Beat that zit: A layman’s guide to acne
Acne! Whether you call them spots or zits or pimples, we can all agree that acne can be very distressing and in severe cases it even affects self-esteem since said spots most commonly appear in areas of skin that have more oil glands, like the face (Yup! They love the spotlight too), and upper torso.
So what happens?
Look closely at your skin. The small holes you see your hair sticking out of are called pores. These pores are connected to tiny oil-producing vats (sebaceous glands) by sacs called hair follicles because guess what, your hair sits in these follicles.
The sebaceous glands produce an oily liquid called sebum. Sebum lubricates the skin and hair and also carries dead skin cells through the follicles to the surface of the skin.
Ordinarily, this is all well and good. But if a layer of dead cells builds up at the opening of a pore, they clog up the hair follicle and the sebum cannot leave the pore. It builds up in the sebaceous gland and a comedone (blackhead or whitehead) develops. If this becomes inflamed, it turns into a pimple (also called zits or spots).
It is this phenomenon that leads to different skin abnormalities that fall under the spectrum of Acne vulgaris.
Types Of Acne
Whiteheads, blackheads, pimples, cysts (fluid-filled lesions), and nodules (solid lesions) are all types of acne.
Blackhead and Whiteheads
A blackhead (Open comedone) results if said blockage is partial whereas a whitehead (closed comedone) results from complete blockage. A blackhead is a comedone that is open to the air (not covered by skin). Whiteheads are closed to the air by the skin. The dark colour of blackheads has nothing to do with dirt: They look dark because this kind of blackhead is “open” and the skin pigment melanin reacts with oxygen in the air.
Pimples (Papules and Pustules)
Strictly speaking, the term pimple refers to an inflamed comedone. Now inflammation is a whole subject on its own but suffice it to say that the blockage of the follicle allows the overgrowth of a bacterium (Propionibacterium acnes) which is normally present in the hair follicle. The bacterium breaks down sebum, but these breakdown products now irritate the skin (inflammation) and the “angry”(inflamed) skin develops the painful, solid, red spots you see (Pimples!).
Papules are inflamed comedones that form red or pink bumps on the skin. This type of pimple may be sensitive to the touch. Another type of pimple – pustules – resemble a whitehead with a red ring around the bump. The bump is typically filled with white or yellow pus.
Avoid picking or squeezing pimples. Picking or squeezing can make the inflammation worse and may lead to scarring, leaving ugly dark spots on the skin.
Nodules and cysts
If the inflammation is in deeper layers of the skin, nodules, and cysts develop. Nodules are large, painful inflamed bumps that feel firm to the touch. Cysts, on the other hand, are large, pus-filled lesions that look similar to boils. Like nodules, cysts can be painful. Both nodules and cysts should be treated by a dermatologist.
Causes: Acne Facts and Myths
The reason acne is associated with puberty, the menstrual cycle, and diseases like PCOS is because these are associated with increased production of androgen, a hormone that causes the skin to produce more oil. Genetics plays a role in acne. If both parents had acne, you’re likely to develop it, too.
Whilst high humidity and sweating, too-tight clothing, some drugs like steroids are also associated with acne, most types of foods, masturbation, and inadequate face washing aren’t.
What to do about acne?
For most people, acne improves with age.
Antibacterial soaps haven’t been proven to be helpful but general care involves washing your face with mild soap once or twice daily.
- Refrain from abrasive (alcohol rubs, heavy frequent scrubbing) products.
- Use water-based (noncomedogenic) cosmetics if you can.
- A balanced diet with lots of water consumption is always advantageous.
Treatment of Acne
When drugs are needed, doctors recommend topical agents (Comedolytics) for mild cases. These either kill the bacteria or dry up/unclog the pores
The commonest and most effective topical agent is tretinoin, but because in itself it is also irritating to the skin, your doctor will recommend some precautions you should take. Older non-prescription agents containing salicylic acid or resorcinol have been used.
Your doctor may decide to give you topical (applied to the skin) antibiotics such as clindamycin or erythromycin if you have inflammation (pimples, abscesses or cysts) upgrading that to oral antibiotics if severe.
Sometimes, you can have a professional extract white or black-heads.
As for those scars, first remember that they don’t define you and don’t let them bother you( believe me, I know they can be worrying). But if you really need to do something about them, your options include laser treatment, microabrasion, and microneedling.