Acne 101

It might sound crazy, but if you do have acne, your phone screen touching your face is a great way to spread P.acnes bacteria…more below

Acne Vulgaris is a skin disease that affects most people at some point in their lives. It usually starts at puberty, affects both men and women and is more common in certain racial groups. It affects mostly the face, back and chest – areas with the highest concentration of oil glands (called sebaceous glands). Acne can, and does, run in families. Clinical history is one way to determine the root causes of acne and can give insights into one’s tendency to develop it.

What causes it?

Acne is influenced by many factors, of which hormonal fluctuations is the most common. It affects the pilosebaceous unit which attaches to our hair follicles and affects both the epidermis and the dermis. Sebum is a necessary component in skin health but when over secreted, it can cause acne. Sebum production is influenced by androgenic hormones, which are influenced by the hormone testosterone (and, yes, women also make testosterone!). Conventional treatment aims to stabilize these hormones to reduce acne, but unfortunately, it is only one factor that affects the sebaceous gland. Females often have an underlying reproductive disorder, such as polycystic ovarian syndrome. It is advisable to consult a medical professional to eliminate possible health conditions which could contribute to the problem, especially if there are other symptoms present. Certain medications can also cause acne.

Other factors include the skin’s barrier function, skin care habits, lifestyle and diet. When the acidity of our skin’s acid mantle is compromised, it does not have the ability to combat bacteria and irritants that may gain access to the skin. A deficiency of natural lipids and hydration may also affect the skins ability to shed dead skin cells effectively. This blocks pores, causing blackheads. It is common for acne sufferers to use harsh cleansers, which strip the skin of its natural lipids and reduce the efficacy of the acid mantle. This leads to a compromised barrier, the ideal environment for bacteria to flourish in. Avoid foaming cleansers with anionic surfactants, like SLS (Sodium Lauryl/Laureth Sulphate). These complex with minerals in tap water (‘hard’ water), forming insoluble compounds that clog pores. If there is a dirty ring around your bath after you empty it, then you are in an area with hard water and using SLS-based cleansers on your face, WILL clog your pores. Furthermore, this type of cleanser destroys the skins natural lipid barrier, leaving your skin feeling tight. In a previous blog we discussed the concept of ‘active’ cleansers. Our Micellar Sensitive Cleanser is fortified with actives that fight acne – niacinamide, NAG and caffeine. It does not disturb the natural lipid barrier and is made with purified water.

If there is a dirty ring around your bath after you empty it, then you are in an area with hard water and using SLS-based cleansers on your face, WILL clog your pores

Our Deep Cleansing Oil contains several beneficial ingredients to combat acne, such as macadamia oil glycerides, shea butter and olive oil esters. This combination is most similar to that of normal, healthy skin sebum. It facilitates the removal of excess sebum (and even waterproof makeup) and restores the lipid balance in the skin, even on oily skins. Linoleic acid is the key active ingredient that combats acne. Linoleic acid is a naturally occurring fatty acid that is present in sebum but acneic skin almost always lacks linoleic acid. It is antibacterial, highly anti-inflammatory and improves skin barrier function.

Four factors are always present with acne vulgaris

• Hyperproliferation of epidermal cells (cells duplicate rapidly and they don’t shed off when they should)
• Excess sebum production (influenced by hormones)
• Presence of Propionibacterium acnes or P.acne’s bacteria (influenced by excess sebum, poor skin barrier function and too high skin pH)
• Inflammation

The approach to treating acne has changed over the years and although there is still a need to treat certain types of acne with medication, targeting acne during its early stages with a specific combination of active ingredients, can prevent it from escalating. Treating the skin gently, to preserve the barrier function is the best approach. And it all starts with a good cleansing routine.

The next step in ensuring the effective treatment of acne is in using treatment products that reduce sebum production, reduce bacteria and restore barrier function by reducing inflammation. Acne prone skins are particularly at risk of oxidative damage due to free radicals. Often adolescents who suffer with acne may also develop hyperpigmentation when they are older.  We can combat this by using Green Tea Serum. This contains green tea extract, a powerful antioxidant which is highly anti-inflammatory, antimicrobial and will target excess pigment production as well (as discussed last week in our blog). Our Balance cream is ideal for normal and oily skins. It can be used morning and evening and although it has powerful ingredients, it still preserves the skins natural protection mechanisms. It contains niacinamide, NAG and caffeine, all excellent for reducing breakouts and inflammation. These ingredients also assist in the treatment of post-acne hyperpigmentation which is especially common in darker skins. Other useful tools to fight acne are Vitamin A (our Retinic A10) and Vitamin C (our Vitamin C serum).

Advice (especially) for darker skins

1. Leave pimples alone

It’s common knowledge that aggravating your acne can prolong healing, but for ethnic skin it can be even worse, because post-inflammatory hyperpigmentation (PIH) is easy to induce in darker skins. This causes patches of skin to be darker. Picking at blemishes can cause PIH and scars that may take months, even years to fade.

2. Use medication cautiously

Some of the most harmful products for ethnic skin can be found in common medications for treating acne. They’re found in many cleansers, skincare products, and acne treatments because they kill the bacteria under the skin, but, for ethnic skins, these common chemicals can be harmful. Benzoyl peroxide, for example, can be especially irritating for darker skin. Salicylic acid can sometimes dry skin out too much, causing it to create more oil. Seek professional help and check with a dermatologist — one that’s experienced in different ethnicities and skin types.

3. Get sun but protect yourself from harmful UV radiation

It’s a myth that darker skins don’t need sun protection. Half an hour of healthy sun exposure can help heal acne, but that exposure should be SPF protected to avoid increasing your risk of skin cancer.

4. Keep your pores clear

When buying products, think about your pores. Before you pick up that new moisturizer or foundation, read the labels to see if it’s non-comedogenic, which means it won’t clog your pores.

5. Check your hair products

If you’re taking good care of your skin but still breaking out, examine the other beauty products in your bathroom. Some hair products, like pomade, gels and hair oils, may be great for our hair, but not for our skin. So, if your breakouts are around the hairline, they may be to blame. Similarly, if breakouts are popping up on your cheeks or on certain sides of your face, it could be because the hair products left on your pillow. Washing your pillow cases more often and covering your hair at night may help.

6. Clean your phone

It might sound crazy, but if you do have acne, the screen touching your face is a great way to spread P.acnes bacteria. Keep your screen clean to avoid spreading the bacteria. Ideally use an alcohol wipe. See this blog for more.

Next week we will discuss CBD, the legal “medical” component of cannabis and what it can do for your skin.