackheads are not usually linked to inflammatory acne pathologies, but can occur at the same time as its inflammatory counterpart. Unfortunately, acne can act as a negative feedback loop, because acne causes inflammation which can lead to more sebum secretion and irritation. This often causes people with acne to want to pop or extract at home, which can introduce more bacteria, clog more pores and produce more lesions.
So, how do we go about fixing it? There are many routes one can take depending on the severity of the acne. Topical antibiotics, mild surfactants, chemical exfoliants, and retinoids are common effective topical surface treatments, that are often used in combination with each other and in different potencies depending in what is needed. Sometimes, dermatologists will prescribe over the counter medications meant for ingestion, such as select antibiotic tablets and oral systemic retinoids; these are usually for more severe cases and are more likely to have unwanted side-effects. There are many effective combinations out there, but it is common for acne-sufferers to start using too many active ingredients, or ingredients that are too harsh, which puts the skin under more stress. Most of the time any given active ingredient, product or regiment will only start having significant effects after three months of continuous use, with many showing significant effect after six months. So even if you aren’t using our products (though we don’t know why you wouldn’t) we recommend being patient and toning it down.
We hope to help you on your good skincare journey, and will expand a bit more on the skin’s anatomy, acne causes and all the great active ingredients out there. Follow along for a good time.
Sources:
Aydemir E. H. (2014). Acne vulgaris. Turk pediatri arsivi, 49(1), 13–16. https://doi.org/10.5152/tpa.2014.1943. https://pmc.ncbi.nlm.nih.gov/articles/PMC4462260/#:~:text=Abstract,etiological%20factor%2C%20except%20genetic%20tendency.
Pappas, A., Johnsen, S., Liu, J. C., & Eisinger, M. (2009). Sebum analysis of individuals with and without acne. Dermato-endocrinology, 1(3), 157–161. https://doi.org/10.4161/derm.1.3.8473. https://pmc.ncbi.nlm.nih.gov/articles/PMC2835908/
Well, D. (2013). Acne vulgaris: A review of causes and treatment options. The Nurse Practitioner, 38(10), 22-31. https://doi.org/10.1097/01.Npr.0000434089.88606.70
https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047
