•What is Acne?
•Acne Symptoms
•Acne Causes
•Common Myths About Acne
•Acne Complications
•Types of Acne
•Hormonal Acne
•Fungal Acne
•Acne Grades
•Difference between acne and other skin problems
•Ask a FREE Question—Get Answers from doctors within 24 hours
What is Acne?
Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads or pimples. Acne is most common among teenagers, though it affects people of all ages.
Acne Symptoms
- Crusting of skin bumps.
- Cysts.
- Papules (small red bumps)
- Pustules (small red bumps containing white or yellow pus)
- Redness around the skin eruptions.
- Scarring of the skin.
- Whiteheads.
- Blackheads.
Acne Causes
Four main factors cause acne:
•Excess oil (sebum) production.
•Hair follicles clogged by oil
•Dead skin cells.
•Bacteria such as — anaerobic bacterium Propionibacterium acnes
Certain things may trigger or worsen acne:
•Hormonal changes.
•Certain medications.
•Diet.
•Stress.
📌Common Myths About Acne:
It is estimated that 80 percent of all people will have an acne breakout at some point in their lives. Like many ailments that plague so many people, myths have developed over the years about what causes acne and the best way to treat it.
🔸Myth: Only teenagers get acne.
Although acne most frequently appears in adolescents, it also shows up for the first time in people in their 20s and 30s. People of all ages get acne.
🔸Myth: Acne is caused by dirt.
Acne flare-ups cannot be traced to dirt or poor hygiene. In fact, washing too frequently or scrubbing too vigorously can irritate skin and make acne worse.
🔸Myth: Eating chocolate and greasy foods causes acne.
There is no proven connection between chocolate, pizza, potato chips, french fries, cheeseburgers, etc., and acne outbreaks. Recent research has indicated a link between acne and non-organic dairy products.
🔸Myth: Stress causes acne.
Stress does not cause acne to appear – but it can make it worse.
🔸Myth: Popping pimples makes them go away sooner.
Quite the contrary: Squeezing pimples and blackheads can lead to additional inflammation, infection and scarring.
🔸Myth: Getting a tan helps clear up acne.
A little time in the sun won’t hurt, but prolonged exposure to ultraviolet light from the sun or tanning devices can irritate skin and result in more acne. This can also increase the risk for skin cancer.
🔸Myth: Acne will go away on its own.
Acne typically does not resolve on its own. Without treatment, acne can often progress and worsen.
Acne Complications
Acne scarring can sometimes develop as a complication of acne. Any type of acne spot can lead to scarring, but it’s more common when the most serious types of spots (nodules and cysts) burst and damage nearby skin.
Scarring can also occur if you pick or squeeze your spots, so it’s important not to do this.
There are 3 main types of acne scars:
- ice pick scars – small, deep holes in the surface of your skin that look like the skin has been punctured with a sharp object
- rolling scars – caused by bands of scar tissue that form under the skin, giving the surface of the skin a rolling and uneven appearance
- boxcar scars – round or oval depressions, or craters, in the skin
6 Types of Acne You Should Know!
There are 6 different types of acne, and they fall within one of two categories: inflammatory and noninflammatory acne.
Noninflammatory acne
The first acne category is called noninflammatory acne or comedones, and these include blackheads and whiteheads.
Whiteheads
Whiteheads are also known as closed comedones. They form when a pore gets clogged by sebum and dead skin cells.
Blackheads
Blackheads are also known as open comedones. These small, dark-coloured spots are visible on the skin’s surface and slightly raised bumps. A common myth is that blackheads are dark because they trap dirt. This is false. Blackheads are actually caused by whiteheads that have oxidised due to exposure to air, so they darken.
Inflammatory acne
The second category of acne is inflammatory acne. This category of acne is typically what most people think of when they think of the word “pimples”.
Papules
Papules are types of acne that are sensitive to the touch. It’s tender when to touch, and you will notice red or pink or bumps forming around the skin. Picking the acne can make the inflammation worse and lead to scarring. In severe cases, papules can cluster together and appear very red and painful.
Pustules
Another inflamed acne that you should know, pustules, looks like acne with a white or yellow head and is filled with pus. Avoid picking up pustules as it can cause scars or dark spots visible on the skin.
Nodules
Nodules are located deeper underneath the skin, where it needs prescription medication to treat them. It’s a solid, hard lesion that can be over 5mm in diameter (large) and not filled with pus. Most of the time, doctors or dermatologists are likely to prescribe oral medication, isotretinoin, to treat nodules by decreasing oil gland size within the pores.
Cysts
This type of inflamed acne is a large painful, swollen, red and white bump that doesn’t have a head. Cysts develop when your skin is clogged by a combination of bacteria, sebum and dead skin cells. It takes place way deeper into the skin than nodules, and it can lead to scarring if it is picked at.
Hormonal Acne
Hormonal acne, also known as adult acne, affects adults between the ages of 20 and 50. Acne causes bumps on your face, shoulders, chest and back in the following forms:
- Pimples.
- Blackheads.
- Whiteheads.
- Cysts.
Hormonal acne is the direct result of excess sebum in oil glands.
Who does hormonal acne affect?
Hormonal acne affects both men and women, but the majority of cases occur in women, pregnant women and women going through menopause.
Fungal Acne
Fungal acne is an overgrowth of yeast within the hair follicles. Sebaceous glands within your skin produce an oil called “sebum.” These glands can overproduce oil, and your pores and hair follicles can become clogged with oil as well as bacteria and yeast that are naturally found on your skin.
What does fungal acne look like?
These breakouts tend to be small, uniform red bumps arising from the hair follicles, often in symmetric rows on the forehead, scattered on cheeks and, occasionally, on the upper back and upper chest. Fungal acne differs from traditional acne in that you won’t see the blackheads, pustules or deeper, painful nodules and cysts.
Acne Grades
When a dermatologist lands on a diagnosis of acne, it is classified into one of four grades. Dermatologists evaluate the types of comedones (blackheads) present, amount of inflammation present, breakout severity, how widespread the acne is, and what areas of the body are affected.
📌How to tell the difference between acne and other skin problems
There are many skin conditions that resemble acne, and it can be very difficult to know for sure what you are dealing with. Dermatologists Dr Jill Waibel and Dr Tsippora Shainhouse weigh in on some of the skin conditions commonly mistaken for acne.
🔸Rosacea
Rosacea is the most common skin condition mistaken for acne. Rosacea causes small red or pus-filled bumps to develop on the skin and leaves the face with the appearance of a chronic flush and persistent redness across the cheeks, nose, forehead and chin. Those suffering from rosacea also describe a burning sensation associated with the bumps and redness and swelling in the eyes and eyelids. While there may be times when symptoms improve, long-term treatment is usually necessary for treating rosacea.
Some of the ways to treat rosacea medically include applying topical treatments to your skin once or twice a day, such as metronidazole cream or gel, azelaic cream or gel, and ivermectin cream. If you have severe rosacea, your doctor may recommend treating with antibiotics.
Other ways of improving rosacea include:
- Avoiding triggers.
- Using a mild cleanser on your face.
- Using only your fingertips to apply cleansers or lotions.
- Rinsing with lukewarm or cool water.
- Gently patting your face with a soft, clean towel.
- Applying sunscreen when outdoors.
- Covering up your face in direct sunlight.
Additionally, some doctors may choose to treat the redness with laser or light therapy.
🔸Keratosis pilaris
Keratosis pilaris is a very common genetic skin condition that looks like acne and can be very difficult to treat. The main differences between keratosis pilaris and acne, says Waibel, are the appearance of the bumps and the location of the blemishes. People who experience this condition have dry rough bumps on the outer sides of the upper arms, face, thighs and buttocks. Acne, on the other hand, is found throughout your face, chest and back.
These bumps are caused because of an excess of a protein called keratin in the openings of the hair follicles, and due to their white filling, they can look just like acne pustules. But Waibel explains that acne spots are instead filled with an oily substance called sebum.
“While it does tend to improve with age, keratosis pilaris can be managed with moisturisers and topical exfoliators, including alpha and beta hydroxy acids (like salicylic, lactic, or glycolic acids),” explains Shainhouse. But, if those don’t help, she recommends talking to your doctor about a prescription retinoid.
Waibel recommends applying a corticosteroid cream on the affected area twice a day for seven days maximum to help reduce the bumps, along with exfoliating two to three times a week. But she says it’s important to know that while the condition could become up to 80% better, it will never go away completely.
🔸Folliculitis
Folliculitis is caused by inflammation and irritation of the hair follicles, which is the same way acne can be triggered. Shainhouse says that sometimes folliculitis is related to bacteria, similar to acne, but often, it is triggered by yeast on the skin.
Folliculitis usually looks like red pimples with a hair in the centre of each one. The pimples may have pus in them and they may itch or burn. When the pimples break open, they may drain pus, blood or both. Folliculitis looks similar to acne because the bumps can have white filling in the lesion due to a bacterial infection; but it is not sebum, which is what you see with acne.
Waibel says another key difference between acne and folliculitis is the location: folliculitis can be anywhere there is a hair follicle, whereas, acne is only located on your face, chest, or back.
It’s important to see your doctor if you think you might have folliculitis. Then, depending on the severity of the infection, you may be prescribed a cream medication. If the infection is extreme, an oral antibiotic may be prescribed.
Prevention is better than cure, though. And the best ways to avoid folliculitis, according to Shainhouse, include: changing out of sweaty clothing as soon as possible, showering or wiping down with salicylic acid-based wipes after a workout, and trying an anti-yeast wash in the shower.
🔸Sebaceous hyperplasia
Sebaceous hyperplasia is flesh (or pinky-yellow) coloured small bumps that can develop on the forehead, cheeks, nose, and chin.
“They are actually enlarged oil glands in the skin, and sometimes you can even squeeze oil out of them,” explains Shainhouse. But they are not caused by oily skin, and, as Shainhouse says, they are also not the cause of oily skin.
She says that because sebaceous hyperplasia is inherited, you can’t prevent it. The bumps can be flattened during a process called electrocautery so they are not as apparent and can be easily covered by make-up, but this treatment is not available on the NHS.
🔸Periorificial dermatitis
“Periorificial dermatitis is an acne-like eruption that tends to develop in women and children, and presents with persistent pink bumps around the facial openings (eyes, nose, and mouth),” says Shainhouse. “This condition can last for months or even years if not properly treated,” she adds.
And if you do have this condition, Shainhouse says your doctor will prescribe antibiotic creams and tablets, as well as anti-inflammatory medicine that will clear the breakout. But be prepared to wait at least a month or more for it to clear completely.
🔸Basal cell carcinoma
Basal cell carcinomas are slow growing-skin cancers that derive from the base layer of the epidermis. They are usually caused by excessive UV exposure.
Shainhouse explains: “They look like shiny, translucent or pink bumps with tiny blood vessels, and they often have a cycle of bleeding, then healing almost completely, then bleeding again. But they never heal up.”
She says they can be mistaken for a persistent/recurrent picked acne cyst, and if you do have a lesion that just doesn’t heal after a month or two, see your dermatologist for evaluation.
Both dermatologists stress the importance of following up with your doctor regarding any questions you may have about your skin and the recommended treatment options available to you.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.
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