Most people — about 85% of the human population — at some point in life will develop acne, a skin disease whose severity ranges from mild to severe. Teenagers are more likely than other groups to get acne due to puberty-associated hormonal changes. Typical acne symptoms include blackheads or whiteheads, pimples, oily skin, and scarring that frequently appear in the skin of the face, neck, chest, or back, where there are relatively higher numbers of oil glands. Although these symptoms may go away without treatment and cause no serious consequences, acne can sometimes significantly affect the patients’ social life and psychological health. Therefore, it’s better to pay more attention to this common disease.
Etiology and risk factors
Acne, short for acne vulgaris, affects the skin’s oil glands and hair follicles. The disease occurs when oil glands become overactive, and hair follicles become plugged with oil and dead skin cells. Along with dirt and bacteria, excessive oil and dead skin cells lead to inflammation, resulting in acne scars’ formation.
Many factors affect an individual’s risk of developing acne.
Studies of identical twins, fraternal twins, and first-degree relatives have shown that genes can explain over 80% of acne cases, while less than 20% is explained by non-shared environmental factors, such as diet and stress.
Many gene candidates have been identified to affect a person’s susceptibility to acne, such as the TNF-alpha, IL-1 alpha, CYP1A1, IGF-1, AR, SRD5A2, IL-8, IL-6, and IL-1A genes. Individuals with specific variations in these genes are at elevated risk of developing acne.
Although genes play a big role in acne, they do not guarantee acne.
Studying the relationship between diet and any disease, including acne, is difficult. But accumulating evidence suggests that dietary factors play a key role in acne. Acne is closely related to a Western diet, a diet characterized by high intake of red meat, animal fat, sweets, and desserts and low intake of fresh fruits and vegetables and low-fat dairy products.
Some foods contain hormones that affect the risk of acne. For example, milk contains IGF-1 and male hormone (androgen) precursors. IGF-1, or called insulin-like growth factor 1, is a hormone that functions in childhood growth and continues to have anabolic effects in adults. Elevated IGF-1 leads to skin oil production and stimulates the body to produce cells. Excessive skin oil is known to contribute to acne. Over-production of skin cells can cause clogged pores. Thus, milk, dairy products, and other foods that contain IGF-1 might trigger or worsen acne. Like IGF-1, androgens are also associated with elevated skin oil production and increased skin cell production, which may drive the formation of acne breakouts.
3. Cigarette smoking
Some studies suggest that smoking tobacco is associated with a reduced probability of acne.
Maintaining good hygiene can prevent acne. Cleansing your skin daily helps prevent the skin pores from becoming clogged by substances like oil and dead skin cells and, therefore, inhibits bacteria’s growth. Though good cleansing is important, cleansing too much can do more harm than good.
Stress can make acne worse. Some studies show that teenagers under high-stress levels are 23% more likely to have increased acne severity. First, stress can cause an inflammatory response in the body and cause the clogged pores’ walls to break, leading to redness around the broken pore and an influx of pus. Second, stress causes the adrenal gland to become overdrive. Increased androgens (male hormones that can be produced by the adrenal gland) lead to more acne.
Many changes take place during puberty. These changes include hormone swings that contribute to increased oil production, which is a cause of acne. High levels of the male hormone testosterone can trigger an acne outbreak, which is far more likely to happen in teenage boys.
The bacterium Propionibacterium acnes is involved in the pathogenesis of acne. P. acnes is naturally present on the skin of most people. When it meets favorable conditions, P. acnes multiply, and its population increases, contributing to acne development.
How to prevent or deal with acne?
8. Lifestyle changes
Wash your face twice daily, once in the morning and once at night, using a suitable cleanser depending on whether your skin is dry or oily.
Make sure to get 7-9 hours of sleep a night. Loss of sleep causes inflammation, insulin resistance, hormone swings, stress, and fatigue, which leads to acne.
Take physical exercise regularly. Exercise can cut emotional stress and stimulate blood flow, nourishing the skin and carrying cell waste away. But exercise has its negative side; sweat from exercise can mix with oils and bacteria on the skin, causing breakouts.
Eat a healthy diet. It’s recommended to eat more whole grains, beans, and veggies. It’s better to cut back on pasta, white rice, white bread, and sugar and avoid dairy products and packaged foods. Drinking plenty of water is also very important, helping flush out internal toxins and hydrate your skin.
9. Drugs and medical procedures
There are several drugs available for the treatment of acne. These drugs are designed to reduce oil production, promote skin cell turnover, fight bacterial infection, or suppress inflammation. Some of the commonly used drugs include retinoids and retinoid-like drugs, antibiotics, salicylic acid, and azelaic acid, dapsone, anti-androgen agents, and isotretinoin. Which drug should be chosen depends on the patient’s age, the type and severity of your acne. If you have acne, go to see your doctor get the right drug treatment. In addition to drug treatment, medical procedures help solve scarring resulting from breakouts and achieve smoother skin.
In conclusion, acne is an annoying thing that most teenagers will face. Acne usually goes away once the hormonal changes of puberty settle down. But acne still occurs in adults. Acne, especially severe acne, and the resulting appearance may significantly negatively impact moods, such as anxiety, reduced self-esteem, depression, or even thoughts of suicide. So it’s important to know how to prevent acne and how to deal with acne.
Caroline Liu is a writer who regularly writes articles on health and lifestyle. She works at Cusabio, a biotech company that offers life sciences reagents for research.