Skin, it’s only 5mm thick yet it holds so much of our self-esteem and confidence. Acne can cause real psychological trauma and distress, to treat acne you need to understand the underlying causes.
What Causes Acne?
Acne is caused by the pores in your skin becoming blocked. The pores get blocked with dead skin cells and sebum. If they stay closed they are called whiteheads. If they are open the surface oxidizes and turns black these are called blackheads. If they become inflamed and/or infected they are called acne.
How Does Acne Form?
Your skin is made out of layers and within the top layer of your skin are two types of pores. One is a sweat pore and the other in medical terms, is called a Pilosebaceous Unit (PSU).
The PSU is made up of a single strand of hair, a sebaceous gland which makes sebum that lubricates your skin to keep it moist and also forms a barrier to the outside world. It also has a tiny muscle called an arrector pili muscle and If we magnify a PSU it would look like this:
The epidermis is the top layer of skin.
It is split into four layers the bottom layer is called the basal layer. New skin cells are made in the basal layer of the epidermis.
When more new cells are made they push the older cells up through epiderms.
As these cells travel through the epidermis they get further away from blood supply and die. By the time these cells reach the surface of your skin they have changed shape and now resemble a tiny scale. These scales interlink and form the very top layer of the skin called the stratum corneum.
Stratum corneum is Latin for – horny layer. Because by the time your skin cells get to the surface of your skin they are made up of a lot of keratin. Keratin is the protein that your hair and nails are also made of. It is also what horns are made of – hence the Latin name horny layer.
Four Factors That Cause Acne
Acne starts as micro comedones. These form when skin cells build up around the opening of the pore and trap the sebum. If the sebum can’t escape it builds up and pushes against the walls of the PSU. The more sebum the larger the comedones become. If it doesn’t rupture it is called a Whitehead. If it does rupture the surface of the comedones reacts to the exposed air and turns black – this is called a blackhead.
The second factor that causes acne is hormones. Around puberty, your hormones kick into overdrive and it can take a few years to balance out. Growth Hormone or androgen hormones that are produced at this time can trigger an overproduction of sebum. This overproduction fo sebum puts more pressure on the PSU increasing the risk of rupturing and large comedones or acne forms.
The third factor in causes of acne is the bacteria P. Acnes. This bacteria lives harmlessly on our skin, along with many other types of bacteria. However, when P. Acnes gets trapped in the airtight environment of a PSU it triggers inflammation. This trigger makes the body send white blood cells to fight the infection and as the white blood cells overwhelm the infection pus forms.
This pus, dead skin cells and built-up sebum forms the white material that can be squeezed out of the pore. Don’t do that by the way – its very damaging to your skin and can make acne scarring much worse.
The fourth factor is your immune system triggering inflammation in response to blocked pores.
There are different types of acne but by far the most common is Acne Vulgaris.
When To Seek Medical Advice
If your acne becomes more than you can deal with at home with over the counter products you should see your doctor or dermatologist.
If you experience symptoms of acne, the doctor will make a diagnosis by examining your skin. The analysis will help identify your type of lesions and their severity to determine the best treatment.
The doctor can prescribe medications, which work by reducing oil production or by treating bacterial infection. It takes four to eight weeks to see results and several months for your skin to clear up completely. The treatment process depends on your age, severity, and what you are willing to commit to. Treatment can include:
Topical medications such as lotions, creams, and gels containing retinoic acids or tretinoin are used to treat more severe acne.
These include medications such as antibiotics, combined oral contraceptives, and anti-androgen, which are used for moderate to severe breakouts. Antibiotics work by killing bacteria and reducing redness and inflammation. Combined oral contraceptives are FDA-approved for use as contraception as well. Anti-androgen agents can also be used and work by blocking the effect of androgen hormones on the oil-producing glands.
Advanced Treatments for what causes acne
To treat severe conditions and prevent scarring, your doctor may recommend treatments that work by removing damaged skin and reducing oil production. They can include light therapy, chemical peels steroid injections, and extraction.
Skincare Products That Can Help Treat, and Prevent Acne.
When it comes to treating your acne at home, there is no shortage of options!
Many skincare ingredients are now formulated to not only treat acne but the scaring and hyperpigmentation that acne can cause.
You may think that if you have acne your skin is oily and tough. This is usually not the case. You can have acne with dry skin. Also, acne makes your skin sensitive, so always treat it gently. There is no need to treat your acne with harsh abrasive chemicals.
Nearly every skincare brand will have a line of product specifically targeting acne.
The Ordinary has many products that help with acne. You can learn more about what I think are the 6 best ordinary products for treating acne.
La Roche Posay has a line of products called Effaclar that are made specifically for acne and sensitive skin. This range is recommended by a dermatologist from around the world.
What OTC Ingredients Should I Use For Treating Acne?
Benzoyl Peroxide: This ingredient kills the bacteria that cause acne as well as removing excess sebum from the skin.
Azelaic Acid: Gently exfoliates the skin and you want to do that with acne because you need to keep you pores free from build-up and azelaic acid is really good at doing that gently.
Niacinamide: Is a skincare marvel and not only does it clean out pores of sebum, skin cells and environmental pollution it also has UV protection benefits. Oh, and it also blocks and reduces hyperpigmentation.
Ferulic Acid: Has no known side effects and also helps reduce pigmentation caused by acne. Ferulic acid also helps activate other ingredients and makes them more potent when treating acne.
Retinol: Retinol has a long history with the treatment of acne. You might have heard of a product called Retin A. It was discovered in the 1960s and prescribed for the treatment of severe acne.
Retin A worked well in treating acne but it did have a lot of side effects. These included extreme irritation, dryness, skin purging and hyperpigmentation. The science of skincare has come a long way and now there are hundreds of retinol/retinoids on the market.
If possible you should include retinol in your skincare routine when dealing with acne.
Moisturizer and sunscreen: Even if you have oily skin you need to use a moisturizer in your skincare routine. This is because a lot of the products used to treat and combat acne will dry your skin out.
As always you need to use sunscreen every day, chose one that is non-comedogenic (doesn’t block pores).
Acne Is Not Skin Purging
Skin purging happens when your skin sheds the top layer of skin quickly. Very often happens when you introduce retinol/retinoids into your skincare routine.
Skin purging can look a lot like an acne outbreak but it differs in a few ways. Firstly its a response to a new product so you can pinpoint exactly when it started. With acne it’s random.
Fortunately, skin purging is temporary as your skin adjusts and should clear up in 2 – 6 weeks. Acne is often a long process to resolve.
Skin purging is usually accompanied by flaking and peeling skin. Unless you are using harsh chemicals or Retin A your skin does not flake or peel with acne.
What Is A Good Skincare Routine For Treating Acne
When it comes to acne you want to keep sebum, bacteria and dirt out of the pores. You also want to protect your skin from moisture loss and UV damage.
Your morning skincare routine will vary from your nighttime routine because certain acne busting ingredients don’t like each other so you have to separate them.
Suggested Skincare Routine For Treating Acne AM:
Suggested Skincare Routine For Treating Acne PM:
The bottom line on What Causes Acne
Acne is caused when the pores in your skin become blocked with sebum, dead skin cells and bacteria.
Keeping the pores clean and clear and treating the hyperpigmentation and scarring that can accompany acne is vital. Your self-esteem can take a battering when you have acne, but with some good acne busting ingredients and a sound skincare routine, you don’t have to let acne ruin your day.