All about acne

What is acne?

Acne is one of the most common skin conditions worldwide, affecting 85% of adolescents and young adults and 50% of adults (as onset adult acne commonly occurs in people who experience the condition during adolescence).

In the Philippines, acne affects up to 17 million Filipinos—and according to an observational study, we have a lot of false perceptions about what causes it and how to treat it.

And while we typically view acne as a cosmetic issue, it’s also—more importantly—a medical one. Left untreated, it can lead to serious long-term consequences like depression, anxiety, low self-esteem, poor self-image, and an overall decreased quality of life.

Because acne is a complex condition and can have long-lasting physical and emotional effects, it’s best to educate yourself and see a board-certified dermatologist who can determine your best treatment options.

What causes acne?

The typical acne development cycle goes like this:

1. Excess sebum production. While sebum (or oil) is essential in keeping your skin healthy, excessive sebum can lead to oily skin and contribute to acne formation.
2. Clogged pores. When your skin produces too much sebum, it can clog your pores and result in the buildup of dead skin cells, dirt, and bacteria in your skin.
3. P. acnes. Speaking of bacteria, P. acnes (Propionibacterium acnes) are anaerobic bacteria that thrive in the confines of your now-clogged pores—they break down the oil into fatty acids, which causes inflammation in the skin.
4. Inflammation. Accumulation of dead skin cells, oil and bacteria can lead to rupture of the clogged pores causing further inflammation and higher risk of scarring. 

Other causes

Other possible factors of acne can include:

• Genetics. Acne can run in families, making it more likely for you to get acne if your parents or siblings have it.
• Hormonal changes or imbalances. Puberty, pregnancy, menstruation, and starting or stopping birth control pills can also contribute to acne. Polycystic ovary syndrome (PCOS) is another hormonal condition that can make women more likely to develop acne.
• Stress. Studies have found that people with higher stress hormones can trigger sebum production, which clogs pores and causes breakouts.
• Diet. High-glycemic foods, like simple carbohydrates (white rice, white bread, potatoes) and sugary treats, can trigger acne in some people. There are some indications that dairy products (especially skim milk) may influence acne breakouts, too.
• Comedogenic products. Products that clog pores, like heavy creams and oil-based skincare and cosmetics, can trigger acne.‍
• Medication. Certain medications—including steroids, lithium, diuretics, and some antidepressants—can cause side effect-related acne.

What are the different types of acne?

Mild acne, also called comedonal acne, is usually characterized by small, non-inflamed bumps on the skin—namely, whiteheads and blackheads.

Moderate acne, also called inflammatory or papular-pustular acne, typically appears as inflamed pimples that are red and tender to the touch.

Severe acne, also called nodular or cystic acne, is the most severe form of acne. These appear as large, deep,  red bumps that are painful to touch and may contain fluid-filled cysts.

How to treat acne

Topical treatments

Topical medications that contain:

• Salicylic acid
• Benzoyl peroxide
• Retinoids

—are the most common treatment options for mild to moderate acne.They work by reducing the sebum your skin produces and killing bacteria that can clog pores.

‍

Oral treatments

Oral medications like antibiotics and isotretinoin can treat moderate to severe acne that doesn’t respond to topical medications.

Antibiotics are usually prescribed to help clear the skin of acne-causing bacteria, though only for a short period to minimize antibiotic resistance.

Isotretinoin, on the other hand, may be used for a longer period (up to 6 months), but it requires careful dosing and regular monitoring with your dermatologist to avoid any adverse side effects.

‍

In-clinic treatments

In-clinic treatments like:

• Extractions
• Chemical peels
• Cortisone injections
• Laser therapy

—and combining them with topical medications can improve the efficacy of your treatment while also addressing other skin concerns. These treatments are not only highly effective but produce the fewest side effects—making them our go-to remedy for treating acne.