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Acne: Causes And Treatment Explained

Acne is a common skin condition, estimated to affect roughly 80% of people aged 11-30 in the UK. While many associate it with hormonal teens, in reality it can affect anyone at any age. 

“It’s quite common to see patients presenting in their thirties who may have had clear skin in their teens,” explains Dr Justine Hextall, consultant dermatologist on behalf of The Harley Medical Group. 

“Adult acne is increasing in prevalence, in women particularly.” 

Anything from poor diet to pollution can contribute towards acne, but Dr Hextall says that stress and hormonal changes in adulthood are the most common triggers. And no, it’s not caused by having dirty skin or poor hygiene. 

Here, we look at the different types of acne and what treatment is available.

What is it?

“Acne vulgaris is a broad term which covers the occasional spot through to severe cystic acne,” Dr Hextall tells HuffPost UK. “As dermatologists, we look for black or whiteheads with the spots to help differentiate it, for example, from rosacea.”

The condition occurs when hair follicles in the skin become blocked and oil builds up. 

“Sebaceous glands attached to hair follicles secrete an oil-based substance known as sebum,” explains Christine Bailey, a nutritionist on behalf of The Harley Medical Group.

“Sebum normally helps moisturise skin and keep it supple. However, when there is excess sebum produced, the follicle can become blocked. Sometimes, bacteria called Propionibacterium acnes that normally reside in the skin interact with the sebum trapped in a clogged follicle and lead to inflammation.  

“So anything that clogs pores, leads to the rapid division of skin cells, and/or creates or worsens infection and inflammation will contribute to blemishes.”

There are six main types of spots caused by acne, these include: blackheads, whiteheads, papules (small, tender, red bumps), pustules (similar to papules but with a white tip in the centre), nodules (large, sometimes painful, hard lumps that build up beneath the surface of the skin) and cysts (large pus-filled lumps which can cause scarring).

Causes

Hormone imbalances and, in particular, excess production of testosterone can increase the amount of sebum in the skin. 

“This is one of the reasons why acne is more common in adolescence,” explains Bailey. “It also explains why women may notice an outbreak just before their monthly period as levels of hormones fluctuate.”

Stress can also play a key role. “Cortisol, one of our stress hormones, interferes with blood sugar and causes the sebaceous glands to produce more sebum,” she continues.

“Stress can also lead to hormonal imbalances worsening ongoing symptoms.”

Unfortunately acne is also hereditary, so if your parents had acne it’s likely you’ll develop it too.

It is also thought that diet can play a part, however the NHS does note that research hasn’t found any foods that specifically cause the condition. 

“There has been much debate about the role of diet and development of acne,” explains Bailey. “However a number of studies suggest certain types of food could worsen or improve acne. So if you are undergoing treatments for your skin, maximise the benefits by making some changes to your diet.”

She explains that drinking more water can help flush out toxins and replenish water in the cells, which keeps your skin looking “plump and fresh-looking”.

It’s also important to be conscious of foods high in carbohydrates, the nutritionist recommends. 

“In particular quick-releasing carbs such as fruit juices, cakes, alcohol, biscuits, sweet foods, refined white grains and processed foods,” she explains, “as these lead to a sudden rise in blood sugar and the production of excess insulin.”

This spike in blood sugar can result in the production of certain growth hormones like IGF-1, “which can stimulate sebaceous glands, promote more insulin in the body and alter skin cell production”. 

Bailey recommends trying wholegrain rice or quinoa or starchy vegetables such as sweet potato, carrots and beetroot, instead.

She also advices to eat more greens and whole foods, try fermented foods naturally rich in beneficial bacteria (such as yoghurt or kimchi) and possibly cut out dairy.

“For some people dairy produce is known to aggravate acne,” she explains. “Milk is a direct source of hormones and a number of growth factors including IGF-1.

“Simply switching to a milk alternative such as almond or coconut may lead to improvements.”

Treatment

Treatment for acne depends on how severe it is. For mild cases - where you have a few blackheads, whiteheads or spots - you should be able to treat them with over-the-counter gels that contain benzoyl peroxide, the NHS suggests.

A good skin care routine is also important.

Dr Anjali Mahto, consultant dermatologist and British Skin Foundation spokesperson, says: “Ensure that cosmetics and sun creams are suitable for acne-prone skin and preferably ‘non-comedogenic’ (such as products that will not block pores).”

Dr Justine Hextall explains it’s also imperative to try a gentle cleanser, as “you need your skin barrier to be as healthy as possible so that it can retain vital moisturiser”.

“As a rule of thumb, if your skin feels tight after washing it is likely the cleanser you are using has disrupted your skin barrier,” she says.

“Skin should feel calm and hydrated after washing. If you are reaching immediately for your moisturiser you may want to consider a more gentle cleanser.”

It can take several months of treatment before acne symptoms improve. 

For severe cases, medication might be prescribed such as: topical retinoids, topical antibiotics, azelaic acid, antibiotic tablets, the combined oral contraceptive pill (for women only) and isotretinoin tablets.

Topical treatments contain agents that unblock follicles and reduce inflammation.

Antibiotics, both topical and systemic, are used but resistance is increasing. One study found that four in five teenagers with acne showed some resistance to antibiotics. 

For more severe acne, especially if the skin is scarring, drugs like Roaccutane may be considered, however it’s worth noting that it can cause side effects such as dry skin, headaches, depression, hair loss and even psychotic disorders or suicidal feelings. 

The drug recently made headlines after campaigners from the Adverse Psychiatric Reactions Information Link said that too many young people are being put on them and not monitored, which could be particularly dangerous for those who experience side effects related to mental health. 

In 2016, nearly 49,000 Roaccutane prescriptions were dispensed in England compared to 37,000 in 2014, according to NHS Digital data.

In response to worries over increased prevalence of the drug, The British Association of Dermatologists said that as long as safety recommendations are adhered to, this should not be a cause for concern.

Roaccutane’s manufacturer Roche told the BBC: “Information provided with isotretinoin [Roaccutane] carries a warning that some patients may experience mood changes, including an increase in depression.”

Other treatments for acne include dermabrasion (which involves removing the top layer of skin through either lasers or a wire brush), chemical peels and laser treatment which can help reduce post-acne redness and scarring. 

Dr Anjali Mahto concludes: “Do not suffer in silence. Seek support from a healthcare professional, ideally a qualified dermatologist. These are the only people properly trained in managing skin problems.”

痤瘡是一種常見的皮膚病，估計影響約80%的老年人在英國11-30。雖然很多人認為它與荷爾蒙青少年有關，但實際上它會影響任何年齡的人。

“看到患者在三十多歲可能在十幾歲的時候有了明確的皮膚是很常見的，”Justine Hextall博士解釋說，諮詢皮膚科醫師對哈雷醫療集團代表。

“成人痤瘡的患病率越來越高，尤其是女性。”

由於飲食不良污染什麼可以有助於痤瘡，但Hextall博士說，壓力與成年期的荷爾蒙的變化是最常見的誘因。不，不是因為皮膚髒或衛生不好造成的。

在這裡，我們看看不同類型的痤瘡和什麼治療可用。

這是怎麼一回事？

“痤瘡是一個廣義的概念，包括偶爾發現通過對嚴重的囊腫性痤瘡，”Hextall博士告訴HuffPost英國。“作為醫生，我們尋找著一點黑色或白頭來區分，例如，從酒渣鼻。”

這種情況發生時，毛囊在皮膚被封鎖和石油建立起來。

“毛囊附著的皮脂腺分泌一種稱為皮脂的油基物質，”哈雷醫療集團的營養學家Christine Bailey解釋道。

“皮脂通常幫助滋潤皮膚保持柔軟。然而，當有多餘的皮脂產生時，毛囊就會被阻塞。有時候，細菌稱為痤瘡丙酸桿菌通常駐留在皮膚的皮脂堵塞毛囊被困在一個相互作用，導致炎症。

“所以任何堵塞毛孔，導致皮膚細胞快速分裂，和/或造成或加重感染和炎症會導致瑕疵。”

有引起粉刺、斑點六種主要類型包括：黑頭、白頭、丘疹（小的，溫柔的，紅疙瘩），膿皰（類似丘疹，但中間有一個白色的尖），結節（大的，有時是痛苦的，硬的腫塊，增強皮膚表面的下方）和囊腫（大充滿膿液的腫塊可造成疤痕）。

原因

荷爾蒙的不平衡，特別是睾酮的過量生產會增加皮膚中的皮脂量。

貝利解釋道：“這是痤瘡在青春期更常見的原因之一.”。“這也解釋了為什麼婦女可能會注意到爆發前每月的激素水準波動。”

壓力也能起關鍵作用。她說：“皮質醇是我們的應激激素之一，它會干擾血糖，使皮脂腺分泌更多的皮脂.”。

“壓力也可能導致荷爾蒙失衡惡化正在進行的症狀。”

不幸的是痤瘡也是遺傳的，所以如果你的父母有痤瘡，很可能你會發展它太。

也有人認為飲食可以起到一定的作用，然而英國國民保健署確實指出，研究沒有發現任何導致這種狀況的食物。

貝利解釋道：“關於飲食和痤瘡發展的作用一直存在爭議。”。然而，一些研究表明某些類型的食物可能惡化或改善痤瘡。所以，如果你正在接受治療，你的皮膚，最大化的好處，通過改變你的飲食。”

她解釋說，多喝水可以幫助清除毒素和補充水分的細胞，使你的皮膚看起來“豐滿和新鮮”。

營養學家建議，注意富含碳水化合物的食物也是很重要的。

“特別是快速釋放碳水化合物，如果汁，蛋糕，酒精，餅乾，甜食，精製白雜糧和加工食品，”她解釋說，“因為這些導致血糖突然上升和過量的胰島素的生產。”

這種血糖的上升會導致某些生長激素如IGF-1的產生，“它能刺激皮脂腺，促進體內更多的胰島素，改變皮膚細胞的生成”。

貝利建議嘗試全麥稻、藜麥、澱粉含量高的蔬菜，如馬鈴薯、胡蘿蔔和甜菜，而不是。

她還建議多吃蔬菜和綠色食品，嘗試富含有益細菌的發酵食品（如優酪乳或泡菜），並可能減少。

她解釋說：“對於一些人來說，乳製品會加重痤瘡.”。“牛奶是激素的直接來源，包括IGF-1在內的許多生長因數。

“簡單地切換到牛奶的替代品，如杏仁或椰子可能會導致改善。”

治療

治療痤瘡取決於它有多嚴重。溫和的情況下，你有黑頭、白頭或點-你應該能夠通過含有過氧化苯甲醯凝膠治療，NHS的建議。

一個好的護膚程式也很重要。