WHAT IS ACNE
The skin has the largest surface area of all the organs in the body. It is the body’s first line of defense against external factors, regulates the body’s temperature and enfolds all the organs in a protective layer. It is a lot tougher than it looks, but it should be protected anyway because it can be compromised.
You can also consider the skin as the body’s early warning system for when something goes wrong inside. These problems manifest as dryness, rashes, itching, boils, and of course, acne.
Acne vulgaris is a skin condition that manifests itself as pimples and raised lesions all over the face, neck, back, chest and even shoulders and arms. Acne is common among teenagers due to the rampant hormonal changes occurring in their body and tends to clear up after that when a balance has been achieved in adulthood. However, due to systemic oxidative damage, sun exposure, stress and insomnia, erratic hormonal balance and poor nutrition in addition to genetic factors-some adults will continue to suffer chronic acne for most of their lives.
Acne can be a big dent in the self-esteem of the sufferers, and the scars are not sightly. Teenagers, especially, are prone to anxiety, self-esteem and confidence problems and impaired social interactions because of acne and its scars. The toll it can take on the emotional wellbeing, especially of an impressionable young adult, cannot be quantified.
TYPES OF ACNE
Acne is broadly divided into two types: non-inflammatory and inflammatory acne.
NON-INFLAMMATORY ACNE comprises of whiteheads and blackheads, which are the most common forms of acne. They are relatively easier to treat and manage.
Whiteheads: These are also called closed comedones. When whiteheads occur, it is due to clogged pores filled with excess sebum, dirt, and dead skin cells, but in this case, the pore is closed up and under the skin. It presents as a small protrusion from under the skin, and there is no visible opening of the pore. It can be painful and vexatious.
Treatment of whiteheads is usually with salicylic acid and retinoids, and even though it is more difficult to treat than blackheads, it will clear up in a matter of months.
Blackheads: Blackheads are also called open comedones, because in this case, the pores are open, causing the black point on the surface of the skin that we are familiar with. The cause of blackheads is the same as for whiteheads: a combination of dirt, bacteria, environmental pollutants, sebum and dead skin cells that clog up the pores. This type of acne is relatively easier to treat, as the comedones can be extracted to speed up healing of the skin.
INFLAMMATORY ACNE causes raised, red pimples that are swollen and usually have deeper underlying causes. They are painful and usually persistent. There are several sub-types of acne that can be grouped here.
Papules are hard, clogged pimples that form when the area around the pores get inflamed and degrade. This degradation causes a hard, painful lump that can be felt when touched and has no visible opening. It can persist under the skin for months and even years.
Pustules have the same root cause as papules, but in this case, the pimple is not just hard and palpable underneath the skin. Instead, it is filled with pus, with a visible white or red tip. This type is very common with skin infections like with propionibacteria and staph infections.
Nodules have their origin deeper in the skin and get very swollen and painful. Over the counter medication will not clear up nodules. This type of acne needs to be resolved with a direct steroid injection or by medication due to the depth of its underlying causes.
Cysts are more serious than an average pimple, caused by clogging of the pores with excess sebum, bacteria, and pollutants deep under the surface of the skin. They can grow very large and puss-filled and usually reoccurs in the same area after they are drained. The cause of cyst formation is usually due to a serious infection, and they will most likely cause a scar due to the frequent drainage and filling of the same area-especially if the underlying infection is not treated.
Acne fulminans is a type of inflammatory acne that usually affects teenage males on their jaw, chest, and back. It is hormonally triggered and can be treated with topical ointments.
THE CAUSES OF ACNE
The primary cause of acne is when the pores are clogged, leading to a blockage and the development of a pimple. However, the conditions behind this clogging could be either one or more of the following:
ENVIRONMENTAL: The environment we live in is filled with pollutants that can irritate the skin and cause acne if the skin is not properly looked after. This is why deep cleansing and masks are important.
HORMONAL: Androgens are the hormones that are more often associated with the male, and they increase oil production in the body when there are high levels or when the hormone levels are out of sync. This is what leads to the outbreak of acne during the teenage years. It can also affect anybody who is dealing with hormonal fluctuations like pregnant women, women before their periods, women who are taking any form of birth control that involves hormones like the pill and injections, and menopausal women.
STRESS: Stress, anxiety, sleep deprivation, depression and other psychiatric disorders have been linked to acne breakouts. Modern life is stressful, and this is affecting our health and consequently, the skin too. When we do not get enough sleep, the body’s normal hormonal and homeostatic processes are thrown out of balance, and this can cause acne.
DIETARY: Modern diet leans a lot more towards refined sugars and trans fats rather than healthy sugars, fibres, healthy fats, vitamins and minerals. It is no wonder that this poor diet reflects in the rising incidences of acne among young and older people. The skin is a filter for the body’s waste, and when the body has to work extra hard to digest these unhealthy carbs, the skin will naturally reflect that struggle.
DEHYDRATION: Water is important in maintaining the body’s normal workings. If we do not drink enough water, the body’s digestive and excretory processes are impaired. This leads to dry skin and consequently, acne.
Polycystic Ovarian Syndrome: This hormonal condition affects women. Women who are affected have abnormally high levels of male androgens (like progesterone). This results in infrequent, heavy and painful periods, infertility, hirsutism and the development of cysts in the ovaries. These women do not ovulate, and that wrecks havoc on the levels of the hormones in their body, causing physical manifestations like rampant acne.
Rosacea: This chronic skin disease presents as whitish, pus-filled bumps all other the face. The cause of this condition is unknown, but it tends to flare up during menstrual cycles when hormones are out of sync. There are several sub-types of rosacea, and one type also affects men. With a better skin care routine and soothing ingredients like witch hazel and menthol, the condition can be managed but not cured.
GENETICS: It sucks, but the truth is that some people are more genetically disposed to acne than others are. This does not mean that with healthy eating habits and skin care, they cannot have great skin, but it leaves them more prone to developing acne than the rest of the population.
ACNE BODY MAP
In some acute cases of acne, the position where a pimple appears in can be a clue as to a deeper problem or a condition that is wrong or imbalanced in the body. As simplistic as it sounds, mapping the position of a reoccurring pimple can be what you need to finally crack the cause, and thus pin down a treatment for it. Many people swear by this ayurvedic approach.
- The Nose
Whenever you start noticing a continual pimple epidemic on your nose, then maybe it is time to look into your heart health. A diet that is rich in saturated fats like in red meat and vegetable oil, and a diet that is filled with too much spicy food can be the culprit here.
Instead of indulging in fatty food, you can replace them with a diet rich in healthier fats like is contained in deep-sea fish (e.g. salmon), nuts, avocados and seeds like flaxseed and chia seeds.
Another cause is when makeup has stayed on for too long. You should always remove your makeup at the end of the day and keep up with the expiration dates on the products, or they will cause more harm than good.
- The t-zone
Have you gone on a fast food bender lately? Eating all those heavy trans fats that clog up the pores? Well, this is where they show up first!
The T zone is the area between your brows and on your nose, and whenever your diet is not ship-shape, the results will show up there first as painful pimples that keep reoccurring. This is the area that breaks out when you have been eating heavy, difficult to digest foods, or if you have allergies like lactose intolerance that put a strain on your digestive system.
- The forehead
Forehead pimples will most likely plague people who wear a lot of head coverings, especially with hats or caps that rub against the area repeatedly and are not frequently cleaned. The build-up of sebum, broken down skin cells and dirt on the underside of the cap can cause a potential breakout.
This is also a common problem with people who use heavy conditioners and hair products that drip onto the face when the hair is not yet dry, clogging the pores.
Stress pimples also show up mostly on the forehead, and so do hormonal pimples that appear during the period or when some women are ovulating. Lots of water, a better skin care routine and staying clear of junk food will take care of the skin until that stressful even has passed, or the menstrual period is over.
- The chin
Chin pimples have one major cause-hormonal imbalance due to hormonal drugs like in birth control treatments, or a systemic hormonal imbalance. Thankfully, this can be corrected with a visit to the doctor, who can recommend another form of birth control or a treatment for the imbalance. This should clear the pimples right up. It is always recommended that a good, clean diet and lots of water be incorporated into your lifestyle for clear skin.
- The Cheeks
Makeup is great, but it can very quickly become a reservoir for germs if it not handled properly. The makeup brushes and pads can become a breeding ground for the germs that cause pimples, giving you new breakouts every time you use them. Those brushes should be cleaned regularly to prevent this.
Another culprit here is the screen of our phones. You may think it is out of place to disinfect the phone, but it is not! That phone is put on all kinds of surfaces and handled by your hands after they have touched all manner of germs. We are careful about washing our hands, but what of the phones?
If you keep breaking out on your cheeks, then maybe you should look no further than your phone. Swab it down with an antibacterial wipe to get the worst of the germs off, let it dry, and power it back on. The phone will be better than new.
Another reason could be smoking. Smoking wreaks havoc on the skin, and if your cheeks are breaking out with pimples, then maybe it is time to listen to your entire body telling you to lay off those cigarettes. If not, pretty soon the pimples will be the least of your problems.
- The Ears
This is not very common, but it does occur. Pimples on the ears are a sign of a much more serious underlying condition, usually involving the kidneys. Thus, dehydration could be the primary cause of breaking out. The solution is simple-get at least two liters of water every day. Stay away from fizzy drinks and carbonated drinks to clear out your kidneys and help your body get back to its balance.
TREATMENT OPTIONS FOR ACNE
When treating acne, the objective is to reduce oil production, help to heal the skin cells and inflammation, stimulate regeneration and prevent further infection. There are three options for the treatment of acne: prescription treatment options given by a dermatologist, over the counter solutions that are not prescribed but can be bought from pharmacies, and holistic remedies that are usually done at home.
It should be noted that treating acne also comes from within-in fact, internal balance is the first course of treatment. A balanced diet, hydration and better skin care will do much more than a habit of treatment will.
Prescription treatments usually come in for the more serious types of acne, usually caused by microorganisms that need to be taken care of from the inside before they can begin to clear out. The drugs are long-term, and the results are more permanent. They are however, not the first port of call with an acne breakout, as the drugs should not be prescribed lightly.
Topical medication like retinoid creams and gels that are rich in vitamin A help to clear up the skin with daily use. They can be used in conjunction with a topical or oral antibiotic to deal with the underlying microorganisms. Salicylic acid and azelaic acid treatments in creams and face washes are also very effective in clearing up the pores.
When serious hormonal changes occur and cause acne that cannot be treated by other means, an androgen blocker like spironolactone can be given to block the effects of the androgens on the sebaceous glands and thus, the skin. There are some side effects with this treatment though, including painful periods and tenderness in the breasts.
Several procedures can help to clear up acne, especially when used in conjunction with medication. Laser treatment is commonly known, but has limited success, and so do chemical peels. For more serious nodules of the sebaceous glands, injecting steroids directly into the nodules can ease the pain and cause it to thin out.
Another method of extracting whiteheads and blackheads would be for them to be manually removed by a dermatologist using a special kind of spatula. The pores are exposed after the removal, and need to be treated with care so that they close up. If not handled correctly, this method can cause scarring for the patient.
Ointments and preparations that contain benzoyl peroxide, salicylic acid and alpha hydroxy acids can be applied on mild cases of acne to treat the lesions. They are just a temporary reprieve.
Alternative treatments have shown very promising results in treating acne and easing the scarring, spotting, and skin discoloration that it can cause. These remedies come in a host of combinations of different ingredients, which create different results according to how they are mixed. The most common ingredients are honey, green tea, coconut oil, apple cider vinegar and essential oils like tea tree oil and witch hazel.
Here are some reasons why these agents are ideal for alternative treatment of acne.
Aloe Vera is a natural moisturizing agent due to its high water content. It is also anti-oxidant rich, can reduce inflammation, and promotes healing.
Baking soda has the granulation that is ideal for effective exfoliation. It can also help to absorb excess sebum from the skin and clear up fungal infections. Other great exfoliants are sugar and brown sugar. Oatmeal is also an excellent exfoliator and helps with inflammation too.
Apple cider vinegar has pH normalizing properties and is an excellent toner. It also helps to heal scars, and when ingested orally, promotes overall health.
Green tea is an excellent antioxidant and is filled with agents that fight against free radical damage both on the skin and in the body. These can also help to reduce inflammation.
Honey is an antibacterial and antibiotic agent. In this case, it is always better to use raw, organic honey for best results. Honey is a natural moisturizer too.
Coconut oil is a natural moisturizer that is very easily absorbed into the skin. Other excellent oils to use are almond oil, jojoba oil, avocado oil, and olive oil in small quantities.
Cinnamon has natural anti-microbial properties, to deal with the germs that cause acne.
Papaya is a natural lightening agent, exfoliant, and anti-inflammatory agent. It encourages the healing of skin that has been ravaged by acne.
Greek yogurt contains acids and fats that kill germs while moisturizing the skin naturally.
Clay (of different types, always buy cosmetic grade) helps to absorb excess oil for the skin, detoxifies the skin and exfoliates too. It is great as a base for facemasks.
Turmeric is an anti-inflammatory agent, it also helps to fade acne scars and reduce inflammation from acne.
Tea tree oil has shown excellent results in helping to control acne breakouts. It has antibacterial properties that make it ideal as an essential oil for use in alternative acne treatment.
Before application of facemasks and exfoliating agents, it is best and more effective if the pores are open, this is done by steaming the face.
Steaming is a simple procedure.
- Boil a jug of water until it raises steam from the kettle.
- Pour the water into a bucket and put the bucket of water on a surface level with your neck when you sit.
- Put your face over the bucket of water and cover both your head and the bucket with a towel to minimise the escape of steam.
- You will feel the steam opening up your pores. Stay under the towel for at least ten minutes.
- You can now apply the facemask or exfoliating agent.
Steaming is beneficial to the skin, as it not only opens up the pores for more effective treatment; it also helps the skin to absorb much-needed moisture too.
- MOROCCAN RHASSOUL CLAY MASK
- Rhassoul clay
- Green tea
- Honey (optional)
- Tea tree oil (optional)
- Take one tablespoon of clay and put it in a plastic bowl
- Make it into a soft paste with a tablespoon of green tea
- Add a few drops of green tea and half a teaspoon of honey
- Mix the clay mask together and apply on the face in circles, making sure to cover the area around the eyes and the affected areas.
- Keep the mask on for at least 30 minutes, and then wash off with warm water.
- Moisturise after each application.
- Apply this mask once a day and you will start to see results in a week.
This mask is effective because of the active ingredients in the mask. The clay acts to reduce the production of sebum, clear the pores and keep the skin soft. Tea is an antioxidant and promotes the growth of new skin cells, while honey has antibacterial properties to deal with the germs that cause acne and moisturizing properties to soften the skin. In addition to that, tea tree oil is an antibacterial agent and is great for easing the discomfort and itching caused by acne.
As an alternative to making your own face mask, you can use this product as an anti-acne deep facial cleansing and detoxifying clay mask from Northport Naturals.
- GREEN TEA
Green tea is an antibacterial and antioxidating agent, and topical application of green tea can be just as effective as using topical benzoyl dioxide, except without the side effects and risk of developing tolerance. Green tea can be added to face washes, cleanses and a cup or two of green tea every day does the good work from within!
- APPLE CIDER VINEGAR
This potent agent has gotten rave reviews for very many reasons. Apple cider vinegar has antibacterial and anti-inflammatory properties that make it ideal for treating acne. It contains malic and lactic acids that help to balance out the pH of the skin, ease itching, redness, and inflammation, and act as a toner for oily skin.
You can use apple cider vinegar in a plethora of skin care preparations. The most basic use of ACV is a toner that restores the pH of the skin and maintains the integrity of its acid mantle that helps to prevent infections.
- 1/2 cup of apple cider vinegar (organic, pure ACV with the mother)
- 1/2 cup of water/ steeped green tea
- A container for the finished toner, preferably glass and sterilized.
- Tea tree oil/ witch hazel oil/ green tea/ aloe vera (optional)
- Put the half-cup of ACV and half cup of water into the glass bottle and shake together.
- Add a few drops of tea tree oil if you want.
You can apply the toner twice daily, after a bath in the morning and before bed. It can also be used as a makeup remover too, for a deep cleanse. Using this toner will keep your skin balanced and treat acne, even helping to eliminate scarring caused by acme. It reduces the sizes of the pores too.
Some people will find that a 1:1 ratio of ACV and water is too potent for their skin, especially people who have really sensitive skin. In that case, the ratio of ACV to water can be tweaked to accommodate the needs of their skin.
- HONEY AND LEMON SUGAR SCRUB
- One tablespoon of green tea
- 1 tablespoon of granulated sugar/ brown sugar
- 2 teaspoon of raw honey
- 1 teaspoon of lemon juice/ two drops of lemon oil extract.
- Mix all the ingredients together into a paste
- Apply to the skin in small circles until the face is covered, and rub gently into the skin.
- Leave the mask on for 20 minutes and then wash off with warm water
- Moisturise after.
- The sugar scrub can be applied twice a week, and the effects on the skin are visible immediately.
In addition to the green tea and honey’s antibacterial properties, the sugar gently exfoliates the skin while lemon juice also adds to the antibacterial effects and helps to lighten the skin and fade scars.
- BAKING SODA SKIN SCRUB
- 1 teaspoon of baking soda
- 2 teaspoon of honey
- 1/2 teaspoon of coconut oil/olive oil
- One teaspoon of apple cider vinegar (optional)
- Mix all the ingredients together in a paste and apply in gentle, circular motions all over the face. Rub the preparation in thoroughly and leave it on for twenty minutes before washing it off with warm water.
- Moisturise after.
This exfoliating scrub can be applied once a week for best effects and the results are immediate. The skin is softer, less prone to acne, and oil levels are reduced manageable.
- TURMERIC YOGHURT FACE MASK
- 3 teaspoons of Greek yogurt
- 1 teaspoon of raw honey
- 1 teaspoon of turmeric
- Mix all the ingredients together and rub into the skin. Use a cotton ball, as turmeric is incredibly staining.
- Leave the mask on for twenty minutes, and then gently wash off with warm water
- Moisturise after application for best effects.
Turmeric has anti-inflammatory properties and can help with scarring too. It can also help to regulate oil production on the skin, smooth out wrinkles and fade dark circles from under the eyes.
Yoghurt has anti-aging and skin rejuvenating properties. Yoghurt contains lactic acid helps to remove dead skin cells and encourage the proliferation of fresh, new ones. It will reduce wrinkles and fine lines for younger-looking skin.
This mask applied three times a week will work wonders for acne-prone skin.
- CINNAMON/HONEY/ALOE VERA FACE MASK
- 2 teaspoons of cinnamon
- 2 teaspoons of Aloe Vera gel
- One teaspoon of honey
- Mix all the ingredients together and apply on the face in small circles with gentle motions.
- Leave the mask on for ten minutes, and then rinse off with warm water.
Cinnamon is great for removing blackheads and fading scarring on the face. The Aloe Vera is an excellent moisturizer, and the antibacterial effects of the honey help to heal the acne and prevent future outbreaks.
- PAPAYA (PAWPAW) BRIGHTENING FACE MASK
- 2 tablespoons of pawpaw pulp
- 1 teaspoon raw honey
- 1 teaspoon of lemon juice/ 2 drops of lemon oil extract
- 1 teaspoon of coconut/olive oil
- Mix the ingredients thoroughly, making sure that they are blended together properly.
- Rub the mask all over the face and wash off with warm water after ten minutes.
Papaya has skin brightening properties and can help to eliminate scars and dark marks caused by acne. The addition of honey, lemon juice, and coconut oil just makes the facemask pack an extra punch.
The body is a balanced system of many different parts working together, and an anomaly in any of the parts that cause its homeostatic balance to go out of sync is what causes illness of every type. In the case of acne, the GIT has been linked to acne outbreaks.
When there is an imbalance in the ecosystem of the beneficial and malevolent bacteria in the gut, there are several systemic manifestations including the skin. This imbalance can be caused by antibiotics, the diet, and even environmental factors that wipe out the population of beneficial bacteria in the gut. Good bacteria keeps pH balance, helps in efficient digestion, prevents constipation and contributes to the all-around health of the body. If the body is healthy, so your skin will be as well.
Probiotics are fermented foods that help to encourage the proliferation of good bacteria in the gut. They are naturally occurring foods that do not need to be synthesized industrially, cooked or modified. Some examples of these foods are yogurt (natural, non-flavored), kefir and sauerkraut. There are some organic, commercially prepared probiotic food capsules that can also be ingested regularly for the gut and consequently, skin health.
ACNE PREVENTION TIPS
The treatment of acne does not always have to be reactive, it should be proactive too. Preventing future outbreaks is just as important as treating them when they crop up. Thus, there are simple lifestyle changes and tips that can help to modulate the outbreaks, prevent future ones and keep your skin healthy.
- Keep your hands off your face as much as you can. The hands are a hotspot for germs that can be transferred to your skin. The same goes for phones, caps, helmets etc.
- Clean your skin at the end of the day. Use a mild wipe or moisturising astringent (or alternatives like apple cider vinegar and a light oil) to wipe off your makeup, and to clean your skin of the day’s pollutants even if you were not wearing any makeup at all.
- Do not pick at the pimples. That will only cause scarring and make it worse. If you must press it, do so with washed hands and a tissue, and wipe the area afterwards and apply moisturiser.
- Moisturise your face; dryness can cause overproduction of sebum, which will result in acne. Moisturise your face with a water-based product if your face is oily, and an oil-based product if your face is usually dry.
- Make sure your moisturiser has some SPF for sun protection, as exposure to the sun can exacerbate the acne.
- Stay away from dairy and sugar, these mess with hormone levels and sebum production in the body, and cause the proliferation of acne. A diet rich in fruits and vegetables will provide the body with essential vitamins and nutrients that help in cellular regeneration and healthy skin, including aiding digestion and gut health, which can all be linked to a healthier skin. Spicy foods can also exacerbate inflammatory acne, and thus should be avoided.
- Clean your bed sheets and pillowcases often, as they collect oil from the hair and the skin-especially if they are cotton.
- Exfoliate regularly. Exfoliation helps to remove the dead skin cells that can cause acne outbreaks, leaves the skin smoother and softer, and exposes the fresh new skin underneath to prevent clogging up of the pores.
- Exercise helps the blood to flow in the body and promotes the elimination of free radicals-two things that cause the skin to glow in health and vitality. Exercise is very important, especially in our sedentary world of today.
- Be gentle with your skin. Harsh products will only cause the skin to dry out and trigger overproduction of sebum, which will compound the problem. Use hypoallergenic, gentle products that will not be drying or harsh to the skin.
- Before using a new product (soap, face cream, etc) always perform a spot check to make sure that you are not allergic to it.
- Heavy creams that are formulated for the body should not be used on the face. Instead, use natural oils on your face, or buy a facial cream moisturiser that has been formulated to be non-comedogenic, to prevent the heavy ingredients from clogging up the pores and causing acne breakouts.
- When using hair products, try as much as possible to keep them away from the face to prevent contact acne. Rinse out your conditioners thoroughly.
- Wash headgear like scarves and caps and helmets regularly. They can become a breeding ground for the germs and dead skin cells that cause acne.
- When people treat acne, one thing they overlook is patience. The results of these treatments will not be instantaneous. Always give your skin time to heal itself before determining that a treatment does not work. The recommended time frame for skin care treatments is from three to six weeks. The results will be clear in brighter, softer, healthier skin and you will see that those acne breakouts are under control.