Acne vulgaris is an epidermis inflammatory disease of the human sebaceous follicle and is a common dermatologic condition. Typically beginning in adolescence, it may persist into adulthood when left untreated.
How is acne developed?
The development of acne is not fully clarified, but it is agreed upon that the causes are multifactorial. A major cause of acne is related to a bacterium called Proprionibacterium acnes (P. acnes).
As a bacterium that grows deep inside of pores, P. acnes feeds on the sebum produced by sebaceous glands surrounding the base of the hair shaft. P. acnes grows best in an environment with accumulated sebum. P. acnes uses sebum as an energy source, causing the breakdown of sebum by the bacterium to produce byproducts that are inflammatory.
According to Dr.Teo Wan Lin, a dermatologist at TWL Specialist Skin and Laser Centre, she says: “To combat this inflammation, your body releases destructive enzymes to fight the infection. This immune response can cause damage to surrounding skin cells and is responsible for symptoms observed in acne as it permanently damages the skin and leads to acne scars.”
What are the causes that trigger acne?
One major cause is our genetic predisposition. Other factors that aggravate acne include:
Oil-based cosmetics and facial massage
Medicates that promote acne development e.g. steroids, lithium and iodides
Food with a high glycemic number e.g. dairy products, candy
Severe anxiety or anger may aggravate acne as it can stimulate stress hormones
Where does acne occur?
Acne occurs most prominently at skin sites with high density of sebaceous glands e.g. the face, back and chest.
Are there different types of acne?
Generally, acne can be divided into comedones, cystic acne. Comedones are hair follicles that are formed by the blockage of pores with sebum, debris and dirt, causing the pore to become infected.
Open comedones are blackheads, caused by an overproduction and buildup of oil that is oxidized, thus explaining its blackish appearance. Closed comedones are whiteheads, where the follicle is blocked completely. As the opening to the skin is obstructed, the rupturing of closed comedones can lead to skin inflammation.
Cystic acne is angry, red bumps filled with bacteria and pus. Caused by inflammation, it can start off as comedones that were left untreated, leading to an excessive growth of P. acne.
How can I treat acne?
Current treatments include topical formulations in the forms of creams, gels, lotions such as antibiotics, antibacterial agents and retinoids. Yet, patients need to be cautious of such treatments as it can lead to dryness, peeling or erythema. Different forms of acne would require alternative treatment techniques.
To treat open comedones, a mixture of carbon laser peels and chemical peels can be considered. For closed comedones, be sure not to pick those whiteheads as it exposes the skin to bacteria.
If you suffer from cystic acne, oral medication is likely to be given to shrink oil glands or prescription creams that contain tretinoin.
The use of lasers to treat acne is also increasingly popular due to minimal complications involved to allow benefits of treating acne scarring. The lasers will target the colonization of P. acne and high levels of sebum production on the face, chest and back.
If you may find it confusing to face acne alone, talk to a dermatologist. It is also important to visit your dermatologist before the acne gets severe and prevent scarring.
Do you suffer from symptoms such as skin redness, flaking, itch or stinging pain? Did you have eczema, asthma or sensitive nose when you were young, or have a family history of eczema or sensitive skin? Does your skin get red and itchy when you use makeup or skincare products, or when you are exposed to a dusty or sweaty environment? Does your skin act up when travelling to a cold or dry climate?
Dermatologists diagnose true “sensitive skin”, with a medical condition known as eczema, where common exposures to the environment or skincare and make up can trigger off flare-ups.
2. What Is Defined As Sensitive Skin Then?
People with sensitive skin are likely to have atopic dermatitis, which is a genetically determined condition where the skin is deficient in certain fats. The skin acts as a barrier to the environment and, without a proper functioning skin barrier, any dust, climate change, pet fur, or even emotional stress can trigger off a flare-up.
If you have never had any of these symptoms and suddenly experience “sensitivity”, especially soon after using a new skincare or makeup product, it might actually be a form of allergic contact dermatitis to an applied substance. This would be best reviewed by a dermatologist who might suggest a patch test and also receive appropriate medical treatment.
Undiagnosed and untreated skin sensitivity can become chronic and may result in scarring such as post-inflammatory hyperpigmentation which results in dark marks on one’s face.
Your dermatologist will prescribe you anti-inflammatory creams such as topical steroids of the appropriate strength and ceramide-rich emollients that replenish the skin barrier. In the case of any infection, oral antibiotics to clear the skin infection would also be prescribed. Oral steroids may also be required for severe eczema.
Here are three of the best skincare tips for people with sensitive skin:
1) Look for “dermatologically tested and formulated” labels that are produced in certified laboratories and that work with dermatologists rather than cosmetic brands.
2) Get your dermatologist to recommend a gentle cleanser formulated for effective cleansing of eczema-prone skin.
3) Get your sensitive skin treated first before using anti-ageing products Many anti-ageing products contain stimulating ingredients which may worsen sensitive skin. If you do use them, look for a product that’s recommended by your dermatologist.
Meet with Dr. Teo Wan Lin, founder and Specialist Consultant Dermatologist of TWL Specialist Skin & Laser Centre, an accredited dermatologist specialising in medical and aesthetic dermatology. She integrates her artistic sensibility with her research background and specialist dermatologist training, by means of customised, evidence-based aesthetic treatments using state-of the-art machines, injectables (fillers and toxins) which work synergistically with her proprietary line of specialist dermatologist grade cosmeceuticals Dr.TWL Dermaceuticals.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email email@example.com. Alternatively, you may fill up our contact form here.
By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre
Why do I get acne?
Acne occurs when the oil glands under the skin, known as sebaceous glands, become clogged with sebum, an oily substance. This process is known as inflammation, and it is often genetically determined. Hence, if you have a family history of acne, you are at high risk.
A normal amount of sebum usually keeps the skin healthy. Your oil glands become active once you reach adolescence due to hormones and this is when acne usually starts. When clogged, bacteria grow in the glands, and leads to bumps, swellings and visible blackheads and whiteheads on the skin’s surface.
Why do I tend to get acne on my chest, back and neck?
These areas have the highest numbers of oil glands and are acne-prone. Acne is not the only condition that can cause that. A fungal infection, known as pityosporum folliculitis, can also cause a similar condition. If you are developing bumps over these areas, it is important to see your dermatologist for diagnosis and treatment to prevent worsening and possible scarring.
As an adult, is it possible to still struggle with breakouts?
Acne can still affect adults. In fact, many adult females suffer from acne breakouts around the chin especially during certain times of their menstrual cycle. This should be differentiated from other conditions such as perioral dermatitis, which may look similar but is treated differently.
Is there a cure for acne, or do I just wait to outgrow it?
Acne can and should to be treated early to prevent worsening, secondary infections and scarring which may be permanent. It is definitely a fully treatable condition that no one should have to live with. Acne has an impact on one’s emotional well-being, and it is especially crucial during adolescent years and this should not be ignored. Severe forms of acne can result in bleeding, pus and more serious infections, a condition known as acne fulminans, which can result in complications.
What treatments are available for acne?
Under proper dermatologist care, acne can be fully treated with the correct medications, creams and light treatments. For patients who prefer not to be on oral medications, laser therapy is a safe and effective acne treatment method too. Ablative resurfacing can effectively reduce acne scarring. Blue light, a type of laser therapy is designed to treat acne when it is active. Blue light at high energy levels reduces the Propionibacterium acnes burden, leading to improvement of acne.
In addition to treatment, prevention against future acne breakouts are also crucial. Diet and proper skincare are also important factors in contributing to one’s acne condition. Therefore, holistic counselling with specific advice about how to manage your condition is important.