Acne is the most common skin condition, affecting up to 85% of adolescents aged 12–25. Acne affects both boys and girls equally, but severe forms are more common in males. It is an inflammatory disease of the sebaceous glands and hair follicles, triggered by various factors.
In most cases, acne clears up by the age of 25, but nowadays, pimples increasingly appear later in life. For example, in women, acne often worsens before menstruation due to a rise in the hormone progesterone. Certain types of contraceptives and an increase in the stress hormone cortisol, which activates sebaceous gland function, also contribute to the formation of pimples.
Because the condition is visible, it causes not only cosmetic defects but also psychological and social problems.
Acne and Habits
An unbalanced diet affects the functioning of the sebaceous glands and alters the composition of sebum. Excessive sebum production and acne may be triggered by products like dairy, gluten, foods high in carbohydrates, fats, and spicy foods. However, there is no scientifically proven anti-acne diet, so everyone should base their food choices on individual tolerance, and it is recommended to prefer foods with a low glycemic index.
Smoking promotes the formation of comedones, while alcohol activates the sebaceous glands and contributes to inflammation.
Acne can also be caused by certain medications, such as contraceptives (containing only progestin), anabolic steroids, corticosteroids, medications for tuberculosis, cancer, neurological, and psychiatric conditions, as well as some B vitamins. Everyday cosmetic products can also have this effect.
Genetics also play a significant role. Adolescents whose parents had acne during puberty are more likely to develop the condition. Excessive sweating, friction, or physical pressure in certain areas (belts, collars, headbands, mobile phones, helmet straps, earphones, bra straps) can also aggravate acne.
Acne worsens when pimples are squeezed. This pushes sebum and bacteria into a larger area, causing redness, swelling, and the spread of inflammation, which may result in scarring.
How to Fight Pimples?
The severity of acne is determined and monitored by a dermatologist or general practitioner. Acne is treatable, but in most cases, treatment is long-term and requires consistency. The success of treatment largely depends on effective collaboration between the patient and doctor. In addition to medication, it is very important to regularly and properly care for the skin with appropriate pharmacy-grade cosmetics. Acne is divided into three forms based on severity and outbreaks, and each form has its own treatment strategy.
Mild acne is characterized by comedones, small nodules (papules), and superficial skin inflammation.
Moderate acne involves more extensive breakouts, possible pustules, and deeper inflammation, which can spread to the chest and back.
Severe acne presents with widespread inflammation, nodules, and cysts, which can form extensive and deep inflammatory foci. Severe acne may heal with scarring.
What Treatments Are Effective?
In milder cases, using appropriate skincare products, visiting a cosmetologist for treatments, and improving the skin’s condition may suffice. In more severe cases, additional topical and oral prescription medications are needed. For particularly severe acne, further tests, the involvement of specialists, and long-term systemic treatment may be necessary.
The choice of medication depends on the intensity of the disease and the type of acne. The condition is chronic, and treatment may take months, sometimes years. A single treatment regimen is usually followed for 6–8 weeks before any changes are made. Treatment can only be stopped early if there are severe side effects that do not subside. Topical medication should be applied to the entire affected area, not just individual lesions. In the early stages of treatment, the skin may be dry, irritated, red, and flaky, but this usually passes. If side effects occur, the medication can be applied less frequently, and moisturizing creams can help soothe the skin. Oral treatments are used for more severe forms and may require months of treatment, blood tests, and regular monitoring by a dermatologist.
With timely and appropriate treatment, milder forms of acne clear up without complications. Severe and untreated acne can cause skin pigmentation disorders and scarring. Scars may be atrophic (below the skin’s surface), hypertrophic (raised above the skin), or keloid (dense raised scars that most commonly form on the décolletage, shoulders, and back). Scarring results in an aesthetic skin defect that is difficult to treat. Acne and the resulting skin defects can affect a teenager's psychological and emotional state, which is why it is very important to start acne treatment early.
Adult acne 40+
Adult acne is largely influenced by the body’s hormonal balance. For example, stress increases the production of male hormones and cortisol, which activate the sebaceous glands. Additionally, the premenopausal period and discontinuation of contraceptives strongly disrupt hormonal balance, which can promote the appearance of pimples. Painful and red pimples may also develop due to illnesses, such as diabetes, or as a side effect of certain medications. In adolescence, acne mainly appears on the cheeks, forehead, and nose, while in adults, it more often occurs on the chin and neck.
What to do?
It is important to choose skincare products that are appropriate for your skin type and age. Opt for water-based products and avoid harsh exfoliants and cleansers. To speed up skin cell renewal, you can try exfoliants with salicylic or glycolic acid.
You should also pay attention to your diet and improve it if necessary. For example, it has been found that acne is more common in those who frequently consume processed fast food and sweets. Overindulgence in flour and dairy products can also manifest on the skin in cases of intolerance. Choose nutritious, vitamin- and mineral-rich foods like fruits, vegetables, fish, eggs, nuts, and lean meat. Reduce stress by exercising and being active outdoors, ensure enough sleep at night, and give up bad habits!
The article was published in the "Naerata sügis 2020" magazine.