What is Acne?
Acne is a chronic inflammatory disease of the pilosebaceous follicles (i.e. Hair with oil producing glands attached to hair) characterized by comedones (blackheads and whiteheads), papules, pustules, nodules and ultimately leading to scars.
Who gets Acne?
Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple regardless of race or ethnicity. Acne starts between the ages of ten and fifteen years of age and usually lasts till twenty years of age; however, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults and this is known as adult acne.
What are the causes of Acne?
Bacteria: Bacteria that normally lives on the skin plays a role in acne development. The bacteria are known as propionibacterium acnes (p. acnes). The bacteria content can increase in people whose faces are not clean.
Hormones: During the teen years increased levels of sex hormones causes the oil glands of the skin to produce increased amount of oil. These excess skin oils tend to bind with cellular debris causing a blockage and producing a fertile environment for the bacteria to grow. The bacteria causes inflammation, pus, swelling and redness. In adult acne, excessive hormones produced due to polycystic ovaries and other hormonal imbalances causing excess oil production and inflammation, which leads to acne.
What are the factors that precipitate or aggravate acne?
- Stress- Stress is frequently implicated in aggravation of acne while acne itself induces stress.
- Sweat- Sweating in a hot and humid environment causes deterioration in 15% of acne patients.
- Menstruation- Premenstrual flare of acne occurs in 70% of female acne patients.
- Friction and pressure- Friction and pressure from helmets, backpacks and tight collars can induce blackheads and papules. Pressure from face massages or facials can aggravate acne.
- Pregnancy- Pregnancy has an unpredictable effect on acne. Pre-existing acne may aggravate or remit during pregnancy.
- Diet- High glycemic load foods (sugar loaded and starchy foods), oily foods may aggravate acne.
- Drugs- Oral contraceptives, anti tuberculosis medication, oral steroids, antidepressants may aggravate acne.
Treatment for acne needs to be individualized as per the type of acne and type of your skin.For comedones, we recommend comedone extraction procedure.For red papules, we recommend topical creams, chemical peels and oral antibiotics as per severity. For nodules [big swelling], intralesional steroid injections work fastest and are safe.For scars, there are various procedures like dermaroller [microneedling], subcision, deep chemical peels and lasers. Total duration of treatment for acne varies from 2 to 4 months for complete cure and for acne scars varies from 8 to 12 months. I recommend you to consult qualified dermatologist to prescribe you correct treatment that suits you the best after examining your skin.