Acne

Acne is a prevalent skin condition affecting millions globally, is more than just a collection of pimples; it's a complex interplay of biological factors impacting skin health. 

These often painful and pus-filled bumps can impact individuals of all ages, with teenagers and young adults being the most commonly affected.

Acne is a long-term skin condition that can affect the face, back, and neck. It is characterized by oily skin, whiteheads, blackheads, and inflamed spots that can be painful to touch.

The condition can also cause people to be embarrassed and lack confidence. Acne is most common in people aged between 11 and 30.

Understanding Acne

Acne, scientifically known as acne vulgaris, is a multifactorial skin disorder characterized by the formation of blackheads, whiteheads, pimples, nodules, and cysts.

The primary actors include hair follicles, sebaceous (oil) glands, dead skin cells, and bacteria. When these elements converge, they create a breeding ground for acne.

Who Gets Acne?

While acne affects people of all races and ages, it is most common in teenagers and young adults. Teenage acne is more prevalent in males, but adult acne, especially hormonal variants, is more common in women.

Acne Treatment: Acne is treatable, there several effective treatments for acne available at Ashcroft Pharmacy including  Differin, Epiduo, Lymecycline, and Oxytetracycline.

Types of Acne:

There are two types of acne: Commedonal acne and inflammatory acne.

Comedones: Comedonal acne is small bumps that appear on the forehead or the chin giving you rough skin. Examples of these bumps include Whiteheads, blackheads, micro comedones, solar comedones, macro comedones, and giant comedones. This type of acne is common in young adolescents.

Inflammatory Acne: They are inflamed pus-filled pimples found deep into your skin. Examples of inflammatory acne blemishes include Nodules, cysts, and pustules.

Differences Between Inflammatory and Comedone Acne

Inflammatory Acne: 

• Pimples appear deep in your skin surface
• Pimples are swollen, painful, and contain pus
• Common in all types of ages 
• Pimples may appear in the form of pustules, cysts, or nodules
  

Comedone Acne:

• Blemishes appear closer to your skin surface 
• Blemishes aren't swollen or painful 
• Common in young adolescents 
• Blemishes may appear in the form of blackheads or whiteheads 

Acne-Resilient Lifestyle

The amount of sebum in your skin is directly influenced by your lifestyle. Practicing a healthy lifestyle will help you maintain smooth, naturally glowing skin. Some of the lifestyle tips that you can adopt include:

1. At-Home Skincare routines for acne:

• Gentle Cleansing: Regular cleansing with mild products aids in controlling oil and preventing clogs.
• Moisturization: Always use Non-comedogenic, oil-free moisturizers to maintain skin hydration.

1. 2. Preventive Measures

Dietary Choices: While the direct link between diet and acne is debated, a balanced, nutrient-rich diet is generally beneficial.

Foods that raise your blood sugar quickly cause your body to release IGF-1 hormone, excess of this hormone in your blood causes your oil glands to produce more sebum, increasing acne.

White sugar, pasta, and white bread are a few examples of blood sugar foods that you can avoid in your diet.

Lifestyle Adjustments: To prevent acne practice stress management, regular exercise, and avoid pore-clogging substances contributing to acne.

Diagnosis and Evaluation

Your healthcare provider can diagnose your symptoms by enquiring about your medical history, and physical examination and later evaluate your results by taking a lab test.

Diagnostic Approaches

• Medical History: Healthcare providers inquire about your family history, hormonal changes, and medication usage.
• Physical Examination: Skin assessments help in categorizing acne types and evaluating severity.
• Laboratory Tests : In typical acne cases, lab tests are seldom necessary. However, they may be recommended if unusual presentations or underlying conditions are suspected.

Acne is caused by the overgrowth of a bacteria called P. acnes on the skin and is linked to changes in hormones. Hormones called androgens control the amount of oil released onto our skin.

A hormone imbalance means there is a high level of production of the hormone, which causes blockages in our pores, resulting in spots and oily skin.

The hormone imbalance varies in individuals and can be due to many factors such as stress, weather, pregnancy, puberty, or a woman’s menstrual cycle.

Some of the things that trigger acne include:

Sebum Overproduction: Overactive sebaceous glands contribute to excess oil, a key player in acne formation.

Dead Skin Cell Accumulation: When keratinocytes, skin cells, cling to your hair follicles, they impede natural shedding, promoting clogs.

Bacterial Influence: Propionibacterium acnes, a bacterium thriving on the skin, exacerbates inflammation within clogged pores.

Factors Leading to Acne: Some of the factors that lead to acne include:

• Hormonal Flux: Androgen hormones, particularly testosterone, surge during puberty, triggering increased sebum production.
• Genetic Predisposition: Family history plays a role, suggesting a genetic component in acne susceptibility.

Best Acne medications

• Skinoren 20% Cream
• Lymecycline 408mg Capsules
• Differin 0.1% Cream/Gel | Treat Acne
• Oxytetracycline 250mg Tablets
• Treclin Gel

Acne Treatment Strategies: There are different strategies that you can use to treat acne. Below are some of the most common acne treatment strategies.

1. Topical Medications

• Benzoyl Peroxide: This product is used to treat mild to moderate acne and works by killing the bacteria causing acne hence reducing sebum production.
• Salicylic Acid: It is a topical medication accessible in the form of gel, lotion, or cream. Salicylic acid works by exfoliating and unclogging pores.
• Retinoids: They are derived from vitamin A, and they work by unclogging pores, promoting skin renewal, and reducing inflammation.

2. Oral Medications

• Antibiotics: Work by tackling bacterial overgrowth and inflammation by killing bacteria on the skin that can infect plugged hair follicles.

•  Isotretinoin: It's a potent oral retinoid reserved for severe cases and works by regulating oil gland size.

3. Hormonal and Birth Control Therapies

• Contraceptives: Hormonal birth control may regulate sebum production.

•  Anti-Androgen Medications: Spironolactone may be prescribed for hormonally influenced acne.

4. Procedural and Laser Treatments

• Chemical Peels: Facilitate exfoliation and improve skin texture.

• Laser and Light Therapies: Target acne-related inflammation and scarring.

There are six types of spots (listed below) that may appear. All six may not be present at once in an acne breakout.

• Nodules - painful spots under the skin
• Pustules - red spots that may feel tender
• Whiteheads - white spots on the skin that are difficult to squeeze
• Blackheads - black spots on the skin that get their color from the hair follicle’s inner lining
• Papules - pus-filled red spots with a white center
• Cysts - large spots that contain pus and cause scarring

Signs and Symptoms: You will notice changes in different parts of the skin if you are suffering from acne. Some of the most affected parts of the skin include the face, arms, legs, and shoulders.

1. Non-Inflammatory Lesions
   a. Comedones

• Blackheads: They are open comedones that develop when hair follicles are clogged but remain open, resulting in darkened plugs on the skin surface.
• Whiteheads: Closed comedones where follicles are clogged, leading to small, white, or flesh-colored bumps beneath the skin.

1. 2: Inflammatory Lesions

• a. Papules: They are small, raised, red, or pink bumps on the skin. They are tender and appear inflamed.
• b.Pustules: Similar to papules but topped with white or yellow pus. They appear red at the base causing discomfort.

• c. Nodules: They are large, solid, painful lesions lodged deep within the skin. They are a sign of severe acne that requires medical intervention.

•  d. Cysts: Cysts are fluid-filled, pus-containing lumps under the skin. They are painful and lead to scarring if not managed well.

3. Additional Symptoms

• a. Redness and Swelling: Commonly occurs around inflammatory lesions. The skin may appear inflamed, warm to the touch, and exhibit varying degrees of redness.
• b. Itching and Discomfort: You may experience itching or discomfort, particularly with heightened inflammation.
• c. Flare-ups: Acne symptoms can vary in intensity, with periodic flare-ups. Flare-ups are Influenced by hormonal changes, environmental factors, and lifestyle choices.

Potential Complications

• a. Scarring: Acne can lead to atrophic, hypertrophic, or keloid scars, affecting skin texture. You can minimize scarring through timely and effective acne management.
• b. Hyperpigmentation: They are Dark spots that form after acne lesions heal. You can manage them by using a sunscreen or using treatments that help in fading hyperpigmentation

Duration of Symptoms: Symptoms vary with time. Some lesions may clear within a few weeks while some are persistent or recurrent and require regular management.