The 5Ws and 1Hs about Acne: What You Should Know to Solve it

What is acne?

Acne happens when your hair follicles become clogged with oil and dead skin cells. It causes whiteheads, blackheads or pimples. Infected and inflamed acne can manifest as bigger cystic and nodular acne.

What types of acne are there?

There are different types of acne: papules, pustules, cysts and nodules. 

1. Blackheads: which are open comedones, typically clog up and remain open, the superficial layer gets dark and creates a blackhead. 
2. Whiteheads: are closed comedones where the follicle is completely blocked with sebum. If a pore clogs up, closes but bulges out from the skin, it results in a whitehead. 
3. Papules: a papule is a raised, inflamed area of skin forming small red or pink bumps on the skin. 
4. Pustules: Pustules are another kind of inflamed pimple which is typically filled with white or yellow pus. 
5. Cystic Acne:  Cysts are large, painful, pus-filled lesions which look similar to boils. These are considered a severe form of acne. 
6. Nodules: large, inflamed bumps that are very firm and often painful.

Why does it happen? 

A comedone, or basic acne lesion, is a hair follicle that has become clogged with oil and dead skin cells.

There are many triggers why you may get acne. Some of the more common reasons include factors like your puberty, diet, makeup, skincare, sleep and even genetics. 

During puberty, there is a major hormonal imbalance, with a surge in testosterone and changes in our bodies. These hormones stimulate the sebaceous glands in our body to make more sebum and the glands can become overactive. When there is too much sebum, oil clogs up the pores and leads to acne. However, adult hormonal acne commonly affects females even after puberty as hormones fluctuate with the menstrual cycle, pregnancy and even perimenopausal.

Sugar causes your body’s insulin levels to elevate that lead to a burst of inflammation that goes throughout your entire body. Consuming too much sugar damages collagen and elastin which are the components that keep your skin taut and elastic. As sugar is processed, it causes overproduction of oil and dehydrates your skin, contributing to the formation of acne. 

Another reason for acne could be the lack of sleep. With less sleep, cortisol, a stress hormone is released, this encourages inflammation to the skin, leading to acne breakouts. Generally, 7 to 9 hours is an ideal amount of sleep everyone should get.

How to get rid of acne?  

1. Laser and light – treating pigmentation, reducing acne redness
   Lasers release single wavelengths light that enters the skin and helps improve the appearance of acne scars and pigmentation. Different lasers have various effects on the skin, targeting different skin problems. At Nuffield, we provide PICO laser treatment, which effectively treats post-inflammatory hyperpigmentation (PIH). By targeting hair follicles where the sebaceous glands are, PICO laser is a method where acne can be reduced by shrinking oil glands. Click here to read more about the PICO laser treatment. LED light is usually used to reduce inflammation and kill acne-causing bacteria. For instance, blue LED light targets issues such as wrinkles, scars, and persistent wounds, among other conditions. It promotes healing and kills bacteria. Studies show evidence for the effectiveness of blue light treatments for people with mild to moderate acne. With LED directly targeting these problems, it helps to reduce the chances of active acne. Another form of light therapy is Photodynamic therapy (PDT), commonly used for unwanted hair removal, which includes Intense Pulse Light (IPL). Unlike lasers, IPL releases light in many different wavelengths. Pigmented cells in your skin absorb the light energy, which is converted into heat. The heat destroys the darkness of the pigment, which aids in targeting redness, reducing inflammation and helps diminish pigmentation. This way, hyperpigmentation gradually lessens. 
2.  LED Light + Oxygen (OxyAcne) – killing acne bacteria
   As aforementioned, LED light is a very effective technique used to reduce inflammation and active acne. A similar treatment we offer at Nuffield Aesthetics combines the use of LED light together with oxygen in the form of a facial. Oxygen is known to accelerate wound healing and also kill acne-causing bacteria. With the LED light targeting pigment and bacteria, the oxygen helps in doubling that effect. As acne treatment commonly dries the skin, the oxygen in the facial assists in hydrating the skin by infusing the serums into the skin. This makes your skin look and feel hydrated.
3. Mechanical removal of clogged pores – exfoliate the skin 
   Our next acne treatment is a chemical peel facial. Generally, chemical peels are recommended to treat acne scars. However, light-duty chemical peels work in cases of moderate to severe acne. Primarily, these peels help to gently exfoliate the skin using an alpha hydroxy acid (AHA) or beta-hydroxy acid (BHA) depending on what your skin needs. AHAs are water-soluble acids which are primarily used for mild hyperpigmentation like age spots, melasma, and scars, enlarged pores, fine lines, surface wrinkles, and uneven skin tone. Some AHAs typically used to cure acne are glycolic acid and lactic acid. Glycolic acid is an AHA that comes from sugar. It has small molecules which makes it easier to penetrate the skin. This means its effects show over a shorter time. It is very strong so beginners might want to start by using a milder product like lactic acid or mandelic acid. Lactic acid is a product derived from dairy. Due to its big molecules, it is found to be a gentle exfoliator than other AHA products to improve the texture, appearance, and pigmentation of the skin and lighten acne scars. It is usually used as an anti-wrinkle and pigmentation-fighting ingredient part of the skincare regime. It is a milder exfoliator which is more suitable for sensitive skin.On the other hand, BHAs are oil-soluble. Unlike AHAs, BHAs can get deeper into the pores to remove dead skin cells and excess sebum. It also assists in improving skin texture, speeding up skin cell renewal, and cleaning out pores of acne, etc. This helps to target acne more effectively.As an oil-soluble acid, a BHA product exfoliates the topmost layer of your skin. It also penetrates deeper, breaking deep-set comedones (bumps under your skin that will become acne). This makes BHAs great for treating whiteheads and blackheads. It’s considered to be one of the best treatments for acne scars for its anti-inflammatory and antimicrobial properties. Some common examples of BHA include salicylic acid and citric acid. Salicylic Acid is a popular BHA which helps clear pores, reduce swelling and redness, and exfoliate the skin when applied topically. Although considered to be much gentler than AHA, you may experience adverse side effects if your skin is unable to take it. These effects include redness, stinging/burning, itching, and general skin irritation.
4. Topical Creams & Medications – reduce active acne

Other than the previous in-depth treatments, we offer prescribed topical creams and oral medications. Typically, we provide antibiotic creams and retinoids to be applied directly to the skin once or twice a day. For antibiotic creams, popular and effective creams are tazarotene (Tazorac) and adapalene (Differin). Retinoids contain vitamin A which helps regulate cell turnover which in turn reduces the clogging of pores and acne.

Benzoyl peroxide 

Benzoyl Peroxide often comes in many forms; acne creams, gels and facial washes. It usually works by drying out existing pimples and preventing new ones. Benzoyl peroxide works by peeling away the skin to get rid of dead skin cells, excessive oil, and bacteria that may be trapped underneath.

Some of its side effects include dryness, redness and excessive peeling. You might notice itching and general irritation at the site of application too. 

There are products with various concentrations of Benzoyl Peroxide that best suit you according to the sensitivity of your skin. You are advised to see a dermatologist to get the best recommended level for your skin. 

Oral medications

Oral medications are also another way acne is treated. We provide antibiotics, isotretinoin, birth control pills and Aldactone.

Antibiotics can help with treating acne. They work by reducing the bacteria on the skin surface and in the follicles and have anti-inflammatory properties. They are usually prescribed to those who are suffering with mild to moderate acne which needs to be taken for a few months to years depending on the severity of acne. They may have side effects like dryness in the skin and increased sensitivity to the sun. 

Birth control pills can also be prescribed for acne. The hormones in combination birth control pills can help reduce acne. These pills decrease the circulation of androgens (testosterone), which also helps in reducing the production of sebum. The hormones in combination birth control pills can help reduce acne. Some side effects include nausea, vomiting, weight gain, changes in your period. 

We also provide Aldactone sold as Spironolactone is a diuretic which aids in removing fluid from your body. It targets the hormones that cause acne in women. This is commonly recommended to women as it decreases the production of testosterone which may not be ideal in men. Some of its side effects include increased urination, changes in your menstrual cycle, breast tenderness and fatigue.

Lastly, Isotretinoin, better known as Accutane, is used for severe acne such as nodular, pustular and cystic acne where other treatments have not helped. Mainly targeting clogged pores, bacteria, inflammation and controlling oil production, it works by decreasing the size and the amount of the sebaceous glands. With less oil, chances of clogged pores decrease which aid in improving the appearance of acne. However, isotretinoin has many side effects like chapped lips, increased sensitivity to sunlight and itchiness. To find out if you need this medication, you can opt for a consultation with Dr. Sau. 

No one laser or treatment can cure acne. A variety of treatments need to be combined to treat acne. 

Home remedies

Some common acne fighting products include benzoyl peroxide, tea tree oil, salicylic acid and aloe vera which work in their own unique ways to get rid of pimples. 

1. Benzoyl peroxide 
   Benzoyl Peroxide often comes in many forms; acne creams, gels and facial washes. It usually works by drying out existing pimples and preventing new ones. Benzoyl peroxide works by peeling away the skin to get rid of dead skin cells, excessive oil, and bacteria that may be trapped underneath.Some of its side effects include dryness, redness and excessive peeling. You might notice itching and general irritation at the site of application too. There are products with various concentrations of Benzoyl Peroxide that best suit you according to the sensitivity of your skin. You are advised to see a  dermatologist in order to get the best recommended level for your skin. 
2. Aloe Vera 
   This ingredient is a very popular remedy for acne. Aloe vera is an anti-inflammatory plant. It contains a compound called “aloesin” which also helps to reduce inflammation and hyperpigmentation in acne scars. It also promotes healthy skin cell growth and hydrates and moisturises the skin. It can be used as a spot treatment on smaller areas or applied to an entire area of skin. Other than acne, aloe vera is very effective in treating sunburns and moisturising the hair.
3. Tea Tree OilTea tree oil is used for spot treatment to be placed only on the pimples. It is very effective for anti-bacterial and antimicrobial properties which aid in reducing skin inflammation.Using this product in high concentration may result in adverse side effects like skin irritation, dryness, flaking, rash and itching so it is important to do a spot test.Apart from home remedies and treatments, keeping your acne at bay boils down to the maintenance. Some things to note include:

• Using a gentle cleanser to ensure that your natural oils are retained. To help prevent oil buildup, you should wash your face once or twice a day. 
• It is important to regularly exfoliate your skin. While that is important, make sure not to over scrub your face as it may disturb the acne and spread it. Choose a gentle exfoliator that does not strip your natural oils.
• Most importantly, do not pop or burst your pimples. That causes pigmentation and acne scars (acne pits). It can be difficult to get rid of these problems. However, if you do need help in getting rid of acne scars and pigmentation, read this. 
• It should be noted that results take time. You should usually be able to see the effects of a new product after 6 weeks.

Why choose Nuffield Aesthetics?

At Nuffield, we care about serving with medical-grade machines. You can trust that our aestheticians and doctors will do their best to target your problem areas complemented by recommendations to maintain your skin with suitable active ingredients and prescription products. With our wide variety of treatments for the face, skin, body and medical facials, you can be sure to find something that will suit your needs. 

Conclusion

Treating acne is a long battle can be frustrating as you need to closely examine your skin to see exactly what is causing your acne.  The common acne is easier to treat once the cause of it is figured out like cutting out sugar from your diet or premenstrual symptoms. However, for more acne prone skin, preventing and cure can be a little tougher. It is crucial to have a skincare regime that helps keep acne at bay. For instance, those with acne-prone skin can use an oil free moisturiser and sunscreen to reduce the chances of breakouts. 

While there are some recognised home remedies, it is highly recommended to seek help from board certified dermatologists for the best possible outcome. It may take several sessions to see desirable results depending on your skin conditions. Seeking professional treatment may work faster and may be more suited for your skin. 

Treatment for acne should be started as early as possible to minimise the risk of permanent acne scarring. When it comes to treating acne and scars it is important to persevere and constantly review your progress. If you are keen on getting more information, please visit the Nuffield Aesthetics clinic for a consultation.