Acne is something that affects 80% of people at some point in their life. Although acne isn’t a life-threatening disease, it can really affect your confidence and your personality. 

Being a therapist I have seen all types of acne and heard all the myths. I have seen what has worked and what hasn’t…

A lot of people think their acne is the worst ever because they have nothing to compare it to, so people tend to want to jump on the ‘Accutane’ bandwagon when they actually don’t need it. 

I hope this post helps you identify what type of acne you have and what treatment is best for you. 

What is acne

The skin is covered in pores which are also hair follicles.  Inside the hair follicle, we also have sebaceous glands that produce sebum which lubricates our skin.
We are constantly shedding skin cells on top of and inside our pores.  When sebum is secreted and meets these skin cells, they form a thick paste which clogs the pore. This is the least likely to scar and is known as Non-inflammatory Acne.

Non-inflammatory Acne includes:
White head’s (A pore becomes clogged, a seal forms, it bulges out and has a white head).
Black head’s (A pore becomes clogged, no seal is formed, the paste oxidises and appears as a blackhead).

This thick paste can attract bacteria which can then lead to Inflammatory Acne. 

Inflammatory Acne includes:
Papule’s (The pore walls break down due to inflammation, this makes the papule tender to the touch and red)
Pustule’s (The pore walls have broken down and are filled with pus.  These are also red in colour but have a yellow/ white head).

The bacteria cause infection which spreads deeper into the skin and this is known as cystic acne. 

Cystic acne includes:
Nodules (when a papule or a pustule is irritated and grow larger beneath the surface).
Cysts (Cysts grow even further into the skin than nodules and are the most likely to scar).

These 3 type’s of Acne can be brought on by:
Genetics
If your parents suffered from Acne, then you will be more likely to get it.

Skin type
Having an oily skin can induce acne because there is more sebum being produced, which is what clogs the pores.

Hormones
Producing too much testosterone can lead to acne as we have enzymes in our body called Five Alpha Reductase, that mix with the testosterone and cause acne. Certain people have too much of that enzyme. Androgen is a hormone produced by the adrenal gland, ovaries and the testicles. If the Androgen ratio is off, this causes acne.  Stress and sugar can offset this ratio. Stress also depletes levels of b5 in the body which helps to support the skin.

Bacteria
We have a layer of good bacteria that live on the surface of our skin, but an overproduction of sebum can attract bad bacteria to the skin.  This can get inside the pores and cause infection.

Hair
You may have acne on your forehead and try to cover it with your fringe, but the product you use in your hair could be what is causing it, as it may be irritating the skin. This is known as Pomade acne.   Also, the grease that builds on the hair can rub onto the skin, which attracts bacteria and causes acne.

Poor exfoliation
When we exfoliate we remove dead skin cells but we also stimulate our sebaceous glands to produce and secrete more sebum, which pushes out any dead skin cells that are inside the pore.  When this slows, the dead skin cells are not removed as fast, which can lead to the sebum and skin cells forming a paste, which clogs the pores.

Washing your face too much
A lot of us think the cleaner and less oily we keep our face, the better.   However, if we strip our skin of natural oil, our skin will try to replace it by producing more, which leads to excess oil production. There is a fine line between washing your face too much and not enough.

Vitamin deficiency 
Vitamin A, D, E and K have the ability to be stored in the fat and can go through the fat layer of the cell and into the centre of the cell where the DNA is.   They can affect the DNA of the cell and control your genes, so if you are deficient in these fat-soluble vitamins, you can have a lot of structural problems with your body tissue.

How to treat Acne

Non-inflammatory acne:
If you have whiteheads or blackheads they are very responsive to Retina-A.  You can also use Retinol which is a weaker version of Retina-A that can be found in skin care. Retinol can be de-activated by the sun, so it’s best to use it at night. 

Inflammatory acne:
Papules and pustules are caused by a bacterial infection so a topical or oral antibiotic may be prescribed to kill an infection.

Cystic acne
As Cystic acne is the most severe form of acne, stronger antibiotics are needed to cure the deep infection. The most commonly is known as Accutane.  This needs to be prescribed and may only be taken for a period of 6 months as it is so strong.

Hormonal acne
If the acne is caused by hormones, using oral contraceptives can help as they regulate your hormones.

What you need to do for an overproduction of Alpha Reductase is to take an Alpha-Reductase Inhibitor, and that can be found in all the Cruciferous vegetables like spinach, kale, broccoli, cabbage, or you can take a tablet containing DIM. 

If you are uncomfortable treating it yourself and you are able to visit a professional for treatment:
Estheticians can do facials or Comedone Extractions.
Dermatologists can do chemical peels and acne laser treatments.

I hope this has helped you to decide what type of Acne you have and what method is best for you.  If it has helped, or if you still have questions, please let me know in the comments.