I’m going to tell you something about treating acne: patience is key. We live in a society where instant gratification is taken for granted. You want a computer tomorrow? Sure, no problem. It’ll be in your mailbox tonight! Acne doesn’t work like that. Acne is a genetic problem, a medical dilemma, a social nightmare (it seems) and a windfall for cosmetic companies that are willing to prey on your suffering for the almighty dollar.
In a nutshell, Acne is a disease of the hair follicles and sebaceous glands found on your face, neck, back and shoulders. It’s considered a disease because the bacteria and genetic predispositions that cause Acne are, by definition, pathogenic in nature. The most important concept to grasp here is that true Acne Vulgaris is a disease of the hair follicles found on your face, neck, chest, back, and upper arms.
More Acne Topics
So, what causes acne?
The short and simple answer: androgenic hormones (sex hormones) cause more oils to be released into the hair follicles and pores where a certain bacteria (Propionibacterium acnes) uses those oils as nutrients, grows and causes inflammation, which then leaves your pores susceptible to more bacterial infections (like “Staph”).
The long answer to what causes acne:
There are a myriad of combinations of circumstances that may cause acne, but the short version is thus: oils called sebum from your sebaceous glands–your skin’s own moisturizing lotion–build up along with dead skin cells and clog the hair follicle. It happens to all of us with varying severity. When this happens, your hair follicle will grow and push outward, causing a comedome to appear; they’re also known as pimples or zits.
Now, if you have bacteria on your skin, and we all do, then the conditions are right for bacteria to grow inside of your swollen hair follicle. If that happens, then your body will start to produce white blood cells, injecting them into the hair follicle to fight the bacteria, causing what we call a “pustule.” This pustule may grow, depending on how hard your body brings the hammer down. If it does grow, it will become red and tender with a white top that looks like it’s about to burst.
This is the part where the pustule is supposed to burst. Sometimes it doesn’t. Instead, your hair follicle ruptures at the bottom, down into your dermis. When this happens, it becomes a nodule. If that mixture of oil, dead skin, bacteria, and pus doesn’t get released, it can become worse; it can become a cyst. If your skin doesn’t break and release that sticky mess and becomes infected consistently, you have cystic acne, one of the most severe forms of acne.
Things you can do to treat acne at home:
Stop using oil-based makeup, hair products, and similar cosmetic products if you want to get rid of acne. Oil buildup on the skin is one of the primary causes of acne, so you will want to avoid getting any kind of oil on your skin. This includes mechanical oils and greases, as well as cooking oils. Many teenagers fail to follow this advice, eating fast foods which contain large amounts of oils, while continuing to apply oil-based cosmetic products. Diet and lifestyles may need to be changed in order to get rid of acne.
Avoid harsh soaps and facial scrubs if you want to get rid of acne faster. Many acne cleansing products claim to wipe away dirt and oils, while “gently” exfoliating your skin. So long as you avoid contact with oils that aren’t produced by your body, you shouldn’t need these products. They can irritate your skin, damage your sebaceous glands, and cause even worse acne breakouts in the long run. The fact of the matter is that your sebaceous glands are producing oils because they’re trying to protect your skin from being dry, cracked, and overly clean. Facial scrubs are not a good way to get rid of acne.
Taking showers regularly and washing your face with gentle soaps will help get rid of acne. While it is helpful to avoid contact with contaminants and synthetic oils (or oils that are foreign to your body), it is not always possible. Washing acne-prone skin once in the morning and once in the evening while help reduce breakouts. Remember, however, to use gentle soaps, not harsh ones, when you wash yourself. There are a couple of all-natural soaps listed among the “Natural Acne Cures” that are recommended for gentle cleansing.
Don’t pinch, prod, or poke your blemishes to get rid of acne. Many people choose to pinch out their whiteheads, pimples, and zits with their fingers. There are a few problems with this method. First, your fingers are covered with unnatural oils. Second, your fingers are covered with plenty of bacteria. Thirdly, you will probably damage your sebaceous glands or create an impacted pimple, which will cause more fluid buildup and eventually an infected zit. Refer to the articles we’ve written on zits, whiteheads, and pimples for the appropriate ways to get rid of these types of acne issues.
Using a dermatologist-recommended acne lotion will help you get rid of acne. Don’t just grab a bottle of lotion that says it’s dermatologist-recommended; call or go see a dermatologist and ask them what lotion they would recommend. These lotions are different from soaps because they’re specifically designed to break down oils, kill the bacteria that cause infected acne blemishes, and promote the sloughing (shedding for lack of a better synonym) of dead skin cells (the other primary cause of acne). The better lotions recommended to get rid of acne contain either sulfur, resorcinol, or salicylic acid.
Clinical Treatments for Severe Acne
If home remedies for acne aren’t working for you, then it might be time to escalate your treatment plan. The following section discusses the use of topical retinoids, topical antimicrobials, azelaid acid, and oral antibiotics. For the sake of brevity, we won’t get into too much detail in this article. I’m just going to outline the basics of treatment plans that most dermatologists are using today, and I’ll discuss the mechanisms behind the most common medical treatments.
Topical retinoids are usually the first choice of medications to get rid of acne. Retinoids like tretinoin, Adapalene, and tazarotene are derived from Vitamin A. They are used to accelerate your skin’s natural ability to slough dead skin cells, decreasing the chance of occlusion (medical fancy-talk for clogging) of your pores. This is done at a cellular level by affecting the DNA of the cells on the surface of your skin, “tricking” them into shedding and regenerating themselves more quickly. On top of that, retinoids have properties that inhibit the inflammation associated with acne lesions. They’re available in both gel and ointment form. People with oily skin are usually given the gels because they tend to dry the skin.
Topical antimicrobials are usually the second choice of medications used to get rid of acne. Antimicrobials are exactly what you think they are: they kill microbes (i.e. bacteria, P. acnes). Benzoyl peroxide is a very common antimicrobial acne treatment. There are so many topical antimicrobial ointments and gels out there that it’s hard to keep track of them all. The mechanism of action is simple: kill the P. acnes bacteria that are causing the inflammation (a result of infection) to reduce the number of acne lesions. More examples of common antimicrobial ointments are clindamycin, dapsone, and erythromycin.
The third and least-prescribed choice for acne treatment is oral antibiotics. This form of treatment is generally reserved for very serious cases of nodular (cystic) acne, acne conglobata, and acne fulminans. Like topical antimicrobials, oral antibiotics work by targeting the P. acnes bacteria. Examples of these medications include azithromycin, doxycycline, and tetracycline. Except in serious cases of acne where topical antimicrobials are ineffective, oral antibiotics are losing favor among dermatologists because of increased instances of antibiotic resistant bacteria.
Note: Many of the newer topical medications are a combination of both retinoids and antimicrobials, and it has been suggested by recent studies that formulas containing both benzoyl peroxide and adapalene are the most tolerated combinations on the market.
Natural Acne Treatments
Tea tree oil, as you will find, is a commonly promoted natural treatment for acne on this site. For reasons that are beyond my understanding, tea tree oil acts as a natural antibiotic, or perhaps more like a natural disinfectant. Because it kills bacteria without harming the skin, it is considered one of the best natural treatments for mild cases of acne.
Low carb diets appear to be one of the best preventative treatments for acne. Researchers in Australia have shown tremendous results in reducing moderate to severe acne by administering a low carbohydrate, low glycemic index diet to patients. This isn’t news to many people, exactly. The fast food they tell you to avoid is usually loaded with super-processed carbohydrates. So try cutting out baked goods, cereals, sweets, and other starchy foods from your diet. It’s worth a shot, right? And you might lose some weight while you’re at it.
Black currant seed oil has been suggested as an acne-reducing herbal treatment. The average adult dosage per day is roughly 1500 mg, divided by at least three (3 doses of 500mg per day). Antioxidants and essential fatty acids are the accepted explanations for how black currant seed oil cures acne, but you may want to consult a trained herbalist before trying this remedy.
Earth Science Clarifying Facial Wash is loaded with a number of natural extracts meant to clean the skin gently and naturally to help prevent acne breakouts. It’s hypoallergenic, vegan, and animal friendly — meaning it hasn’t been tested on animals.
Natural Results Acne Body Wash is a naturally cleansing, gentle body wash. While you may be able to use just about any acne soap for body wash, this contains enough product to last you more than a week. This is a very good option if you’re looking for a natural acne remedy that helps to prevent back acne and chest acne as well as facial acne.
Forms of Acne
Rare Acne Types
Infantile Acne or “Baby Acne” is the result (usually) of the acceleration of androgenic functions (i.e. hormones). Most cases of baby acne are noticed around 3-6 months of age. It’s important to differentiate between infantile acne and neonatal acne, because the former may actually require treatment with topical medication, while the latter is a harmless skin condition that usually clears up after a few months.
Acne Conglobata is a severe form of acne, punctuated by deep, painful nodules usually present on the chest, back, and sometimes the butt. These nodules often form a network and their inflammation and subsequent eruptions can cause a considerable amount of scarring. It is not accompanied by a fever, which helps differentiate it from Acne Fulminans.
Acne Fulminans is a systemic disorder, meaning that the extreme number and depth of nodular acne lesions start to affect the body’s ability to function as a whole. Sores are usually found on the trunk of the individual and are preceded by a fever and other symptoms associated with a systemic infection. It often requires a combination of steroidal and antibiotic therapies. It’s rare, very rare, and it’s commonly confused with Acne Conglobata.
Skin conditions that are mistaken for acne:
Rosacea is not acne. Acne Vulgaris requires the presence of comedones (clogged pores) and a hormonal component for a positive diagnosis. Rosacea is not accompanied by any clogged pores, but papules and pustules similar to those caused by Acne Vulgaris may be present. However, a typical rosacea diagnosis is made by observing the presence of redness in the nose and cheeks as well as visible blood vessels and dry skin.
Drug-induced Acne is the expression of papules (kind of like whiteheads) caused by the use of certain medications.
Acne Cosmetica is a fancy-pants term for acne (not Acne Vulgaris, mind you) caused by comedogenic cosmetic products (i.e. oil-based cosmetics).
Occupational acne is, again, a type of acne (still not Acne Vulgaris) caused by individuals being exposed to certain chemicals or materials in their workplace.