Are you tired of your skin getting greasy midday? Oily skin is a common cosmetic problem that gives the appearance of shiny skin. While there is no way to prevent it, there are certain techniques that can help fight it.
What causes oily skin?
We begin by understanding the oil, or sebaceous, glands on our face. These glands release a complex mixture of lipids (fats) onto the skin surface called sebum. Oil glands are highly concentrated on the face, upper chest, back and behind the ear. An excessive volume of oil glands is the main cause of oily skin.
Our oil glands are stimulated by a hormone called androgen to produce sebum at puberty and beyond. The enzyme that catalyses androgen to its most active form is also found in higher concentrations in oil glands as compared to other skin parts.
At various life stages, your body experiences changes in androgen levels. This explains why you do not have oily skin all your life. Oil glands are present at birth but sebum production remains low until puberty when it increases exponentially. Sebum secretions are typically the highest among 15-35-year-olds and decline gradually afterwards. They stop after menopause for women, and for men in their sixties or seventies.
At any age, men are more likely to suffer from oily skin than women. This is because men have higher sebum production levels mostly due to testosterone secretions.
A diet rich in carbohydrates and a high glycemic index is associated with high insulin levels. Example of high glycemic load foods is sugary foods, white rice, white bread, and potatoes. Low glycemic load foods include fruits, legumes, soy products and porridge.
Insulin stimulates oil glands to produce more lipids. Switch to a low glycemic-load diet for an improvement in insulin level, which can, in turn, keep your oily skin in check.
Insulin levels typically peak during late puberty and gradually decline in the 30s, which explains why some of us develop oily skin at school.
Various genes control the activity of our oil glands. In most individuals, an overexpression of a gene called Smad7 leads to an increase in lipid synthesis. This means an individual with oily skin will not be able to eliminate the condition. However, with proper long-term cosmeceutical skincare, it is possible to have less oily skin.
Temperature: Sebum production varies directly with temperature; an increase in 1°C leads to a 10% increase in sebum excretion rate. Unsurprisingly, summer is the season when our oil glands produce the most sebum. Hot, humid climates also cause skin to be oilier.
Cleansing habits: Using a harsh cleanser or over-washing to remove excess sebum can strip skin completely dry, leading to reactive seborrhea. This is a condition where the excessive skin drying is read by the body as a signal to produce more oil.
Treating oily skin
This vitamin A derivative helps reduce the growth of sebum-producing cells, decreases the size of oil glands and suppresses sebum production.
This moisture-binding ingredient delivers hydration to your skin and restores moisture balance. Ensuring your skin has sufficient moisture helps prevents your skin from producing excessive sebum. Hyaluronic acid also plumps up your skin for an even complexion.
Use a gentle cleanser, ideally an anti-bacterial one like Miel Honey Cleanser. Dermatologist-formulated for all skin types, even oily or acne-prone skin, this cleanser is effective in removing grime, oil, bacteria and other environmental pollutants without stripping the skin’s essential lipids off. With honey as a natural humectant, it also traps moisture under the skin while you cleanse.
Individuals with oily skin may think their skin does not lack hydration. However, just because your skin has a lot of oil does not mean it has sufficient hydration. UV rays, environmental pollutants or harsh products can disrupt the skin barrier, affecting its ability to retain water. As a result, moisturizing regularly is an essential step.
If you have oily skin, look for a lightweight moisturizer. Radiance Fluide™ Hydrating Emulsion is an oil-in-water emulsion formulated for Singapore’s humid climate. An oil-in-water formula means small droplets of oil are dispersed in a larger volume of water. This gives a lighter texture compared to water-in-oil formulas where small droplets of water are dispersed in a larger volume of oil.
5. Oral isotretinoin:
An oral retinoid has the greatest results in suppressing sebum production, often a 60 to 90% reduction. A significant consideration before starting on oral isotretinoin is teratogenicity though (ability to affect fetal development and cause birth defects at the time of conception or during pregnancy).
Oral retinoids are only available on prescription due to their side effects. For cautious management, always consult a dermatologist first.
Suffering from acne? Also known asacne vulgaris, patients who suffer from this inflammatory disease typically develop it in adolescence.
Does my diet cause the acne?
The answer is not straightforward, because acne itself is multifactorial in origin, with genetics, inflammation, hormone related oil production in a complex interplay. However, a quick answer would be yes, diet does appear increasingly to influence the severity of acne and treatment outcome to a certain extent.
Acne vulgaris is often touted to be the epidemic disease of civilization, typically in first-world countries. Caused by an unhealthy diet fueled by modernization, it affects the sebaceous follicles of adolescents and adults. Today, a typical diet is characterized by high glycemic index foods, insulinotropic milk proteins and saturated fats.
Does a Western diet trigger acne?
To convince you, populations that are exposed to diets with low glycemic load and no milk/dairy consumption are acne-free, such as the Inuit, Ache hunters of Paraguay, rural areas of Brazil. Prevalence of acne increased as Okinawa islanders and the Chinese switch from traditional diets to Westernized food.
How do hyperglycemic carbohydrates cause acne?
High glycemic index foods are those that are extremely high in glucose. The glycemic index works by measuring the impact that your food has on your blood sugar level. High glycemic index foods cause your blood sugar to rise faster.
Eating lots of food like white bread and cereal can also cause the elevation of hormones, leading to increased sebum production. The high glycemic load changes the composition of sebum fatty acids, causing proinflammatory and comedogenic responses. A diet-induced change in sebum composition can trigger acne inflammation and drive the process of comedogenesis, also known as the formation of blackheads.
Can saturated fats lead to my acne problems?
The major culprit is a saturated fatty acid called palmitate, and it consists of 32% milk triglycerides. Palmitate triggers the abnormal proliferation of keratinocytes, a cell that produces keratin, resulting in micro-comedones. The continuous sebum accumulation, enlargement of follicle and build-up of keratin within the micro-comedones causes the formation of comedones.
Trans-fats, produced industrially that structurally resemble palmitate, are in the fast food that we eat. With the replacement of natural solid fats and liquid oils with hydrogenated fats in fast food, fried food and baked goods, it has led to unhealthy diets that contribute to acne. Such a diet contributes to inflammatory responses of our sebaceous glands and hair follicles.
Does milk cause acne too?
The link between milk consumption and acne is not a breakthrough, adolescent acne is closely associated with their diets being rich in milk, cheese, yogurt, cakes and low in fish, fruits and vegetables. Milk contributes to increased insulin levels which prevent that production of an important protein FoxO1. The deficiency of this protein has been linked to major factors of development of acne.
Milk intake can also influence comedogenesis as it contains androgens, a type of hormone, steroids and other components that can affect the sebaceous gland and hair follicle. Such molecules survive processing, and for instance, in cheese, fermentation leads to more testosterone being produced from the precursors in milk.
Milk facilitates the pathway of sebaceous lipogenesis and sebocyte proliferation. Excessive intake of milk protein also explains the onset and aggravation of acne.
How can I adjust my diet to be less acne-prone?
You may opt for a palaeolithic diet – no hyperglycemic carbohydrates, no milk and dairy products. Fish consumption has shown to have anti-acne effect, as the fatty acids from the fish can reduce inflammation.
Resveratrol, a compound found in the skin of grapes, has shown to inhibit the growth ofP.acnes, a bacteria that facilitates ace development in optimal environments.
Though multifaceted, dietary factors can worsen breakouts in acne-prone individuals. For a clearer skin, a good tipis to bear in mind what you consume, have a healthy balanced diet and lifestyle. However, if you have a persistent flare of acne for anything more than several months, medicated treatments such as oral antibiotics and topical retinoids may be necessary. So do visit a dermatologistearly to prevent complications such as secondary skin infections i.e. gram-negative folliculitis, orsevere acne scarring.
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.