Let's Talk About Acne

 A situation that is no doubt familiar to most people across all age ranges and all societies is waking up in the morning to a new, swollen, red bump on your face. What are these pesky marks, and how do they occur? More importantly, what can be done to avoid them? 

Acne Vulgaris, more commonly known as Acne, is the medical term for the pimples we have all experienced. Dermatologists categorize acne based on how it is formed. Before understanding the types of acne, it is crucial to comprehend the structure of our skin. The clogging and subsequent inflammation and infection of the hair follicle cause acne. A hair follicle is a tiny, tube-like structure in the skin that produces and contains hair. It’s found in the dermis layer of the skin and extends from the surface into the deeper layers of the skin. Connected to the hair follicle, the sebaceous gland produces sebum (an oily substance) that helps lubricate and protect the hair and skin. Sebum can clog the hair follicle, allowing bacteria and dead cells to build up and cause inflammation.

The various types of acne include:

Whiteheads: These small, white bumps occur when hair follicles are clogged with sebum and dead skin cells but remain closed at the surface. 

Blackheads: Dark spots that appear when hair follicles are clogged, and the surface is open, allowing the sebum and dead skin cells to oxidize and turn black. Whiteheads and blackheads are the two categories of noninflammatory acne, and neither involves the production of pus underneath the skin. 

Papules: Small, red, raised bumps that occur when the walls of the pores become inflamed. They are often tender and can be a sign of early inflammation.

Pustules: Similar to papules but filled with pus. They are red at the base with a white or yellowish center, indicating an infection and inflammation.

Nodules: These are large, painful, solid bumps that form deep under the skin. They occur when there is severe inflammation, and the pores are deeply clogged.

Cysts: Large, painful, pus-filled lumps also occur deep under the skin. They can cause significant scarring and represent the most severe form of acne.

Congestion: Although not always categorized as acne, congestion refers to a buildup of dead skin cells and sebum in the pores, which can lead to blackheads and whiteheads.

The most common demographic of acne sufferers is teenagers. Hormones called androgens, including testosterone, prompt sebaceous glands to produce sebum. Testosterone and other androgens that become estrogen are also produced in women. During puberty, the body ramps up androgen production leading to higher sebum production by the glands. This excess sebum, combined with dead skin cells that are naturally shed as part of the skin's regular renewal process, can clog hair follicles. Additionally, other factors that alter hormone levels, such as pregnancy, menstrual cycles (including menopause), and specific medical conditions, can also trigger acne. While teenagers are disproportionately affected by acne, it is a common misconception that it necessarily ends once adolescence is over.

To address the issue of acne, the most effective long-term solution is an analysis of lifestyle habits that could cause increased sebum production and pore-clogging. Some studies suggest that certain foods, like high-glycemic-index foods, such as refined flour products, sugary foods, and dairy products, might exacerbate acne. Another factor that often leads to acne is high stress levels, which can trigger hormonal changes that may lead to increased oil production and acne flare-ups. Inadequate skin cleansing can also lead to oil and dead skin cells buildup, increasing the risk of acne.  These factors can be controlled by maintaining a healthy diet, lifestyle, and hygiene practices. Some factors, such as hormonal changes, cannot be avoided but can be treated through the use of topical ointments and oral treatments as prescribed by a dermatologist or purchased over the counter. Regardless, 85% of people have experienced this frustrating condition at some point in their lives, so just know you are not alone in this encounter.

Written by Sohani Ramnani

Edited by Saranyah Kannuchamy

References:

1. "Acne (Acne Vulgaris).” Yale Medicine, Yale Medicine, 22 Sept. 2023, www.yalemedicine.org/conditions/acne. 
2. Cherney, Kristeen. “Pimple Pus: What It Is, How to Treat and Prevent.” Healthline, Healthline Media, 29 Oct. 2019, www.healthline.com/health/pimple-pus#what-is-pus. 
3. Harth, Dr. Yoram. “Acne Statistics – Update.” MDacne, www.mdacne.com/article/acne-statistics-update. Accessed 3 Aug. 2024.