Anatomy of an acne attack

Say goodbye to all the myths you’ve heard about what causes acne. You can blame your woes on an oil called sebum, which blocks the skin’s pores and leads to over 50 different types of skin blemishes, including pimples, whiteheads, blackheads and cysts.

Here’s what happens: the pores or hair follicles in your skin contain glands that make sebum. This oil is usually beneficial: it lubricates the skin, keeping it soft and preventing it from cracking. Normally, sebum travels up the hair follicle and leaks out onto the skin’s surface to do its job. But when sebum, along with dead skin cells and bacteria, gets blocked up in a hair follicle, red swollen pimples (called lesions), sometimes containing pus, show up on the face, neck and upper body. This messy result is what you see in the mirror.

Acne can be mild — showing up as whiteheads and blackheads limited to the face — or severe, consisting of deep pimples or painful cysts (bumps underneath the skin) which can lead to scarring. These cover wider areas of the body, including the chest, upper back and shoulders. But the good news is that all acne is treatable.

It’s all in the hormones

We don’t know why some people are more prone to getting acne vulgaris, the technical term for a pimple onslaught. We do know that it usually starts in adolescence, anywhere between age 11 and 18, and it’s often hereditary. So if either or both of your parents had acne when they were teenagers or young adults, your chances of having it go up.

Why does acne attack most during puberty and young adulthood? It’s not because you eat more oily or fatty foods like french fries, pizza or chocolate. And it isn’t triggered by wearing sunscreen or makeup, although any cream or lotion that clogs the pores can make matters worse, even if it’s labeled “oil-free.” Instead, as your body matures, it produces more of the hormones called androgens. These stimulate the sebum-making glands to produce extra amounts of the oil, leading to blocked hair follicles, which end up as zits. This also explains why for women, the break-out often comes just before their periods — the hormonal changes that come with the menstrual cycle add even more fuel to the sebum-manufacturing process. Luckily, acne usually disappears as puberty ends in the late teens or early 20s.

Break free of break-outs

Treating acne begins with good skin care. This means cleaning the skin twice a day with an unscented soap, and patting it dry with a soft towel. But be gentle! Vigorous and frequent washing may actually irritate your skin and cause more pimples to appear. Also, resist that urge to squeeze or pick at pimples: this won’t make them go away faster but only causes more irritation, spreads infection and — worse — can lead to permanent scars.

You can treat mild acne with certain non-prescription skin products that you’ll find at the pharmacy. Look for those that contain benzoyl peroxide, which dry out the area they’re applied to, or other products that contain retinoids (Retin-A) which effectively clear pores of oil buildup and discarded skin cells. To fight the infection that’s part of acne (that’s why pimples are often red and sore), creams or lotions containing antibiotics can prevent new acne attacks by cutting down on the amount of bacteria found on the skin.
If you have more severe acne, or those over-the-counter medications aren’t doing the trick, it’s time to see a doctor or dermatologist. A skin specialist has a whole armoury of prescription medications that can help, including oral antibiotics and isotretinoin (Accutane®). And, if you’re a female, you also have another option for mild to moderate acne, since flare-ups are triggered by hormones in about 25% of women: certain birth control pills approved in Canada have been proven to control acne symptoms. A doctor can prescribe one that can kill two birds with one stone.

There’s another good reason to see a doctor or specialist: some blemishes that seem to be acne are actually rashes — allergic reactions to hygiene products like soaps and shampoos. You might need to be tested for skin allergies. Whatever your situation, a doctor can offer you a solution that will best meet your needs.

Facing the day

Meanwhile — until you’ve got the problem licked with help from a doctor — here’s a fact that might help you face your day. While you might be horrified to find those
pimples on your face before an important rendezvous, know that you’re not alone. About 80% of the population suffer from acne at some point in their lives. So when your doorbell rings, don’t be surprised if that hot date is also sporting a pimple or two!

Clearing up the myths on acne

If you’re clear on these facts about acne, you’ll be on the road to a zit-free life.

Myth: Acne is caused by poor hygiene.
Reality: Acne isn’t caused by dirt, surface skin oils or poor hygiene. In fact, vigorous and frequent washing actually irritates your skin even more, and can make your acne worse
by spreading the bacteria from infected pimples. A gentle face wash twice a day with a mild soap is the best way to get clean. After rinsing, pat — don’t rub — your skin
dry with a soft towel.

Myth: Acne is caused by diet.
Reality: It’s a scientific fact: there’s no relationship between what you eat and acne. While soft drinks and french fries aren’t exactly good for your health, they don’t cause pimples. Otherwise, the only thing sugary, fatty or oily foods might affect is your waistline.

Myth: Sunshine improves acne.
Reality: If you think that sunbathing will “dry out” your acne, think again. Suntans, not to mention sunburns, actually increase your skin’s oil production — and this can lead to more acne, not less. Also, the sun’s rays can cause severe skin irritation in some people using certain acne medications.

Myth: Acne will only go away after running its course.
Reality: Acne can be treated. With the range of treatments available today, there’s no reason that you should have to live with it. See a doctor or skin specialist to get a handle on your options — and start clearing acne out of your life for good.

Source: MeFirst, Winter 2001