Acne is one of the most common skin concerns in the world. While it is more prevalent in the adolescent stage, ages 12-20, acne can be seen in adults as well.
Furthermore, according to the American Academy of Dermatology, an estimated up to 50 million Americans complain of acne. Studies estimate that by 2026, 683 million worldwide will be suffering from acne with an average increase of 0.55% per year.
It is driving the demand for acne treatments. The choice here is endless. Over-the-counter (OTC) drugs, creams, gels, acne serums, cleansers, and exfoliants are commonly used to treat acne. Constant innovation in acne care products has also been a boon for the skincare industry. Natural probiotic acne serum, blue light therapy, or the vegan alternative to Retinol, Bakuchiol – cutting-edge acne treatments are revolutionizing the industry.
However, board-certified dermatologists prefer to find the underlying cause before treating it. So, what causes acne, and how can it be treated sustainably? Let’s find out.
Acne: How Is it Triggered?
While the American Academy of Dermatology calls the real cause of acne ‘a mystery’, several studies over the years have narrowed down some patterns that trigger it.
Excess Sebum Production
Acne, popularly known as pimple or zit, happens due to clogged pores. Each pore on human skin, which is made of one hair and an oil gland, is the opening for hair follicles to grow. On normal, healthy skin, sebum or oil released from the gland comes out of the pore to keep the epidermis of the skin lubricated.
However, when this process goes wary, acne occurs. Excess oil production, dirt, dead skin cells, and harmful bacteria clog the pores, causing inflammation or acne.
Another major trigger for acne is hormonal disbalance. It can happen for many reasons, e.g. periods, pregnancy, or excessive production of testosterone hormone.
Polycystic Ovarian Syndrome or PCOS often causes major hormonal imbalance in women. Acne, irregular period, and sudden obesity are some of the common symptoms of PCOS. If left untreated, it can cause cancer.
Therefore, in the case of PCOS, dermatologists often suggest seeing an Ob-Gyn or prescribing birth control pills. If those pills don’t work by themselves, Dr. Kanade Shinkai, a dermatologist at the University of California, San Francisco School of Medicine, prescribes spironolactone.
Acne can also be drug-induced. Certain medicines like anabolic steroids, a well-known antidepressant called lithium, and anti-epileptic drugs can cause severe acne. Furthermore, some progestogen-only contraceptive pills have shown side effects like an acne breakout.
Types of Acne
There are many types of acne. Therefore, to determine the best treatment method, the first step should be to identify the acne type and its severity. Dermatologists can decide based on the type of lesions:
- Mild noninflammatory acne (comedonal acne or c. acne) includes whiteheads and blackheads.
- Moderate inflammatory acne includes papules and pustules.
- Severe inflammatory acne includes nodules and cysts.
- Blind Pimples (invisible in the naked eye, but a bump can be felt)
Popular Formulations for Acne Treatment Recommended by Dermatologists
1. Benzoyl Peroxide
Benzoyl Peroxide is an OTC product commonly used for treating acne. It kills the acne-causing bacteria, thereby reducing blackheads, whiteheads, and the frequency of breakouts.
How to use: It can be used as cream and cleansers. Apply this once or twice a day.
Concentration: Benzoyl Peroxide can be purchased at 2.5%, 5%, and 10% concentration. If you are using Benzoyl Peroxide for the first time, start with a lower concentration; otherwise, it can cause dry and flaky skin and redness.
2. Acne Phages Serum
Over the last few years, the use of probiotics for acne treatment has seen rapid growth. According to researchers at UCLA, Propionibacterium acne (P. acne) and C. acnes bacteria are majorly responsible for acne breakouts.
That’s not all; our skin naturally houses P. ache phages, a family of good viruses that naturally kills acne-causing germs. Probiotic serums activate these P. acnes phages to treat acne quickly. It is a new-age technology that is rapidly gaining momentum.
Probiotic-based serums target only acne-causing bacteria on your skin so that the good bacteria can thrive. The result is healthier skin and a stronger protective epidermis.
3. Salicylic Acid (BHA)
Salicylic acid is a popular beta-hydroxy acid. It removes the upper layer of the dead cells and penetrates the skin. Salicylic acid benefits include unclogged pores, shrunk blackheads, and reduced sebum production. Thus, it effectively treats acne.
How to use: Salicylic acid can be used as a serum for acne. However, it can be used as a cleanser or gel as well. It can be used twice a day based on the particular product you are using.
Concentration: Unlike Benzoyl Peroxide, salicylic acid is highly potent and is available in ranges of concentrations, e.g. 0.5% to 5%. However, dermatologists suggest 1% or 2% concentration is safer to use.
Alpha-hydroxy acid or AHA is a powerful chemical exfoliator. Once applied, it effectively removes the layer of dead skin cells and prevents the collection of sebum and the overgrowth of acne-causing bacteria. Some of the popular AHAs are:
- Lactic acid
- Mandelic acid
- Glycolic acid
How to use: AHAs can be used as an acne-fighting serum once a day or every alternate day. Alternatively, it can be used as a chemical peel exfoliator (not more than) once a week.
Concentration: If used as a serum, dermatologists suggest 3% to 8%. If used as a chemical peel, it can be used in higher concentrations (10-15%). However, do note that AHA makes skin highly sensitive to UV radiation. Therefore, you must use sunscreen after applying AHA.
Retinol is a type of retinoid primarily produced from vitamin A. It accelerates skin cell turnover rate and removes the top layer of dead cells.
The major benefit of retinol is that it promotes the growth of collagen and healthy skin cells. Furthermore, it prevents painful pimples.
How to use: As an OTC product, retinol is available in acne serum and gel form. Retinol often causes redness, itching, and dryness. The thumb rule to use retinol is to use less and go slow.
Therefore, it can be used every alternative day or once in three days. A vegan alternative to retinol, Bakuchiol, can also be used as it does not cause any skin irritation.
Concentration: Retinol is available in concentration ranging from 0.025% to 2%. However, 0.1% is the safest and most popular concentration.
6. Tea Tree Oil
Tea Tree oil is a natural essential oil that is highly popular in treating acne and acne scars. It is effective in treating mild noninflammatory and moderate inflammatory acne.
How to use: It should not be applied directly on the skin as it can cause rashes. The most effective technique to apply tea tree oil is to add 2-3 drops into a mixture of aloe vera gel and a pinch of turmeric.
Myth 1: “Poor diet causes acne.”
Fact: According to research, foods that contain a high glycemic index and dairy products ‘may‘ trigger acne in some people. However, no concrete results have been found.
Myth 2: “Squeezing blackheads, whiteheads, and spots is the best way to get rid of acne.”
Fact: Popping blackheads and whiteheads may feel addictive, but it aggravates acne and leads to scarring. Try to avoid picking or squeezing pimples.
Myth 3: “Acne is infectious.”
Fact: Acne is not at all infectious.
Acne is the most common skin condition in the world. But it can be treated. Today, many robust OTC products are being manufactured that work considerably well.
However, they fail to deliver adequate results; maybe it is time to visit a dermatologist and use the recommended products. Nevertheless, acne is treatable.