ACNE – how can we help ourselves?

Before we dive straight into acne, let's first calm you down a bit. Acne affects more than 90% of the population at least once in their lives, both men and women of different ages, and it occurs in mild and severe forms. So, acne is something everyday, which does not mean that it is not annoying. It is visible at first glance, it can lower our self-confidence, and it is also painful to the touch.

We will touch on several topics in this blog, but we won't go into detail, as there is so much information that one doesn't know what to do with it. That's why we will call this an introduction to the world of acne, but if you are interested in the topic in more detail, we will be happy to write you a more detailed blog on the subject.

What is acne?

The US Food and Drug Administration (FDA) defines acne as a disease involving the sebaceous glands and hair follicles, which manifests as blackheads or whiteheads, or if inflammation occurs, papules, pustules, or nodules form.

Of course, in Slovenian we have a lot of terms for different forms of acne, depending on which part of the skin layer is affected. The further the acne extends (the deeper layer of the epidermis or even the dermis), the more severe the forms are. However, if they are more superficial and painless, they are considered milder forms of acne, which are often just a transitional phase.

Acne is common, what does this mean for the cosmetics industry and for us?

Every year, huge sums of money are spent on acne. This also means that a lot of money is spent on developing new products for acne-prone skin, which means more choice for us consumers. This can be both a blessing and a nightmare. Sometimes it can be difficult to find your way around the flood of products, but the fact is that we can find a product that suits us, because it probably exists.

How does acne occur?

1. Increased sebum production and flaking.
2. Exfoliation causes dead cells, or corneocytes, to accumulate, which clog the pore.
3. This creates the perfect environment for the growth of cutibacterium acnes. inside the follicle, which is normally present on our skin.
4. Cutibacterium acnes and can also cause inflammation and an immune response.

The first two are the most important factors, because together they cause the formation of the primary form of acne – a microcomedone, which develops into a non-inflammatory comedone or then becomes inflamed and develops into papules, pustules or nodules. Androgenic hormones increase sebum production, which is why we often talk about hormonally-induced acne.

Some general tips that can help improve the condition

Individuals with acne-prone skin usually also have sensitive skin. Therefore, when it comes to cosmetics, we advise you to:

1. You are using unscented products.
2. You use acid or enzyme peels.
3. Stick to your facial care routine and always go to bed with a cleansed face, not with makeup on.
4. Cleanse your face morning and evening, and if necessary, also cleanse after wearing a mask.
5. Buy products that are gentle on the skin.

And also, that:

1. Visit a dermatologist if the condition does not improve.
2. You talk on the phone through headphones and do not hold the phone to your ear.
3. Change your pillowcase every 2 days (you can use a towel).
4. Dry your face with tissues and not with the towel you use for your hands.
5. Touch your face as little as possible.

What about acne treatment?

Topical retinoids and antibiotics

They successfully fight acne for several reasons. They inhibit the formation and number of microcomedones, reduce mature comedones, promote normal exfoliation, and some retinoids have an anti-inflammatory effect.

For best results, it is recommended to use it in the initial phase of acne development, applying it wherever necessary. In case of inflammation, a combination with antibiotics is necessary. Retinoids also help to better tolerate topical antibiotics, and when the condition subsides, we maintain the condition only with retinoids. In principle, benzoyl peroxide is also suitable for reducing inflammation.

Retinoids are suitable for mild and moderate forms of acne, as well as for maintaining the condition once improvement has occurred.

The table below lists topical medications that can be used for mild to moderate acne.

The table below lists the known effects of topical medications for individuals with acne-prone skin.

Hormone therapy

The goal of hormone therapy is to reduce the impact of androgen hormones on the sebaceous gland and keratinocytes. This can be achieved, among other things, with oral contraceptives, glucocorticoids, and others.

Contraception is another option for "managing" acne, but you should be aware that contraception does not suit everyone and some women experience serious negative consequences and then decide to stop using it.

Oral isotretinoin

The main drug for severe forms of acne (nodules, pustules). It targets all factors that cause acne, and has recently been used more in cases where the individual does not respond to therapy. Side effects are common but manageable (dry skin, eyes, chapped lips, headaches, etc.). In some cases, re-treatment is necessary. You must be careful not to get pregnant while taking isotretinoin, as isotretinoin is teratogenic and can fatally affect the fetus between the 3rd and 8th week of pregnancy.

As an alternative to reduce inflammation, zinc can also be taken orally, usually 200 mg per day.

What about other therapies?

There are also chemical peels, but only if your dermatologist has advised you to do so, otherwise you may do more harm than good to your skin. Other options include phototherapy with ultraviolet light and corticosteroid therapy.

In this blog, we wanted to introduce you to a part of the world of acne. There is truly a lot known about this topic and it is difficult to summarize everything in one blog. If you have acne problems, there are several different treatment methods available, but you can do most of them at home with the right choice of products and constant skin care. Acne can be affected by several factors, so in the case of moderate or severe acne, we recommend visiting a dermatologist who will advise you on how to proceed with further treatment.

Literature:

Roth PT. Attacking Acne: OTC Topical Treatments. Clinical Skin Care. Cosmetics&Toiletries. New York. 2020

Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden J, Shalita AR, Thiboutot D. Management of Acne: A Report From a Global Alliance to Improve Outcomes in Acne. 2003; 49(1):1-37