Having clear skin is a sought-after trait among young and old alike. Unfortunately, many of us fight dreaded pimples and persistent breakouts, sometimes for a good portion of our lives. In fact, Americans spend almost $400 million a year on over-the counter acne solutions. We’ll get to the bottom of acne causes and treatments to help combat this condition.
What Is Acne?
Acne vulgaris, simply known as acne, is a chronic, inflammatory skin condition that causes breakouts primarily on the face, neck, chest, shoulders, back, and upper arms. While it is not a threat to your overall health, acne can be emotionally concerning and affect self-esteem, as well as potentially lead to scarring.
The main culprit behind the development of acne is an imbalance in hormones, which alters how your skin’s sebaceous glands work. These glands are meant to produce oil, or sebum, to keep hair and skin lubricated. An overproduction of sebum can clog pores with dead skin cells and excess oil. Combined with the bacteria P. acnes, your body reacts, attacking the foreign body and causing inflammation. This reaction leads to swollen, red pimples, one of the main acne symptoms. Typically, the dark part of the pimple is called the blackhead, and the clogged pore with a skin layer is a whitehead.
Types of Acne
How you treat acne depends on the type of acne you've got.
- Whiteheads: Pores clogged by dead skin cells and sebum can form pimples under the surface of the skin. Topical retinoids such as Retin-A and products with salicylic acid are the ingredients of choice to help combat white heads.
- Blackheads: The characteristic black marker of a blackhead isn't from dirt. It's the clogged pore full of debris that remains open. In addition to retinoids and salicylic acid, it can be helpful to cleanse skin with a face brush such as Clarisonic.
- Papules: These tender but hard pink bumps form when bacteria, dead skin cells, and excess oil become trapped deep under the skin, giving rise to inflammation and redness. Wash your face with a salicylic acid or benzoyl peroxide cleanser. Be gentle with your skin, and avoid makeup and other products that can further exacerbate the inflammation.
- Pustules: The "classic" type of acne marked by a pus-filled center, pustules are best treated with benzoyl peroxide, salicylic acid, or sulfur-based acne treatments. Clay can also help draw out impurities.
- Nodules: Located deep within the skin, acne nodules require a doctor's intervention in order to subdue the swollen, irritated pores and prevent scarring. Dermatologists typically prescribe isotretinoin to shrink oil glands, as well as oral antibiotics or oral contraceptives.
- Cysts: Even deeper below the skin's surface than nodules, cysts (cystic acne), is caused by a buildup of sebum and dead skin cells in the recesses of hair follicles. If the cyst is severe enough, surgery to remove it may be warranted.
Who Gets Acne?
Acne is the most common skin condition in the United States, afflicting up to 50 million people every year. Commonly developing in puberty, acne affects both genders and all races and ages. According to research, 85% of people have experienced a degree of acne at some period in their lives. While acne can be a common problem in teenage years, in the past decade, acne sufferers are now an average of 26.5 years old.
What Causes Acne?
Many factors are often to blame for the development of acne, including hormones, personal hygiene, genetics, side effects of medication, and pore-clogging makeup. Then there are acne causes that are mere myths: greasy foods, chocolate, and dirty skin. These factors can affect your health, but do not directly cause acne to develop.
The internal workings of your body and its functions can cause hormonal changes that can show up on your skin. Certain spikes in hormones can increase oil production and your pores can become clogged quickly. Normally, your body is effective at shedding dead skin cells before bacteria can grow. If you are more susceptible to acne, the oil in your skin feeds the bacteria and it can quickly spread. Bacteria isn’t the sole cause, but the buildup of dead skin cells combined with the oil leads to acne.
Our hormones fluctuate throughout our lives. In women, estrogen and androgen help regulate the reproductive system, and when off balance, can lead to hormonal acne. This is the type of acne that occurs during puberty but also appears before menstruation in adult women.
Androgens are produced in both women and men, but testosterone spikes during puberty in young men. As men age, hormones typically balance out, and the production of oil evens out as well, lowering the frequency of acne. Testosterone is actually helpful for thickening skin and reducing wrinkles as men age.
Your genes play a big role in whether you are at a higher risk for developing acne and how aggressively your immune system reacts to the bacteria in your pores. You may only deal with an occasional whitehead, while another person may have to contend with large, red pimples covering the face. You may also produce higher amounts of oil, have difficulty shedding dead skin cells, or have pores that clog more easily.
Certain prescription and over-the-counter medications can affect how your body functions and lead to hormonal imbalances implicated in acne development. Birth control pills, steroids, and DHEA supplements have been linked to acne as a side effect.
Stress and Diet
When your stress levels rise, so, too, can acne. If you already suffer from acne-prone skin, stress can increase inflammation in the body and send the production of oil into overdrive. Poor sleep habits can also throw hormones off balance, increasing sebum production and the emergence of acne.
The foods you eat also affect your physical health by either nourishing your body or depleting it. While eating certain foods does not directly cause acne to form, your skin health is affected by the nutrients you consume. Your glucose levels in the blood, for instance, spike when you eat processed food high in starch and sugar. In response, insulin is created in the pancreas to counteract this spike. The side effect increases the prevalence of acne.
Environmental factors can play a role in acne development and also worsen an outbreak. Grease, chemicals, oil, and pollution can all negatively affect your skin. Sometimes high humidity and heat can lead to a rise in sebum production. In the winter months, your skin may produce more oil in response to the cold, dry air.
Certain factors that lead to acne, like genetics, are not something you can change, but you can be mindful of lifestyle habits to help lower the frequency of breakouts. If you are prone to acne, look for lightweight, hypoallergenic personal care products that have a higher amount of natural ingredients. According to the National Institutes of Health, greasy cosmetics can even alter the cells within follicles, making them more susceptible to clogging and bacteria growth. Sunscreen, hair products, and lotion can also be culprits for worsening acne and leading to flare-ups.
You may come across many acne medications at the drugstore, get a prescription from your doctor, or try natural home remedies to minimize pimples, clear skin, encourage healing, and prevent future breakouts. A dermatologist may be needed if you suffer from severe acne that does not react to any other treatments and you are looking to receive better results.
Over-the Counter Treatment Options
Sulfur is a keratolytic that helps prevent clogged pores. If you deal with minor blackheads and pimples or the occasional breakout, you may have luck with sulfur treatments. Sulfur can also inhibit P. acnes bacteria from growing, leading to further clogged pores.
A non-prescription medication that kills bacteria, benzoyl peroxide (BPO) encourages new skin turnover so that dead skin cells and excess oil are cleared more effectively. BPO comes in different concentrations, including 2.5%, 5%, and 10%, to provide different strengths for treating blemishes.
Salicylic acid is a common ingredient in many over-the-counter acne lotions and medications and helps by unclogging pores of oil and dead skin cells. Also available in different concentrations, it exfoliates by removing the top layer of skin, helping to dissolve blackheads.
Acne Home Remedies
If you want to go the home remedy route to help clear up your skin, here are several effective treatments you can try.
Tea Tree Oil
A study of 60 patients showed that 5% tea-tree oil was helpful in treating mild to moderate acne. With its natural inflammation-fighting properties, tea tree oil is useful on more sensitive skin, but offers a powerful punch against pimples. Mix a few drops of tea tree oil with a small amount of witch hazel and apply to infected area twice a day.
An excellent astringent, witch hazel can help dry out a pimple and reduce inflammation. Using a cotton swab or pad, apply to pimple twice a day.
Green tea has antimicrobial and antioxidant compounds that can help fight acne. Brew a cup of tea, allow to cool, and use the liquid to wash your face. You can also use a brewed bag as a compress and apply it directly to the blemish.
Aspirin contains salicylic acid that soothes inflamed skin and encourages drying of excess oil. Combine a crushed aspirin tablet with water to form a paste and apply to the area of concern.
Chamomile is a soothing plant that is used for treating many conditions, including acne. Useful in subduing inflammation and encouraging healing, chamomile tea is easy to find at any grocery store. You can empty the contents of a tea bag into a cup and mix with water to form an acne paste, or create a compress from a brewed tea bag. You can even combine green and chamomile tea into a soothing steam treatment. Just boil water, steep leaves, and then breathe in the steam using a towel to cover your head and trap the steam.
Aloe can help promote healing, fight infection, and reduce scarring caused by acne. Scrape the gel from an aloe plant or buy pure gel from a health food store and apply directly to the blemish.
This citrus fruit helps exfoliate skin cells, lighten spots and scars, and fight bacteria to treat pimples and prevent new ones from appearing. After washing your face, dip a cotton pad into pure lemon juice and hold over your pimple for several minutes, then rinse.
Apple Cider Vinegar
Apple cider vinegar has many uses, including minimizing red marks, treating acne, and exfoliating the skin. You can create your own disinfecting toner by combining water and vinegar in a 1:1 ratio. Apply all over the surface of your skin with a cotton pad each day. You can store your toner in the refrigerator for a cooling effect; just make sure to shake the bottle well before using.
Clay is a popular ingredient in many acne-busting over-the-counter masks, but there's no need to spend a pretty penny on a fancy clay mask. Just purchase a tub of pure bentonite clay and it will last you for years. Using a non-metal spoon and glass bowl, mix a teaspoon of bentonite clay with water or apple cider vinegar, apply to face as a mask, and let dry for 20 to 30 minutes. The solution will draw out toxins and impurities, and firm the skin.
To help reduce the swelling and red appearance of a pesky zit, apply an ice cube directly to the spot for at least 30 seconds. If you are prone to cysts and large pimples, ice can help reduce the pain and inflammation associated with these areas.
While most of us are tempted to pop a pimple the minute it shows up, it’s best to avoid doing so to prevent acne scars or spreading the bacteria. Every time you touch a pimple, the more aggravated and infected it can become. If you squeeze a zit, you can cause pus and bacteria to move further under the skin’s surface, leading to more inflammation and irritation. Plus, pinching can cause scabbing, leading to scars or pitting that may not fade with time.
While many factors can put you at a higher risk for acne, there are steps you can take to proactively boost your immune system and improve your health, helping your body fight skin problems more effectively. Making a nutrient-rich diet a part of your life provides your body with the tools it needs to prevent acne or clear up a bothersome breakout. Zinc, vitamin A, and vitamin E support skin health and reduce the risk of acne developing. To feed your skin and keep inflammation at bay, fill your plate with salmon, walnuts, flaxseed, and avocados for a beneficial dose of omega-3s. Reducing the stress in your life and practicing stress management through exercise and meditation can also help keep hormones in balance.
Practicing good hygiene and adopting healthy skin care habits is a must for keeping acne free. Begin and end each day by washing your face with a gentle soap and using an oil-free lotion. Washing your face more frequently can dry out your skin and cause your body to produce more oil to counteract the dryness. When looking for hair products, sunscreens, and other care products, search for non-comedogenic, oil-free versions.
While acne is not life-threatening or a reason for concern, it can be very challenging to live with and may affect your emotional well-being. Finding an acne treatment that works for you may take some time, but there are many remedies to try and support available to make the search easier. Working with a dermatologist, using prescribed medications or at-home solutions, and updating your lifestyle in healthy ways can help you obtain the clear skin you’ve always wanted.