Acne

Introduction

“Acne is a common skin disease, characterized by blackheads/ whiteheads (comedones, pustules, papules) on the face, chest and neck due to clogged pores on the skin with oil, dead skin cells and bacteria.”

Acne (also known as pimples or zits) is a common skin problem that usually presents as skin eruptions that occur due to clogging of skin pores with dirt, bacteria, and dead skin cells. Acne may even contain pus at times.

Pores are tiny holes on the surface of your skin that are connected to oil glands (sebaceous glands) hidden beneath the skin. In acne, either the pilosebaceous glands (oil glands of the skin) or the pores get clogged with excess oil, bacteria (Propionibacterium acnes or P. acnes) and dead skin particles which in turn causes inflammation.

To keep your skin soft and healthy, your glands produce an oily substance called sebum. The sebaceous lipids in the sebum are crucial for waterproofing and lubricating the outer skin and hair. The overproduction of this substance can lead to a host of skin conditions including acne.

Scientific synonyms: Acne Vulgaris, Acne

Non-Scientific synonyms:

Pimples
Zits
Cystic Acne
Pustules
Papules

Disease type:

Acute
Non-communicable

Onset age

Early Adolescence
Late Adolescence
Young Adults

Almost everyone suffers from acne at some point of their life although it is most common in teens and young adults. According to National Institute of Arthritis and Musculoskeletal and Skin Diseases, an estimate of 80% people aged between 11 and 30 years suffer from acne at some point. Acne commonly starts at the beginning of puberty. In most of the people acne disappears at the age of 25, but it can continue even during adulthood due to different reasons. Often, acne arises in adulthood as adult-onset acne.[1]

Organ System: Skin

Sex:

According to American Academy of Dermatology, women experience acne at higher rates than males across all age groups 20 years and older.[2,3]

Causes:

Four main factors that are responsible for acne outbreak are:

Excess oil production
Hair follicles clogged by oil and dead skin cells
Bacteria
Hormonal imbalance

Risk Factors

There are few common and scientifically proven risk factors that can trigger acne:

1. Age (Non-modifiable): Teenage and young adults aged between 11 years and 30 years are at very high risk of developing acne.

2. Gender (Non-modifiable): Women are more prone to have acne due to changes in hormonal levels during menses. During or before periods, women are more likely to have pimples as at that time there is a change in hormones.

3. Family history (Non-modifiable): Acne can run in families. If your parents had acne, it is likely that you will also develop it. According to a study, if both your parents had acne, you are likely to develop a severe acne at an early age. The study also found that if one or both of your parents had adult acne, you are more likely to get adult acne too.

4. Greasy makeup (Modifiable): Oil-based makeup and cosmetics can worsen the pimples that are already present. Moreover, this form of make-up can increase your risk of developing acne.

5. Medications (Modifiable): Certain medications such as steroid-containing medicines (sometimes given to body-builders for muscle growth), lithium (used to treat depression and bipolar disorders) and some anti-epileptic drugs (used to treat epilepsy) can flare up acne.

Symptoms[4]

Acne commonly appears on the face and shoulders. It may also occur on the trunk, arms, legs, and buttocks. Skin changes include:

Whiteheads
Blackheads
Papules (small red bumps)
Pustules (small red bumps containing white or yellow pus)
Cysts
Nodules
Scarring of the skin

Investigations

Your healthcare provider may diagnose acne by looking at your skin. Severity of acne is often characterized as mild, moderate and severe.

For mild acne, normal clinical manifestation can be useful. But for severe cases few tests need to be done. These tests can be:

Hormone tests

Some women are advised to take blood tests to check the hormone levels. These tests may include:

Testosterone
Sex hormone binding globulin
Free androgen index
Dehydroepiandrosterone sulfate
17-hydroxyprogesterone
Synacthen test of adrenal stimulation
LH and FSH test
Prolactin test
Cortisol
Dexamethasone suppression test

Imaging Tests

A pelvic ultrasound test and a CT Scan can be done to detect PCOS in severe cases of adult acne in women.[5]

Treatment

Nowadays, with a better understanding of the factors that lead to the development of acne, it has become easier to decide the most suitable treatment procedure. Treatment of acne is directed towards known pathogenic factors such as follicular keratinization, increased production of sebum because of high androgen secretion, proliferation of P. acnes and inflammation.[6]

The grade and severity of acne plays a major role in determining which of the following treatment alone or in combination is appropriate. Following treatment methods are currently available:

Topical Therapy
Systemic Therapy
Physical Treatment

1. Topical Therapy: Topical therapy is generally given in the treatment of mild to moderate acne. It can be used as monotherapy, in combination and also as maintenance therapy.

Topical retinoids: Topical retinoids are comedolytic and anti-inflammatory medicines. They normalize follicular hyperproliferation and hyperkeratinization. Topical retinoids reduce the number of papules and pustules, and reduce the risk of worsening of acne. Topical retinoids should be initiated as first-line therapy for both papules, pustules and inflammatory acne lesions and should be continued as maintenance therapy to prevent further microcomedone formation.[7]

The most commonly prescribed topical retinoids for acne vulgaris include:

Adapalene

Tazarotene

Tretinoin

These retinoids should be applied to clean and dry skin once at night daily. The frequency of using these retinoids may need to be decreased if irritation occurs. Skin irritation accompanied with peeling and redness may be because of the early use of topical retinoids. This typically resolves within the first few weeks of use. The use of mild non-irritating cleansers and non-comedogenic moisturizers may help reduce this irritation. Alternate day dosing may be used if irritation persists.

Topical retinoids make the stratum corneum (outermost layer of skin, consisting of keratinized cells) thin and have been associated with sun sensitivity. Therefore, the patients are instructed to protect themselves from the sun.

Topical antimicrobials: Use of topical antimicrobials is an effective way of treating acne. These work against P. acnes.[8]

Topical antimicrobials include:

Benzoyl peroxide: Benzoyl peroxide is an oxidizing agent that possesses antibacterial properties and is comedolytic. Benzoyl peroxide products are also effective against C acnes (formerly P acnes). Bacterial resistance to benzoyl peroxide has not been reported. Benzoyl peroxide products are available over the counter and by prescription in a variety of topical forms, including soaps, washes, lotions, creams and gels. Benzoyl peroxide products may be used once or twice a day. These medicines may occasionally cause true allergic contact dermatitis. More often, an irritant contact dermatitis develops, especially if Benzoyl peroxide is used with tretinoin or when accompanied by aggressive washing methods. If intensive erythema and pruritus develop, a patch test with Benzoyl peroxide is indicated to rule out allergic contact dermatitis.

Topical Antibiotics: Topical antibiotics are mainly used for their role against P. acnes. They may also have anti-inflammatory properties. Commonly prescribed topical antibiotics for acne vulgaris include:

Clindamycin

Erythromycin

Dapsone (most recent)

Topical dapsone is a sulfone antibiotic with anti-inflammatory properties that has been shown to be effective for mild to moderate acne. It has a convenient once daily and twice daily application schedule. The major drawback of topical antibiotics is that the body can develop bacterial resistance against antibiotics. Therefore, it is mostly used in combination with other medicines to support the treatment.

Topical clarithromycin, azithromycin and nadifloxacin are available in India but trials for their efficacy and safety are lacking.[6]

Antimicrobials should be combined with topical retinoids for better treatment and greater clearing of lesions.

Combination Therapies: The efficacy of benzoyl peroxide increases when it is used with topical antibiotics, namely, clindamycin and erythromycin.

Erythromycin and benzoyl peroxide

Clindamycin and tretinoin

Clindamycin and benzoyl peroxide

Azelaic acid

Azelaic acid has been shown to help reduce inflammation and may aid in the treatment of post-inflammatory hyperpigmentation. It is present in 10-20% topical creams which have been shown effective in inflammatory and comedonal acne.

2. Systemic Therapy: Patients with mild acne can be treated with topical treatment methods. However, those with moderate to severe acne require systemic treatment. The mainstay systemic therapies for acne are:

Oral Antibiotics: Oral antibiotics are the mainstay of systemic treatment of moderate to severe acne. Following oral antibiotics are used:

Tetracycline

Minocycline

Doxycycline

Sarecycline

Trimethoprim/Sulfamethoxazole

Clindamycin

Daptomycin

Long-term use of oral antibiotics should be avoided as it may lead to resistance as well as some other infections such as vaginal candidiasis.[9]

3. Hormonal Therapy: Hormonal agents provide effective second-line treatment in women with acne regardless of underlying hormonal abnormalities. A number of clinical studies illustrate that hormonal therapy is mainly effective for deep nodules on lower face or back. Estrogen can be used to decrease sebum production. Additionally, it reduces the production of ovarian androgens by suppressing the release of gonadotropins. Oral contraceptives also increase hepatic synthesis of sex hormone-binding globulin, resulting in an overall decrease in circulating free testosterone. Combination birth control pills have shown efficacy in the treatment of acne vulgaris.

Isotretinoin

Isotretinoin is a systemic retinoid that is highly effective in the treatment of severe, recalcitrant acne vulgaris. Isotretinoin causes normalization of epidermal differentiation, depresses sebum excretion by 70%, is anti-inflammatory, and even reduces the presence of C acnes (formerly P acnes).

Therapies/Physical Treatment

Comedone extraction
Chemical peels and microdermabrasion
Intra-lesion corticosteroid injection for acne cysts
High intensity, narrow-band blue light photodynamic therapy
Injectable filters
Laser resurfacing
Derma roller
Subcision
Platelet-rich plasma (PRP)[10]

Management

1. Diet related changes

Healthy diet is always in! Food rich in zinc may reduce your chances of getting acne. [13]

Dairy products and foods with high sugar content (high GI food) may worsen your condition of acne.[11]

High GI foods increases the blood sugar which in turn rises the insulin levels. This can stimulate the oil glands and lead to acne outbreak. People eating low GI food have a lesser chance of getting acne in comparison to those who are taking high GI diet. Several observation studies suggest that few dairy products such as skimmed milk may aggravate acne. Dairy products may make small hormonal imbalance which leads to acne.[12]

There are very few evidences of any link between diet and acne.

As per our dermatologists, healthy diet and lifestyle is always good to reduce the chances of acne.

If you already have acne, then to prevent its worsening you must avoid the following food items:

Dairy products such as skimmed milk
Sugar
White bread
White rice

2. Skin-related tips:

Try not to pick or squeeze your spots. Doing this aggravates the acne and may cause scarring.
Some topical treatments may dry or irritate the skin when you start using them. If your face goes red and is irritated by a lotion or cream, stop the treatment for a few days and try using the treatment less often and then resume gradually.
Makeup may help you gain your confidence. Use products that are oil-free or water based. Choose products that are labelled as being ‘non-comedogenic’ (will not cause blackheads or whiteheads) or non-acnegenic (will not cause acne).
Cleanse your skin and remove makeup with a mild soap or a gentle cleanser and water or an oil-free soap substitute. Scrubbing too hard can irritate the skin and make your acne worse. Remember blackheads are not due to poor washing.[14]
Stress: One should try staying relaxed as excessive stress can lead to fluctuation in hormones. These fluctuating hormones may lead to acne breakout.

Prevention

Some preventive and daily care tips for acne are:

Clean your skin gently with a mild, non-drying soap. If your skin is oily and prone to acne using a face wash which contains salicylic acid or benzoyl can be helpful. Remove all dirt or makeup.
Wash once or twice a day and also after exercising. Avoid scrubbing or repeated skin washing.
Shampoo your hair daily, if it is oily.
Avoid oil-based makeup.Avoid using rubbing alcohol or toners that are very drying to the skin.

Complications

1. Acne scarring

Organ System: Skin

Acne scarring can sometimes develop as a complication of acne when the most serious types of spots, nodules and cysts rupture (burst), damaging the skin surrounding it. Scarring can also occur if you pick or squeeze your spots, so it is important to avoid doing this.

There are three main types of acne scars:

1. Ice-pick scars: These are small, deep holes in the surface of your skin that look as if the skin has been punctured with a sharp object.

2. Rolling scars: These are formed when the scar tissues accumulate under the skin, giving the surface of the skin a rolling and uneven appearance.

3. Boxcar scars: These are round or oval depressions or craters in the skin.

Specialists

Dermatologist

[1]Topics H. Acne [Internet]. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2016 [cited 19 January 2019]. Available from: https://www.niams.nih.gov/health-topics/acne#tab-risk

[2]Women More Likely Than Men To Be Affected By Acne As Adults [Internet]. ScienceDaily. 2007 [cited 9 January 2019]. Available from: https://www.sciencedaily.com/releases/2007/10/071019155627.htm

[3]Skroza N, Tolino E, Mambrin, A. Adult Acne Versus Adolescent Acne. The Journal of Clinical and Aesthetic Dermatology. 2018;11(1):21-25.

[4]U.S.National Library of Medicine.MedlinePlus.[Online]Available from:https://medlineplus.gov/ency/article/000873.h

[5]Dermnet.New Zealand.Investigations-in-acne[Online].Available from:

https://www.dermnetnz.org/topics/investigations-in-acne/

[6]Rathi KS.ACNE VULGARIS TREATMENT:THE CURRENT SCENARIO.Indian J Dermatol.2011.56(1);7-13.

[7]Retinoid therapy decreases the number of comedones and inflammatory lesions by 40%-70%. Haider A.Shaw JC.Treatment of acne vulgaris.JAMA.2004;292(6):726-35.

[8]Strauss JS,Krowchuk DP,Leyden JJ et al.Guidelines of care for Acne vulgaris management.J Am Acad Dermatol.2007.56(4):651-63.

[6]Rathi KS.ACNE VULGARIS TREATMENT:THE CURRENT SCENARIO.Indian J Dermatol.2011.56(1);7-13.

[9]Zaenglein AL,Pathy AL,Schlosser BJ et al. Guidelines of care for the management of acne vulgaris.J Am Acad Dermatol.2016.74(5):945-73.

[10]Kraft J,Freiman A.Management of Acne.CMAJ.2011.183(7):430-5.

[11]Smith RN,Mann NJ,Braue A et al.The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial.J Am Acad Dermatol.2007.57(2).247-56.

[12]Adebamowo CA,Spiegelman D,Berkey CS et al.Milk consumption and acne in teenaged boys.J Am Acad Dermatol.2008.58:787-93.

[13]Rostami MM,Safavi AN,Maleki N et al.Correlation between the severity and type of Acne Lesions with Serum Zinc Levels in Patients with Acne Vulgaris.Biomed Res intl.2014.474108.

[14]British Association of Dermatologists.[Online]Available from:http://www.bad.org.uk/shared/get-file.ashx?id=65&itemtype=document

Key Facts

Usually seen in

Children between 13 to 18 years of age
Adults between 25 to 40 years of age

Gender affected

Both men and women but more common in women

Body part(s) involved

Skin

Prevalence

Worldwide: 9.4% (2015)

Mimicking Conditions

Acne keloidalis nuchae
Acneiform eruptions
Folliculitis
Perioral dermatitis
Rosacea
Sebaceous hyperplasia
Syringoma
Tuberous sclerosis
Hidradenitis suppurativa

Necessary health tests/imaging

Treatment

Retinoids: Retinoic acid, Tretinoin & Adapalene
Antimicrobials: Azelaic acid
Topical antibiotics: Clindamycin & Azithromycin
Anti-acne agents: Salicylic acid
Systemic antibiotics: Doxycycline & Minocycline
Oral Isotretinoin

Specialists to consult

General physician
Skin & hair specialist
Gynecologist

Symptoms Of Acne

Acne, also known as acne vulgaris, is a recurrent skin condition. In this, the pores and hair follicles of the skin get clogged with sebum. Acne can be seen in the form of pimples, blackheads or comedones, or nodes of the skin. Following are the symptoms of acne:

Reddened and painful skin around the acne spots
Skin that may become darker or scarred over time
Fever and joint pain may occur in rare but severe cases of acne

Some symptoms based on the type of acne are:

1. Comedogenic acne (Non-inflammatory acne)

Closed comedones (whiteheads): These are small round lesions that contain whitish material (sebum and dead skin cells).
Open comedones (blackheads): These small round lesions appear as bumpy dark spots.

2. Non-comedogenic acne (Inflammatory acne)

This acne appears as a red and painful area on the skin.
They are small, reddish bumps that may or may not be filled with pus developed from comedones.

Furthermore, this inflammatory acne can be presented in various forms. The most common ones include:

Papules: These are small painful bumps like eruptions on the skin.
Pustules: These pimples have pus collected in them and are red in color.
Nodules: These are large, painful, solid pimples that are deep in the skin.
Cysts: These deep, painful, pus-filled pimples can cause scars.

In some cases, a person may also suffer from a severe form of acne known as nodulocystic acne. In this, knots are formed on the skin that are hardened masses, larger than 5 mm, and usually present in the area of the back and neck.

Causes Of Acne

The common causes of acne are:

1. Hormonal conditions

Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, like PCOS and pregnancy, can also lead to acne breakouts. The menstrual cycle is one of the prime causes of hormonal acne seen in women.

2. Genetic factors

The genes may be somewhat responsible for the development, course, and severity of acne. Although acne is not the result of a single gene but a series of different genes.

3. Environmental factors

Environmental factors, such as sunlight, can worsen acne, along with skin aging. Also, climatic conditions, such as humid weather, can aggravate acne problems in certain individuals due to the overstimulation of sebaceous glands.

4. Lifestyle factors

Certain food products, such as dairy, products made from dairy, and sugary foods, can cause acne. Also, stress and increased weight are two major causes of acne in many individuals.

5. Health conditions

Certain metabolic diseases, such as diabetes, may cause acne in some individuals. Also, the use of some medications, such as lithium, corticosteroids, or testosterone-containing tablets and creams can result in acne.

6. Chemicals/products

The application of perfumed products, such as cosmetics, hair products, and soaps, can result in acne in some individuals. Irritation of the affected skin area by either scratching, pulling, pressing, or wearing tight garments, such as headbands or scarves around the face and neck, can also cause acne.

Want to know about the causes of acne in detail? Check out this video

Risk Factors For Acne

Almost everyone is at risk of developing acne at some point in their lives. Below mentioned are some of the common risk factors for acne:

Age: People of all ages can get acne, but it's most common in teenagers.
Hormonal changes: The changes in hormones, which are common during puberty or pregnancy, can increase the risk of acne.
Family history: Genetics plays a role in acne. If both of your parents or any of your immediate family members had acne, you're likely to develop it too.
Greasy or oily substances: You may develop acne when your skin comes into contact with oil or oily lotions and creams.
Food: Studies indicate that consuming certain foods, including carbohydrate-rich foods, such as bread, bagels, and chips, may worsen acne.
Friction or pressure on your skin: This can be caused by items such as telephones, cellphones, helmets, tight collars, and backpacks.
Stress: It doesn't cause acne, but if you have acne already, stress may worsen it.

Diagnosis Of Acne

If you are suffering from acne, your dermatologist will diagnose you by looking at them. They may notice the type of acne and where the breakouts appear on the face or other parts of the body. This helps them create an effective treatment plan for you.

Women of childbearing age, who are suffering from acne, should go for tests that are done after a history of dysmenorrhea or hirsutism is taken, such as:

Prevention Of Acne

Acne may seem like a non-serious issue but can affect an individual's confidence and lead to self-consciousness, anxiety, depression, and lower self-esteem. If you suffer from acne frequently, here are some of the preventive tips to avoid acne breakouts:

Wash your face after sweating: If you sweat after going out or wearing a hat or helmet, it can worsen your acne. Hence, it is advised to wash your skin as soon as possible after sweating.

Stay away from irritating scrubs: It is advised to use your fingertips to apply a gentle, non-abrasive cleanser, rather than using a mesh sponge or an abrasive cloth that can irritate the skin.

Be kind to your skin: It is advised to use gentle products, which are alcohol-free. Products like astringents, scrubs, and exfoliants may irritate your skin and therefore, should not be used if you suffer from acne.

Use lukewarm water to clean your face: It is advised to rinse your face with lukewarm water after face wash. Avoid too cold or hot water if you have acne.

Shampoo regularly: If you have oily hair, it could be the reason for acne on your forehead; therefore, it is advised to shampoo daily to get rid of the excess oil.

Let your skin heal the natural way: Do not pop, pick, or squeeze your acne. This would not only worsen your acne problem but your skin will also take longer to heal. This also increases the risk of scarring.

Stop touching your face: Your hands carry germs, which transfer to your face when you touch it, and can cause flare-ups.

Be careful of sun and tanning: Sun is not your best friend, especially when it comes to skin conditions. Tanning damages your skin and certain acne medications make the skin quite sensitive to ultraviolet (UV) light.

Diet & Acne

Certain foods are known to promote inflammation in the body, thereby resulting in acne outbreaks. In addition to that, diet can also affect hormone levels, making your acne worse. Following food items can cause acne breakouts:

Foods that are high in fat content, for example, milk and meat
Foods and beverages with a high sugar content lead to high insulin levels, altering other hormones that can cause acne
Fast foods and snacks

In some patients, chocolate consumption was related to past or current acne. Therefore, it is advised to eat healthily and stay away from foods that could trigger your acne. Consult your dermatologist or a nutritionist to know what foods to avoid in order to achieve better and clear skin.

While the exact cause of acne is not known, the appearance and recurrence can be lowered by making simple lifestyle changes. One of these changes includes adding foods to your diet that help in fighting acne.

Click to know about some foods that help in reducing the appearance of acne and blemishes.

Complications Of Acne

Acne, when ignored for a long, can become severe and ultimately lead to scar formation. Some common complications include:

1. Scars: Pitted skin (acne scars) and thick scars (keloids) can remain for a long time after the acne has healed. Scars left by acne can affect both teenagers and adults. Scars are a result of acne breakouts, penetrating deep into the skin layers. The longer someone has inflammatory acne, the higher it is likely to develop acne scars. Therefore, it is best to seek timely treatment for this condition and prevent the formation of acne scars.

2. Skin changes: After acne has cleared, the affected skin may be darker (hyperpigmented) or lighter (hypopigmented) than before.

3. Emotional well-being: Acne can affect more than just skin. It can have a significant impact on one’s emotional well-being. According to studies, acne can lead to low self-esteem, poor self-image, anxiety, depression, decreased quality of life, and feeling alone. Moreover, severe and chronic acne can also take a toll on confidence.

Treatment Of Acne

Acne can be treated successfully by either topical or oral anti-acne preparations. Some dermatologists also suggest a combination of both therapies. Listed below are some commonly used therapies to guide you about the treatment process:

1. Topical therapy

Retinoids, such as retinoic acid, tretinoin, and adapalene, are used either alone or with other topical antibiotics.
Antimicrobials, such as azelaic acid, are helpful in treating normal acne and post-inflammatory pigmentation of acne as well.
Topical antibiotics, like clindamycin, azithromycin, and lotion, are effective in treating acne.
Anti-acne agents, like salicylic acid, are used as topical gel for seborrheic and comedonal acne. These are also useful in treating pigmentation caused after the healing of acne. Topical benzoyl peroxide is taken in combination with adapalene available in the gel base. Topical dapsone is useful in papular and comedogenic acne. Dapsone (aczone) 5% gel is recommended twice daily for inflammatory acne, especially in women. Side effects include redness and dryness.

2. Systemic therapy

Antibiotics, like doxycycline, help in controlling inflammation and affect the secretion of free fatty acids. Minocycline is taken in the form of capsules once a day. Sometimes other antibiotics, such as amoxicillin, erythromycin, and sulfamethoxazole, are also used for acne. Ciprofloxacin is used in case of pseudomonas caused acne.
Oral isotretinoin (a derivative of vitamin A), like amnesteem or claravis, is used to control sebum production and reduce inflammation. It may be prescribed to people whose moderate or severe acne hasn't responded to other treatments.
Low-dose estrogen may also be prescribed along with cyproterone acetate for treating severe recurrent acne.
Spironolactone is prescribed to males dealing with acne issues. It is helpful in reducing the production of androgens and blocking the actions of testosterone.
Combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine progestin and estrogen. The benefit of this treatment may not be visible for a few months; therefore, using other acne medications with these for the first few weeks may be helpful.

3. Other treatments

Dermabrasion: In this procedure, the top layer of the skin is removed with the help of a rapidly rotating brush or another device. This helps remove surface scars. It may also reduce the intensity of deeper acne scars.
Chemical peel: In this procedure, a chemical solution is applied to the scar tissue to remove the top layer of the skin. This helps in minimizing the appearance of deeper scars.
Skin needling: In this procedure, a needle-studded device is rolled over the skin to stimulate collagen formation.

Acne is a painful side effect of oily skin. Here are a few things you could try to improve your skincare game, especially if you have oily skin.

Home-care For Acne

Medications, therapies, and treatments can give long-lasting results; however, it is important to take care of your skin at home too. Below mentioned are some tips to follow at home if you have acne:

Be gentle with your skin: Use a mild cleanser in the morning and evening. Avoid scrubbing your skin as it can worsen your acne.

Avoid certain products: Products such as facial scrubs, astringents, and masks tend to irritate the skin, especially sensitive skin, which can worsen acne. Excessive washing and scrubbing can also irritate the skin.

Refrain from touching your skin too often: People who squeeze, pinch, or pick their pimples can get scars or dark spots on their skin.

Shave carefully: Men and women both can use this tip while shaving facial hair. Men should soften their beards with some soap and water before applying the shaving cream, and the same applies to women too. Facial hairs are delicate and pre-softening is required before shaving. Shave lightly and only when you have to.

Avoid over-exposure to the sun: Many acne medications can make the skin prone to sunburn. Consult a doctor to know more about the reaction of the cream to sun rays.

Choose your makeup carefully: Use oil-free makeup. Look for the word “non-comedogenic” on the label. A ‘non-comedogenic’ label means that the product will not clog up the pores.

Use medications wisely: If the doctor has recommended any treatment plan for acne, it is important to give the treatment some time to show effective results. If acne treatment works, some improvements might be noticed within 4 to 6 weeks. It might take more than 3 months for the skin to clear up.

Avoid using different products all at once: Do not use a new acne product every week as this can irritate the skin and cause fresh breakouts, making it difficult to treat the condition.

Watch this video to know about natural ways to deal with acne or pimples.

Alternative Therapies For Acne

Ayurveda

Ayurvedic science believes that acne results from the ventilation of Vata, Pitta, and Kapha doshas in the body. Here is a list of some herbs that can help heal acne faster.

Turmeric (Haldi): Turmeric has anti-inflammatory, antibacterial, and antifungal effects, which can help relieve acne problems. Apply a thin paste of turmeric over the affected area after consulting a doctor.

Honey (Sahed) and Lemon (Nimbu): Honey and lemon have antibacterial properties that could help in healing the acne. However, be careful before applying lemon directly to the face as it may irritate the skin.

Neem leaves: Neem offers anti-inflammatory, antibacterial, antifungal, and antiviral activities. It works well against both gram-negative and gram-positive bacteria and hinders the growth of acne-causing bacteria, such as Staphylococcus epidermidis and Propionibacterium acnes (P. acnes). Ground fresh or dried neem leaves into a soft paste by adding water and apply it on the face. Wash it off after 10-15 minutes with warm water.

Pimples can be caused due to various reasons. Read to know the home remedies to get rid of them.

Homeopathy

Unlike conventional treatment, homeopathy treatment for acne claims to treat this condition from its root without causing any side effects. Some of the homeopathic medications that are helpful in treating acne are:

Pulsatilla– This is helpful in treating acne associated with the onset of puberty in teenage girls. It can also help treat acne in pregnant women or those facing acne due to menstruation.
Silicea– It is helpful in treating cystic acne, which appears like boils. Along with this, slow-healing acne and acne which leave pitting scars can be treated with this homeopathic medicine.
Sulfur– Sulfur is helpful in treating blackheads and whiteheads, which are not deep and are present over a large area.

Acne scars not only mar the appearance and reduce confidence, but they are also not very easy to get rid of. Click to read about some effective natural remedies to help remove acne scars.

Acne scars not only mar the appearance and reduce confidence, but they are also not very easy to get rid of. Read about some effective natural remedies to help remove acne scars.

Living With Acne

Even though almost everyone suffers from acne, a curable skin condition, in their life, it can still take a toll on one’s emotional well-being. It makes people conscious of their physical appearance, which in turn makes them feel embarrassed and less-attractive all the time. This thought process may become a severe issue in teenagers, and may make them miss out on being active in class, taking up sports, and getting a job.

Instead of feeling anxious or suppressing your feelings, talk about them with your friends or close ones. You can even consult a doctor about its treatment and how to deal with the feelings. Make sure to complete your treatment course and follow the doctor’s advice without fail to fix your acne.

Acne is a completely curable condition, but still has a severe impact on one’s mental well-being. Consult India's best doctor's online with a single click.

Why am I getting acne in my 30s?

The reason you are getting acne in your early or late 30s is due to hormonal changes. Fluctuating hormone levels trigger sebum production, leading to cystic acne which is common in adolescents. Cystic acne can be treated successfully with topical creams, containing tretinoin, retinol, or acids that exfoliate the skin to prevent the formation of cysts.

Which is the best exercise for clearing acne?

Exercising not only improves your body function and health but also helps you get clear skin and keep acne at bay. Exercise removes toxins from your body, improves blood circulation, provides more oxygen to the body, and reduces stress, thereby preventing acne. You can incorporate aerobic exercises, cardio, and yoga to help clear your acne. However, you must pay attention to hygiene after working out as accumulation of sweat and bacteria can also aggravate acne.

Does drinking water help you get rid of acne?

Water can act as a magical potion when it comes to naturally detoxifying your body, regulating blood pressure, maintaining sugar levels, and supporting your immune system. Water also keeps your skin supple by keeping it hydrated, thereby keeping acne at bay. However, if you are well hydrated and still have severe and recurrent acne, it is advised to consult your doctor to know the real cause of acne.

Which foods can trigger acne breakouts?

Diet can have an important role in the way your skin looks. It can make or break skin as well, certain food items are known to trigger acne breakouts. Some of the foods that are known to aggravate acne are refined foods and high-sugar foods. Milk and dairy products like milk, cheese, yogurt, etc can also cause acne in some people. In addition to that, the same effect can be seen with food items that are highly processed such as frozen meals, fast foods, sugary cereals, chips, white bread, and pasta, etc. Apart from avoiding these foods, it is also important to include green leafy vegetables, fruits, and fiber in your diet in order to achieve clear skin.

How can I clear my acne fast?

There is no sure shot way to clear your acne overnight. You can try some simple remedies, such as washing your face with a gentle cleanser, keeping your hands away from your face, and applying spot treatment on your acne as advised by the doctor to help you clear the acne. Apart from this, it is suggested to go light on your makeup and skincare to avoid clogging up of pores. Balanced diet free of processed foods can also help you get clear and acne free skin fast.

Overview

Key Facts

Symptoms Of Acne

1. Comedogenic acne (Non-inflammatory acne)

2. Non-comedogenic acne (Inflammatory acne)