Acne

Everyone gets the odd pimple in life. However, full-blown acne can impact self-esteem. Teens and adults alike should control acne to reduce the risk of permanent acne scars. Find out how to get rid of acne.

What is acne?

Acne is a skin condition that appears in a number of forms, such as comedones (blackheads and whiteheads), papules, pustules, nodules and cysts.

Acne is caused by excess sebum, an oily substance produced by the sebaceous glands. Sebum hydrates the skin and keeps it supple.

When the sebaceous glands produce too much sebum, it accumulates in the skin’s pores. Sebum mixed with dirt on the skin then plugs up the pore.

Clogged pores can become infected with bacteria, which leads to inflammation  (showing up as redness and swelling) and causes acne.

The face and neck are where acne tends to flare up the most. The shoulders, back and arms are other acne-prone areas of the body.

 

What causes acne?

Several factors may make you more prone to getting acne:

  • Heredity. If your parents had acne, you’ll be more at risk of getting it too.
  • Adolescent hormonal changes. During adolescence, the body produces more sex hormones. For example, in boys, testosterone stimulates the production of sebum and the formation of sebaceous glands, which promotes the formation of blackheads and pimples.
  • Hormonal variations in women. For some women, hormonal changes during the menstrual cycle can trigger pimples the week before the menstrual period. Women can also develop acne during pregnancy or menopause.
  • Strong emotions (stress, anger). Strong emotions increase the secretion of cortisol, a hormone that stimulates sebum production.
  • Sweating. Abundant sweating can tighten pores and make them prone to clogging.
  • Dry skin. Dry skin is easily  irritated and reacts by increasing sebum production.
  • Excessive skin friction. The skin can become irritated by friction from things like sports equipment or clothes that are too tight (such as tight jeans) or clothes made of coarse material.
  • Certain medications. A number of drugs can cause skin breakouts. These include corticosteroids, some oral contraceptives, and a few anticonvulsants. The table below is a short list of drugs that can cause inflamed blemishes or make them worse. Don’t hesitate to talk to your pharmacist to find out if one of your medications can cause acne.

Medications that can cause or worsen acne

Indication Medication
Hormone Corticosteroids
Androgen
Some oral contraceptives
Epilepsy  Phenytoin (DilantinTM)
Phenobarbital
Antibiotic  Sulfamethoxazole/trimethoprim (SeptraTM)
Cephalexin
Mood regulator Lithium
Immunosuppressant
Anti-rejection drug for organ transplants 
Azathioprine
Cyclosporine

Does junk food cause acne?

Contrary to popular belief, no scientific studies have shown a link between acne and eating chocolate or fatty foods like French fries or potato chips. However, you should still adopt a healthy lifestyle and eat a healthy and balanced diet.

Tips and advice

By avoiding acne triggers and adopting the following daily skin care routine, you can better control your acne.

Skin hygiene

  • Cleanse your face twice a day with a soap or mild cleanser that is non-irritating and unscented. Avoid washing your skin too often, rubbing too hard or using an exfoliant, as irritation can aggravate acne.
  • After cleansing, apply a moisturizer if you need one. Use lotions if you tend to have oily skin and creams if your skin is dry.
  • Don’t touch your pimples or blackheads, as you might make them worse. Tip: Count the number of times you touch your face in a day to help you get rid of this bad habit!

Body hygiene

  • Regularly wash your hair, particularly if it tends to be oily.
  • Tie your hair back from your face, especially when you sleep.

Cosmetics

  • Avoid using oil-based cosmetics, which can include concealers, liquid foundations, hair pomades, hair oils, hair sprays, etc. Instead, look for products that say “oil free” or “non-comedogenic” (i.e., they don't promote blackheads). Also, use alcohol-free skin products.
  • Always remove your makeup at the end of the day.
  • If you use a topical acne treatment, you need to cleanse your skin before applying this product. After using the product, apply a moisturizing cream or lotion. Put makeup on last.

Shaving

  • Shave your beard in the direction of hair growth, and use a new blade each time. Don’t shave the same area more than once.

Acne treatment

Acne needs to be treated as soon as it appears so that you can better control it and prevent long-term complications, such as scarring.

Mild acne can be treated with over-the-counter (OTC) medications, whereas more severe acne requires a doctor’s prescription.

OTC medications

The most effective OTC medication is benzoyl peroxide. It works by killing bacteria. It should be applied to the entire affected area to prevent new pimples. You should start the treatment gradually to reduce any possible irritation. This product makes the skin sensitive to the sun(lien à la fiche sur la protection solaire) and can discolour clothes and hair. You should see an improvement after 4 to 8 weeks of regular use. However, if you don't see any improvement after 6 to 8 weeks, you should consult a doctor.

Other OTC products, which contain salicylic acid or resorcinol, are much less effective.

Prescription medications

Two  types of topical medications (i.e., medications applied locally to the skin ) are available with a prescription: vitamin A derivatives (retinoids) and antibiotics. These products are sometimes combined with benzoyl peroxide to increase their effectiveness. They decrease skin inflammation, and retinoids may also assist in the skin’s healing process. They need to be applied to the entire affected area, and treatment must be started gradually. Note that your acne may also get worse at the start of treatment. As with benzoyl peroxide, it can take up to 8 weeks of regular use before you see an improvement.

If these treatments don't work or if your doctor feels that you need a more aggressive treatment, he or she may then recommend oral antibiotics. These are more effective than topical antibiotics, and they act by killing bacteria in the skin . However, they may cause  gastrointestinal side effects (e.g., nausea or diarrhea).

For severe acne, the most effective drug is isotretinoin (AccutaneTM or ClarusTM). However, this medication may cause birth defects and many adverse effects. It really dries out the skin, eyes and mucous membranes (mouth and genitals). It can also change liver function and cause headaches and muscle pain. For some people, it can also cause mood changes or, in extreme cases, depression. Isotretinoin is therefore only used for the most severe cases and when other treatments have failed. It is taken in cycles , which can be repeated after periods of cessation. This medication requires close monitoring by your doctor.

Low-androgen index oral contraceptives  can also help treat acne in women, but this type of medication can take up to 3 to 6 months to be effective.

Your skin is a barrier that protects you from the outside world. You need to take care of it, especially when problems like acne flare up, as this condition can leave permanent scars. If you suffer from mild or severe acne, see your pharmacist for advice.

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