When most people think of acne, they envision a teenager or adolescent with a pimply face, but this skin problem isn’t unique to the younger set. Adults get it too. The official medical name for this skin condition is acne vulgaris. Vulgaris literally means common, which is appropriate since so many people are affected by this skin problem.
What Causes It?
The red bumps and clogged pores that are so characteristic of acne is related to the overproduction of an oily substance called sebum. Sebum is made by sebaceous glands that lie adjacent to hair follicles. It has the beneficial function of lubricating and protecting the skin, but when too much is much produced, it causes skin cells inside the hair follicle to stick together. These cells are continuously being produced and sloughed off, but sebum causes them to clog up the follicle and pore that connects to the surface of the skin. Bacteria feed on the dead skin cells and sebum. This leads to inflammation and the red bumps and pustules you see with acne.
People with acne also get whiteheads and blackheads known as comedones. These are essentially follicles plugged with dead skin cells that aren’t inflamed.
The whole process starts with overproduction of sebum, and that’s usually hormonal in nature. That’s why you see acne so often in adolescents in teens as their hormone levels change. Acne is also more common during pregnancy due to hormonal fluctuations. There’s also a genetic component to acne, and it can be triggered by hormonal medications or corticosteroids. Stress and diet also seem to play a role.
Some people with acne cleanse their skin too aggressively. Twice a day cleansing with a mild cleanser, gently moving the washcloth in a circular motion without aggressively scrubbing the skin, is sufficient. Once cleansed, applying a lotion containing benzoyl peroxide helps to reduce the bacteria in the follicles that are contributing to the problem. For severe cases of cystic acne, dermatologist sometimes prescribe antibiotics to reduce bacteria. Unfortunately, oral antibiotics have side effects.
Another ingredient in some over-the-counter products that helps to reduce bacteria is sulfur. Sulfur has the additional benefit of helping to open up clogged pores. It does this by reducing the tendency for dead skin cells in the follicle to clump together. It can cause redness, peeling and irritation.
Another approach for treatment is to use products containing alpha-hydroxy acids or salicylic acid. These weak acids are found in some products used to treat acne. They help to loosen up and remove the dead skin cells that are clogging the pores. Of the two, products containing salicylic acid are usually more effective, although some people experience skin irritation when they first start using them.
Sulfur has the additional benefit of helping to open up clogged pores.
More Advanced Treatment
A dermatologist or aesthetician can do chemical peels using salicylic acid or glycolic acid to reduce comedones and help prevent outbreaks. This usually requires a series of peels to get maximal results. These peels can cause some temporary redness and skin irritation.
Dermatologists frequently prescribe retinoids in products such as Retin-A to treat acne vulgaris. Retinoids work by keeping the dead skin cells in the follicle from sticking together, which opens up pores that are clogged. Despite their effectiveness, many people have redness and skin irritation when they use them. This usually improves over time.
The primary cause of acne is overproduction of sebum, which is usually related to hormonal changes. Some women with adult acne respond to oral contraceptives, but this should be a treatment of last resort due to the potential side effects.
Another treatment that’s growing in popularity is blue light therapy. This involves using a handheld device that delivers blue light to the skin. Bacteria produce chemicals called porphyrins. These porphyrins absorb the light and free radicals are produced that destroy the bacteria which contribute to acne. These handheld devices are now available for home use. They shouldn’t be used to treat cystic acne.
The Bottom Line?
Acne vulgaris is a common skin problem not only in adolescents and teens but adults too. Fortunately, there are treatments that work well for this condition.