Let's Talk Breakouts: A Laid-back Intro to Acne

By: Anagha Kolanu

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Let's talk about acne – those uninvited guests on your face that seem to stick around. It's like having little troublemakers camping out on your skin, refusing to leave. We've all tried negotiating with these stubborn guests, offering them face wash and pledging to cut back on snacks, but they just won't budge! Life can get pretty hard finding ways to get rid of these pesky guests on our bodies- from going to the store and spending our entire life savings on the seemingly perfect skin care routine you saw trending on tiktok or curating natural face masks at home just for them to end up down the drain.

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What is acne and how is it caused?

Acne is a prevalent skin condition characterized by the blockage of hair follicles due to a buildup of oil and dead skin cells. This often results in the formation of pimples, blackheads, whiteheads, or cysts, commonly appearing on the face, neck, chest, back, and shoulders. The main culprits behind acne include an excess production of oil (sebum), the presence of acne-causing bacteria known as Propionibacterium acnes, follicle blockages, and subsequent inflammation. Hormonal fluctuations during life stages such as adolescence, pregnancy, and menstruation can contribute to increased sebum production. Other factors like certain medications, genetics, and lifestyle choices, including diet and stress, may also play a role in the development of acne.

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Some secret culprits of acne in our everyday lives:

• Using the same pillowcase everyday

• Not washing your face after going to the gym

• Not washing your makeup brushes or beauty blenders

• Not washing your hands before starting your skincare routine

• Using the same towel that you used on your body for your face 

• Bacteria from your phone 

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Face Mapping

Face mapping, a concept rooted in traditional Chinese medicine and Ayurveda, suggests that the location of acne on the face may offer clues about potential underlying health issues. While not scientifically proven, some find face mapping a useful tool for gaining insights into skin concerns. Here's a simplified guide:

• 1. Forehead

• Possible causes: Stress, Oil, Sweat, exposure to unclean pillowcases

• Recommendations: Apply benzoyl peroxide or use a salicylic acid wash (anything to help kill bacteria), change pillowcases, wash face right after you sweat.

• 2. Between the Brows

• Possible Causes: Digestive problems, liver issues, or dietary imbalance.

• Recommendations: Monitor diet, stay hydrated, consider liver-supportive foods, avoid using a razor to do your eyebrows.

• 3. Cheeks

• Possible Causes: Respiratory problems, allergies, or exposure to unclean pillowcases/phones.

• Recommendations: Maintain respiratory health, address allergies, and keep bedding and phones clean.

• 4. Nose

• Possible Causes: Poor diet, indigestion, or cardiovascular concerns.

• Recommendations: Consume a balanced diet, improve digestion, and maintain cardiovascular health.

• 5. Eyes and Surrounding Area

• Possible Causes: Stress, lack of sleep, or eye strain.

• Recommendations: Prioritize sleep, manage stress, and take breaks to reduce eye strain.

• 6. Mouth and Chin

• Possible Causes: Hormonal imbalances, digestive issues, or stress.

• Recommendations: Address hormonal balance (if applicable), maintain digestive health, and manage stress.

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What Each Type Of Breakout Means

Blackheads

Blackheads, open comedones resulting from clogged hair follicles with excess oil (sebum) and dead skin cells, stand in contrast to closed comedones like whiteheads. The characteristic dark color of blackheads stems from a reaction between the follicle's oil and the air, not dirt. Here's an overview of what blackheads typically signify:

• Excessive Sebum Production: The primary cause of blackheads is the overproduction of sebum by the sebaceous glands. Hormonal shifts, especially during puberty, can trigger these glands, leading to an abundance of oil.

• Accumulation of Dead Skin Cells: Continuous shedding of dead skin cells can contribute to blackhead formation when these cells accumulate with sebum, clogging hair follicles.

• Presence of Propionibacterium acnes: This skin bacterium, typically present, thrives in clogged follicles, contributing to blackhead development and inflammation.

• Non-Inflammatory Acne: Blackheads fall into the category of non-inflammatory acne lesions. Unlike inflammatory acne types, such as papules, pustules, nodules, and cysts, blackheads usually do not induce redness or swelling.

While blackheads are generally not a major concern, they can be a cosmetic bother. Implementing proper skincare practices, including regular cleansing and exfoliation, is key to preventing and managing blackheads. It's crucial to refrain from squeezing or picking at blackheads, as this may result in inflammation and scarring. 

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Whiteheads:

Whiteheads represent a form of acne characterized by closed comedones, indicating a complete blockage of the hair follicle. Unlike blackheads, these lesions lack an opening to the skin's surface, trapping oil (sebum) and dead skin cells beneath the skin. Here's an overview of what whiteheads typically signify:

• Accumulation of Sebum and Dead Skin Cells: Whiteheads develop when excess sebum and dead skin cells gather within a hair follicle, resulting in a blockage.

• Closed Nature: The closed structure of whiteheads prevents the trapped material from oxidizing with air, maintaining a colorless or white appearance.

• Hormonal Influences: Hormonal fluctuations, particularly during puberty, menstruation, or pregnancy, can contribute to heightened sebum production and the formation of whiteheads.

• Genetic Factors: Genetic predisposition plays a role in acne and the occurrence of whiteheads.

• Skincare and Cosmetics: Certain skincare products or cosmetics that clog pores may contribute to the development of whiteheads.

• Diet and Lifestyle: While not conclusively proven, some individuals find that dietary choices and lifestyle factors, such as stress, may impact acne, including whiteheads.

Whiteheads are categorized as non-inflammatory acne lesions and typically present a lower risk of causing redness or swelling compared to inflammatory acne types. Adopting proper skincare practices, including regular cleansing and exfoliation, is crucial for preventing and managing whiteheads. It's important to refrain from picking or squeezing whiteheads, as this can lead to inflammation, scarring, and potential progression into inflammatory acne.

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Cysts: 

Cysts represent a severe category of acne lesion, signifying a deeper and more inflamed form of acne. Here's an overview of what cysts typically suggest:

• Deeper Inflammation: Cysts arise from inflammation deep within the skin, unlike superficial pimples. They manifest at a deeper level in the dermis.

• Nodule Formation: Cysts often appear as large, painful nodules filled with fluid beneath the skin's surface. These nodules can be felt and extend deeply into the tissue.

• Pustule Development: Over time, cysts may progress to the formation of pustules, larger lesions filled with pus that can be challenging to treat.

• Severe Acne: Cysts are classified as a severe form of acne and are commonly associated with persistent and widespread cases of the condition.

• Potential Scarring: Due to their inflammatory nature and depth, cysts pose a higher risk of causing lasting scars and skin damage.

• Hormonal Influence: Hormonal fluctuations, especially during puberty, menstruation, or conditions like polycystic ovary syndrome (PCOS), can contribute to cystic acne development.

• Genetic Factors: Genetic predisposition may influence susceptibility to cystic acne.

Cystic acne can be emotionally distressing and physically painful, often requiring professional medical intervention for effective management. Dermatologists may prescribe medications such as oral antibiotics, hormonal treatments, or isotretinoin (Accutane) to address cystic acne. In some instances, drainage or corticosteroid injections may be considered to reduce inflammation. Attempting to squeeze or pop cystic lesions at home is discouraged, as it can exacerbate inflammation and increase scarring risk

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Treatment

Blackheads:

Goals of Treatment:

The primary objective is to eliminate pore blockages and clear away excess oil and dead skin cells, the main contributors to blackhead formation.

Approaches to Treatment:

• Exfoliation: Utilize exfoliating products containing ingredients like salicylic acid or glycolic acid to eliminate dead skin cells and thwart the obstruction of pores.

• Topical Treatments: Employ products with salicylic acid or benzoyl peroxide to effectively treat blackheads by unclogging pores and reducing inflammation.

• Clay Masks: Regular use of clay masks can assist in the absorption of excess oil and impurities, serving as a preventive measure against blackheads.

Professional Measures:

Dermatologists may administer specialized treatments such as chemical peels, microdermabrasion, or extractions to address particularly stubborn blackheads.

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Whiteheads:

Goals of Treatment:

The primary aim is to prevent and address the buildup of sebum and dead skin cells within closed pores, which leads to the formation of whiteheads.

Approaches to Treatment:

• Gentle Cleansing: Utilize a mild, non-comedogenic cleanser to maintain clean skin without causing irritation. You'll know if it's noncomedogenic or not by reading the label on the back of the product.

• Exfoliation: Regularly exfoliate to thwart the accumulation of dead skin cells. Opt for products with salicylic acid or glycolic acid.

• Topical Retinoids: Incorporate over-the-counter or prescription retinoid creams to encourage skin cell turnover, preventing whitehead formation.

• Topical Treatments: Use products with salicylic acid or benzoyl peroxide to unclog pores and diminish inflammation.

Professional Measures:

Dermatologists may suggest professional interventions like chemical peels or extractions to address persistent whiteheads.

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Cysts:

At-Home Care:

• Gentle Cleansing

• Topical Treatments

• Warm Compress

• Chemical Peels

Lifestyle Adjustments:

• Dietary Changes: Consider avoiding dairy, sugary foods, and high-glycemic index foods, as some individuals find these may trigger or worsen cystic acne.

• Stress Management

• Avoid Picking or Squeezing

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Look out for my next blog post on the science of different skincare products and how I formulated my own skincare routine as well as what products I use!