Advertisement

How to Treat Acne

Photo credit: Squaredpixels - Getty Images
Photo credit: Squaredpixels - Getty Images

From Men's Health

There’s never a good time for an acne flare-up, but experiencing the condition as an adult feels particularly unjust. You’ve done your time as a gangly, awkward teen with a wispy moustache, and mum has the embarrassing pictures to prove it. And yet here you are, multiple decades old, covered in angry spots, oily skin and a red raw face that burns when you touch it. What gives?

Despite what airbrushed Instagram images might lead you to think, acne affects near enough everyone at some point or another, in fact around 80 per cent of people between ages 11 and 30 have experienced an acne outbreak, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. And guess what? A flare-up is as distressing at the age of 40 as it is as 14.

Acne is unforgiving. It’s most likely to crop up on your face, but it might also reach across your chest, shoulders and back, a.k.a the dreaded ‘bacne’. There are six distinct types of spot that are symptomatic of acne, explains Dr Ross Perry, medical director at CosmedicsUK. Each case of acne is different – you might suffer from one, several, or all of the below.

Blackheads

Small black bumps also known as open comedones. They’re not filled with dirt, as you might presume – they’re black because of pigmentation produced by the inner lining of the hair follicle.

Whiteheads

Similar in appearance to blackheads, but may be firmer and won’t empty when squeezed. Also called closed comedones.

Papules

Small red bumps that may feel tender or sore.

Pustules

Similar to papules, but have a white tip in the centre caused by a buildup of pus.

Nodules

Large hard lumps that build up beneath the surface of the skin. They can be painful.

Cysts

The most severe type of spot caused by acne. Large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring.

Before you go about treating acne and acne scars, you should first know what causes it.

What Causes Acne?


Your skin may act as a barrier to the outside world, but it also has its own delicate ecosystem that can be disrupted by rogue hormonal imbalances and bacteria. Acne is what happens when the relationship between your skin’s pores and oil glands – and the hair follicles that connect them – is thrown out of whack.

Your glands make an oily substance called sebum, which carries dead skin cells to the surface of your skin via the hair follicle. For one reason or another – if your body produces too much keratin, a type of skin protein, or too much oil – the hair, sebum, and skin cells sometimes clump together to create a tiny plug, blocking the pore.

“These clogged pores will lead to the formation of comedones, since the excess oil can’t flow freely onto the skin’s surface,” says dermatologist Dr Stefanie Williams, founder of skin clinic Eudelo London. “Acne bacteria invades the comedones, causing inflammation, which leads to the development of papules, pustules or cysts.”

Photo credit: PeopleImages - Getty Images
Photo credit: PeopleImages - Getty Images

While teenage acne often is characterised by oily skin, adults suffering with acne may report combinations of dry and sensitive skin, she adds. “They may apply skincare that is too rich – facial cleansing oil, coconut oil and others – which then further aggravates their acne.”

Wearing clothes that cover the affected area such as hats, scarves, headbands and backpacks can worsen acne, says Kay Greveson, aesthetic nurse practitioner and founder of Regents Park Aesthetics, who adds that smoking has also been linked to increased risk of acne.

Though acne may be a physical condition, it can directly impact your mental wellbeing. “Acne has been associated with anxiety, depression, poor quality of life, lack of self-confidence, feelings of isolation and unattractiveness, embarrassment, low self-esteem and problems with body image,” says Dr Alia Ahmed, psychodermatologist at Eudelo London.

This has a knock-on effect that can impact your entire life, from clothing choices and everyday social interactions to the type of exercises you do, your relationships and even to some extent your career choices. It can even put your life at risk – suicidal ideation affects around seven per cent of people with acne, says Ahmed.

What Causes Acne Scars?

If you’re unlucky enough to suffer from papules, pustules, nodules or cysts – referred to collectively as skin lesions – they may leave patches of discoloured skin after they disappear, known as Post-Inflammatory Hyperpigmentation (PIH), as well as either dented or raised acne scars.

Acne scars fall into four key categories, Dr Perry explains, and each has different characteristics. “A patient may have one predominant type of scarring or a mixture of all four,” he says. “Understanding the nature of the scars is important in assessing the best possible treatment.”

  1. Ice pick scars which are sharp, deep and V-shaped.

  2. Boxcar scars which are round or square craters often found on the cheeks and temples.

  3. Rolling scars which are wide but not deep, resulting in an uneven, wavy texture.

  4. Hypertrophic scars which are raised and lumpy and formed by severe acne cysts.

Acne Treatment

You might not be able to swerve it completely, but if a breakout is imminent there are some immediate steps you can take to soothe your symptoms. Firstly, make sure you’re cleansing your skin thoroughly morning and night to get rid of any dirt and debris, says Dr Perry. “Choose an option with salicylic acid, glycolic acid or benzoyl peroxide, which all help to break down the bonds between dead skin cells, eliminating them from the surface of your skin.”

Benzoyl peroxide kills the bacteria that causes acne, helps to remove excess oil from the skin and removes dead skin cells. Salicylic acid helps to prevent pores from plugging, while alpha hydroxy acids remove dead skin cells and reduce inflammation. Pair with a gentle oil-free moisturiser and consider buying an oil-free daily SPF30, since the sun can also cause breakouts.

Photo credit: Jose Luis Stephens / EyeEm - Getty Images
Photo credit: Jose Luis Stephens / EyeEm - Getty Images

“Try not to keep touching your face – especially your chin, which naturally produces more oil and sebum and definitely don’t squeeze,” Dr Perry continues. “If skin is red and angry, try dabbing on witch hazel. Drink plenty of water to keep the skin hydrated and lay off the alcohol. Eating a healthy diet consisting of leafy greens, fish and probiotics will also help.”

Sometimes even the best emergency skincare routine in the world just isn’t enough to eradicate the inevitable. It’s better to treat acne as early as possible to prevent scars forming, advises Greveson. “If someone experiences recurrent, painful acne that does not improve with over the counter preparations and is causing them distress, a GP visit is recommended,” she says. So if you’ve done everything in your power to manage your symptoms and still have no relief, it’s time to call in the big guns.

How to Get Rid of Acne

Your GP will be able to prescribe medications such as topical retinoids, topical antibiotics, azelaic acid, antibiotic tablets or isotretinoin tablets, explains Dr Perry. They can also refer you to your local NHS dermatology department for an appointment with a dermatologist if they feel it would be more appropriate.

There are also a number of private treatments available to treat acne such as laser treatments like ClearSkin. “This advanced procedure is based on a very simple principle, which is to destroy the overactive bacteria causing the inflammation,” Dr Perry says. “The laser energy penetrates beyond the surface of the skin and reaches into the pores, where bacteria can grow in the sebum, and cleverly seeks out the bacteria without damaging the surrounding skin tissues.”

Photo credit: knape - Getty Images
Photo credit: knape - Getty Images

It might also be worth investing in a monthly dermatology-grade facial, adds Dr Williams. One of the most beneficial steps to acne control is the thorough extraction of comedones, because every single spot starts as a comedone,” she says. “However, make sure it’s a dermatology grade facial, not a spa or high-street facial, as these have been shown to often aggravate acne and should be avoided in anybody with breakouts. ”

Certain types of chemical peels – containing, for example, glycolic or salicylic acid – may help, particularly when used in tandem with blue LED light treatment.

Finally, check your bathroom shelf. It’s vitally important to use light, oil free products, suggests Dr Williams, so always run an eye over the label. “It may say ‘oil-free’ on the pack, but if you check the ingredients list, you will still find oil-based ingredients,” she says. “Avoiding oils is also true for tea tree oil, which is often marketed for acne. It may have mild anti-inflammatory effects, but its pore-clogging properties greatly outweigh the mild benefits.”

How to Get Rid of Acne Scars

Eliminating acne is an uphill battle made worse by the stubborn scars it leaves behind. There is, however, a silver lining. “Modern advances in cosmetic dermatology have made it possible to greatly reduce or even nearly eliminate acne scarring,” says Dr Williams. But – and it’s a big but – any ‘active’ acne needs to be completely under control first. “A common mistake is to try and treat acne scarring while you still have active spots,” she says.

However, once it’s gone, there are several methods that can not only help reduce scarring but also improve your overall skin quality, too. These include micro-needling, certain types of localised peels, subcisions, microdermabrasion and carboxytherapy, but you should seek the advice of a dermatologist who can direct you to the optimal course of treatment depending on the specific type of scarring involved.

('You Might Also Like',)