How to Conquer Acne?

Medically reviewed by John A. Flores M.D., M.S. May 02, 2024| Written by Zenda Nel

How to Conquer Acne?

Acne is a common but distasteful skin condition that most people experience at some point in their lives. While it mostly affects teenagers, it can also bother people in their 40s and 50s.

Though acne is not life-threatening, having your face disfigured by ugly red blotches accentuated by yellow puss is not exactly a life-enhancing experience either. 

Acne’s effects may reach deeper than skin deep.  The emotional and psychological burden of having ugly skin, especially when you are a teenager, can be devastating. Apart from feeling embarrassed and ashamed, acne-riddled skin can lead to cruel comments and rejection. 

Severalscientific studies have found the condition can lead to a lack of confidence, social withdrawal, feelings of insecurity and inferiority, limited employment opportunities, functional and interpersonal difficulties at work, and suicidal tendencies.

What is Acne?

Acne is a skin condition caused by hair follicles on the skin becoming plugged with oil and dead skin cells. When this happens, the result is whiteheads, blackheads, or pimples. 

So, what are hair follicles? They are microscopic tubes that hold the hair. It looks like a test tube with the closed part embedded in the skin and the open part on the surface of the skin. This is where the hair grows out. 

The follicles also act as canals for an oily substance called sebum excreted by glands under the skin. When this tiny 'test tube' gets filled with sebum and dead skin, you have acne.

When the resulting acne and pimples are red, the bacteria in the follicle are causing inflammation.

Symptoms

Acne typically appear as red or swollen pimples, blackheads, whiteheads, and sometimes cysts or nodules under the skin. Acne primarily appear on the face, back of the neck, chest, back, and shoulders. 

Whiteheads, also known as closed comedones, develop when a follicle is completely blocked, and the sebum and dead skin cells inside remain trapped beneath the skin's surface. This causes a small, white, or flesh-colored bump on the skin.

Blackheads, known as open comedones, form when the follicle is only partially blocked and the stuff inside reaches the surface of the skin where it oxidizes, turning it black.

Acne can also present as small, tender red bumps called papules. But papules with pus on top are called pustules. In severe cases, this condition can leave scars on the skin.

Are Acne and Pimples the Same?

Acne is the general term for a group of skin conditions that include pimples. Pimples are small, red, inflamed bumps on the skin that contain pus. Meanwhile, acne includes various skin conditions like blackheads, whiteheads, cysts, nodules as well as pimples. 

In other words, pimples are just one form of acne lesions. 

Myths Surrounding Acne

Did you know if you sleep with wet hair you'll catch a cold? If you think this is nonsense, you're right. Here are some more nonsense about acne that you should know about. 

Myth

Reality

Only teens get acne.

Acne is a common skin condition, afflicting people of all ages. A third of adults have acne. Although 85% of teens get some form of acne, they aren’t the only ones who can suffer from it.

Acne is caused by poor hygiene.

If dirt were the problem, acne would have cleared up with frequent washing; it doesn't. 

In fact, washing too much can worsen the condition.

Greasy foods like pizza and French fries cause acne.

There is no scientific evidence that these foods or any other junk food cause acne.

Only people with oily skin develop acne.

You can get acne irrespective of your skin type.

Stress lies at the bottom of acne.

Stress doesn't cause acne; it can make acne that's already present worse.

You can scrub acne away.

You can scrub all you want, but the acne won't wash away. In fact, vigorous scrubbing can irritate the acne and make it worse.

You can get rid of acne and pimples by popping them.

No, this will also make the condition worse by spreading infection.

Eating dairy can cause acne.

There are no robust scientific studies that prove dairy products cause acne. A meta-analysis found the intake of any dairy leads to a higher risk for acne - no causal relationship was found.

You can get rid of blackheads, whiteheads, and pimples by squeezing them. 

Squeezing spots will only make them worse.

Sexual behavior can affect acne.

Having sex or masturbating does not affect acne.

Sunbathing can improve acne.

There is no scientific evidence that exposure to the sun resolves acne symptoms.


These and other myths and misconceptions about acne are the result of the dearth of actual facts about the condition. 

What are the Main Causes of Acne?

Oddly enough, we seek to know more about what doesn't cause acne than what causes it. 

We know that acne appears on the skin when the pores of the skin become blocked with oil, dead skin, or bacteria, but we still don't know exactly what causes it to happen.

Researchers have identified some factors that may play a role in the development of acne. These include:

  • Changes in hormone levels, especially during puberty and menstrual cycles can stimulate sebum production. It's common for women to develop acne before or during their periods. Sometimes hormone fluctuations during menopause may trigger acne.

  • Polycystic ovarian syndrome (PCOS) can also cause acne.

  • It may be genetic - a family history of acne may increase the likelihood of developing it.

  • Some cosmetic products like cleansers and moisturizers, and other beauty products with a high oil content may aggravate acne but are unlikely to cause the condition.

  • Certain medications, such as drugs to treat conditions like seizures or bipolar disorder may cause an acne breakout.

  • Smoking affects the skin in many ways, from early aging and poor wound healing to skin conditions like eczema and acne.

  • Lack of sleep and poor quality sleep have been shown to contribute to acne severity. 

Also Read: What causes Insomnia? Tips to Deal with the persistent sleepleness!

Does Stress Cause Acne?

There is a relationship between stress and acne, but acne is not caused by stress. Stress can worsen acne that is already present and, as mentioned earlier, acne can lead to emotional stress. 

According to the American Academy of Dermatology, researchers have established a link betweenstress and acne flare-ups. When under stress, the body increases production of the hormone androgen, which stimulates the oil glands and hair follicles in the skin - the cause of acne. 

In addition, stress tends to lead to an increase in the hormone cortisol, which may also aggravate acne. When under stress, cortisol stimulates oil glands, leading to sebum secretion, which can worsen acne. 

Another hormone, prolactin, can also increase oil production by raising androgen levels. So, in stressful situations,these hormones may contribute to more sebum and worsen acne.

To top it all, people tend to pick at their skin when they are under stress. This habit can make acne inflammation worse and lead to scarring, and hyperpigmentation – the scratched areas become darker than the rest of the skin, which then looks permanently unsightly.

How Does Diet Affect Acne?

A2021 review established that certain foods and diets may be a factor in the development of acne.

The researchers found several studies that showed people with acne follow a diet of foods with ahigh glycemic index. At the same time, studies showed that diets low in glycemic index food reduce acne lesion counts. Cutting back on foods with a high glycemic index, such as pastries can potentially reduce acne lesions.

The same review also found a link betweenchocolate consumption and an increase in acne. Several studies found that eating chocolates and confectionaries every day was highly associated with acne.

Studies about the effect ofmilk and milk products on acne have produced diverging results. One study found that full-fat, skimmed, and low-fat milk consumption is related to acne but found no association between acne and plant-based milk and cheese.

For some people, certain milk products could worsen acne.

The review also foundomega-3 and omega-6 fatty acids may help reduce inflammatory acne lesions. 

Interestingly, even thoughvegan diets exclude dairy products like milk and cheese, the review didn't find that these diets are better for people with acne. 

The review also looked at the possible effect ofprobiotics on acne. One small study found that probiotics (found in yogurt, other fermented foods, and supplements) may be beneficial in the treatment of acne. However, more investigators say more research is needed.

How Do I Remove Acne? 

While there are many remedies people use to get rid of acne, there isn't one that will get rid of the condition quickly or immediately. 

Here we discuss some home remedies that some people have found helpful.

1. Tree tea oil

Tea tree oil has antibacterial and anti-inflammatory properties. The antibacterial properties can kill the bacteria that is present in the follicle and the anti-inflammatory properties can calm down any inflammation and redness.

Be careful not to use the tree tea oil as is on the skin as it is extremely strong and can irritate the skin. If you decide to use it, be sure to dilute it.

One study that compared 5% tea tree oil in a water-based gel with 5% benzoyl peroxide found thattea tree oil worked slower than benzoyl peroxide but also showed statistical improvement in the number of acne lesions and with fewer side effects.

2. Echinacea

Echinacea, also known as purple coneflower, coneflower, or American coneflower, is a perennial flowering plant in the daisy family. Echinacea is often used to treat colds and is believed to boost the immune system and reduce inflammation.  

The plant extracts have been shown to help with a range of common skin complaints, including eczema, hydration, and wrinkles. It is aneffective and safe alternative for the treatment of acne.

3. Aloe Vera

Aloe Vera is well known for its antibacterial and anti-inflammatory benefits. It can reduce the inflamed appearance of acne and limit or prevent acne breakouts. You can simply apply pure Aloe Vera to the skin, which will clean it, boost blood flow, and get rid of any bacteria. 

People also leave it on the affected area overnight to minimize infection and reduce redness.

When used in conjunction with traditional anti-acne medication Aloe Vera gel has been shown to,decrease acne lesions.

Aloe Vera can also be combined with other ingredients for skin treatments, including honey, lemon, tree tea oil, and cinnamon. 

4. Zinc

Zinc is an essential micronutrient necessary for the function of the immune system. It's important for metabolism function, wound healing, and for the sense of taste and smell.

Oral and topical zinc have been used for the treatment of acne and research has confirmed that it iseffective for the treatment of acne, and the number of inflammatory papules, whether used on its own or in conjunction with other substances. 

You can choose between zinc supplements or topical creams that contain zinc.

5. Birth Controls

One conventional treatment for acne is contraceptives. A Cochrane overview of 31 studies involving about 12,500 participants found that all thebirth control pills tested were able to improve acne. However, it took some time (weeks or months) before skin improvement was observed.

Birth control pills contain different hormones. Those that contain estrogen and progesterone are the best for this purpose.

However, it’s best to consult a physician before taking an over-the-counter birth control solely for acne.  

What to Do About Acne Scars?

Again, there is no single way to get rid of acne scars. Home remedies are not likely to help with acne scarring. Some over-the-counter creams and lotions may help to improve the appearance of acne scars, but they are unlikely to make the skin appear flat and without any blemish. 

For that, medical treatments are the solution.  

The effectiveness of any one, or combination of the following treatments, will depend on several factors, such as your skin type and the extent of the scarring.

Medical Treatments Dermatologists Use for the Treatment of Acne Scars 

1) Chemical Peels

Chemical peels involve applying a chemical solution to the skin to exfoliate the outer layer, promoting new skin growth. This approach stimulates the body to produce more collagen and elastin leading to the skin appearing healthier and the scars less noticeable.

2) Dermal fillers

Injecting fillers can temporarily improve the appearance of pitted scars by adding volume to depressed scars. Fillers can also stimulate the production of collagen and elastin to fill in the scars. Dermatologists use different fillers, including collagen-based products, hyaluronic acid, silicon, and others.

This treatment provides temporary results and must be repeated from time to time.

3) Injections

The appearance of certain types of scars can improve with the injection of steroids into the raised scars. Dermatologists also inject botulinum toxin, or Botox around acne scars to improve the overall appearance of skin.

These injections must be repeated from time to time.

4) Laser Treatment

Laser treatment, also called laser resurfacing uses lasers to remove the outer skin layer and reveal younger skin cells underneath. As the skin heals after each treatment, it produces collagen and elastin, which can produce new skin and disappear or diminish scars.

Laser treatment is not suitable for all skin types.

5) Microdermabrasion

The American Academy of Dermatology describes this treatment as a surgical procedure. It involves the use of a fast-moving brush or other device to exfoliate the scar-affected area. This procedure removes the top layer of skin, which can result in the complete removal of scars. 

However, this is a drastic approach that can lead to further scarring and changes in skin color, according to the Mayo Clinic.

6) Skin Needling

Also called collagen induction therapy, this approach involves the use of tiny needles on the affected skin to stimulate collagen production. It's a safe procedure that doesn't cause skin discoloration, but the results are modest and need to be repeated.

7) Surgery

For more severe scars, dermatologists use surgical procedures like punch excisions or skin grafts to minimize the appearance of acne scars.

Individuals respond differently to these treatments – what works well for one person might not have the same results for others. Sometimes a combination of treatments is required to get the desired results. 

Can Diet and Lifestyle Changes Get Me a Clear Skin? 

There isn't a specific diet that guarantees clear skin, just as there is no clear indication of what food, if any, causes acne. There is little scientific research on the issue and current research has not produced any clear-cut evidence either way.

A review of studies on the effects of diet and acne found thata low-glycemic diet may reduce acne because it doesn't cause spikes in blood sugar. When blood sugar rises quickly, the body releases insulin-like growth factor 1 (IGF-1), a hormone that has to do with growth.When too much of this hormone is in the blood, it may cause oil glands to produce more sebum, which can result in acne.

High-glycemic foods contain simple sugars that raise blood sugar quickly. These include sweets, breads, and pastries baked with white flour, white rice, sweetened breakfast cereals, and pasta. 

So, following a diet consisting of low-glycemic foods could help protect your skin against acne. Low-glycemic foods that consist of complex carbohydrates include whole grains, legumes, fruits, and vegetables.

One good way to follow a low-glycemic diet is to eat a prediabetic or diabetic diet which is built essentially to maintain regular blood sugar levels. 

Check out our low-glycemic or diabetic-friendly meal plan here.

Some study results also indicate that milk and milk products are best avoidedif you have acne. 

The above-mentioned review also mentions several studies that indicated the benefits of a diet rich in omega-3 fatty acids for reducing inflammation and improving acne symptoms.Foods rich in omega-3 fatty acids include fish, such as mackerel, salmon, and sardines, plus walnuts, flaxseeds, chia seeds, oysters, and soybeans.

Since there is no conclusive evidence about the dietary factors involved in acne, it is very difficult to know what to do to avoid getting acne. Until more definitive research results come out, all you can do is manage your acne as best you can.

The American Academy of Dermatology suggests the following steps to take care of acne.

  1. Keep your skin clean by washing the area with acne gently, preferably twice a day, and after sweating, using a mild, non-abrasive cleanser applied with your fingertips rather than a facecloth or a sponge.
      
  2. Choose your skincare products with care, opting for alcohol-free ones. Don't be tempted to use astringents, toners, and exfoliants on your skin believing that they will get rid of acne. These products can irritate infected skin, making it look worse. 

  3. Don't use regular soaps as they have a higher pH level than the skin, which can cause irritation and dryness.

  4. Wash your hair often, especially if you have oily hair. Besides, acne always looks worse on someone whose hair is oily and dirty.

  5. Don’t chop and change the products you choose to use on your skin. Remember, your skin is in a state of imbalance, don't irritate it further. Just stick to your treatment program and give it a chance to work. 

  6. Do your best to keep your hands off your skin. Scratching your face and fiddling with pimples, only make them look worse. Remember, acne can lead to scarring, and darkening of the skin, especially if you don't leave it alone.

  7. Avoid the sun and tanning beds. Tanning, whether outside in the sun or indoors using a tanning bed, can damage your skin and lead to skin cancer.

Conclusion

If you have trouble with acne, the best approach is to consult a dermatologist if your skin doesn't improve despite following a healthy diet and keeping your skin clean. Fortunately, acne is treatable. 

Also, if the condition is affecting your self-image, don't hesitate to speak to a counselor. 

Your mental health is just as important as flawless skin.