The Skin Nerd: Here's my guide to taking action for acne

Acne is said to affect 9.4% of people globally, making it one of the most prevalent diseases in the world.

The Skin Nerd: Acne is said to affect 9.4% of people globally, making it one of the most prevalent diseases in the world.

June is Acne Awareness Month, and so I thought this would be a great time to speak about the skin condition and what you can do if you suffer from it.

Whilst, technically speaking, all spots are a form of acne, when we say acne, we are usually referring to moderate to severe acne, sore, inflamed whiteheads, cysts and nodules, rather than small spots or flat blackheads.

For lots of us, acne may be something that we have to manage long-term, but even if for some it cannot be completely eradicated, it can be addressed, and thankfully, there are an increasing number of treatment options available. 

As acne is a medical skin condition, it requires medical intervention and so your first port of call would always be your GP.

“Acne is a multifactorial condition, with a complex interplay between genetics (your family history), hormonal influences, and other environmental factors, including stress and hormonal influences,” says Professor Caitriona Ryan of the Institute of Dermatologists, Ireland. 

“Oil glands become oversensitive to hormones, which causes an increase in oil secretion. Follicular openings (pores) become blocked with a higher turnover of dead skin cells, which combined with this excessive oil production causes blackhead formation. The normal bacteria that colonise our skin then multiply and cause inflammatory acne lesions.

“Increased levels of stress-related hormones such as cortisol sends the skin’s sebaceous (oil) glands into overdrive, which clogs the hair follicles (pores), increases inflammation and causes acne breakouts.”

There are several forms of acne, as Caitriona explains. “Acne mechanica is caused by mechanical obstruction of follicular openings, such as the chronic use of a face mask, or using a mobile phone or headset over one side of face. Cosmetics such as heavy foundations or oil containing moisturisers can induce acne cosmetica by blocking pores. Hair products (particularly oils and gels) can cause “pomade acne” over the forehead and temples. Certain medications can also cause acne or acneiform eruptions, particularly steroids, some newer chemotherapy drugs and hormonal treatments.”

Acne across the body is also common, earning names such as ‘bacne’ and threatening to extend our anxiety from the face, ‘There are several causes of spots or pimples of the chest and back. Sometimes this can be truncal acne but more commonly it is folliculitis — inflammation of the hair follicles. This can affect anywhere there are hairs, including the chest, back, buttocks, arms and legs and typically presents as small red bumps or white-headed pimples around hair follicles, which can be itchy, painful or asymptomatic. Folliculitis can be due to infection, particularly
bacterial or yeast infections, occlusion (blockage), or irritation of the skin. Bacterial folliculitis causes itchy white pus-filled spots, and typically occurs when hair follicles become infected with Staphylococcus aureus. Staph bacteria colonises the skin in healthy individuals but can cause problems when the skin or hair follicle becomes inflamed. Pityrosporum folliculitis is a very common yeast folliculitis which produces red, itchy pustules on the back and chest and sometimes on the neck, shoulders and upper arms. This is more common when the skin is sweaty or clammy, so I often see it in gym-goers, particularly if they delay showering after a work-out.”

Sadly, many people suffer in silence as a result of anxiety accompanying the condition. 

In fact, a huge 70% of acne sufferers report a negative impact on their self-esteem and confidence and around 50% admitted that they avoided social interactions and events due to embarrassment about their condition. 

These sobering stats really hit home on the impact that skin can have on our mental wellbeing, and I encourage anyone struggling with their skin to seek support.

Luckily, as awareness grows, so do the options for treatment and psychological support and you can benefit inside and out from the advice and guidance of a variety of experts.

Congestion and acne benefit from a multi-disciplinary approach, what I often refer to as the ‘jigsaw puzzle.’ 

This jigsaw includes many experts such as skin therapists, GPs, dermatologists, pharmacists, nutritionists, and psychologists. 

Now, you might not need to see all of these types of experts but may need a combination of a few to get the results you want. 

An example of this is if you are stressed and consuming a lot of caffeine or sugar as a coping mechanism. 

You may find these things then exacerbate your acne. An option here would be to work on managing your stress whilst speaking to a dietician about what you are eating or not eating. 

A skin therapist could also be useful; to help ensure you are using any prescribed skincare effectively.

When it comes to topical skincare, the ingredients that are commonly recommended for acne include vitamin A (retinyl palmitate or a prescription retinoid), hyaluronic acid, salicylic acid, antioxidants and of course, SPF. 

Hydration is important but sometimes forgotten in acne-prone skin, but this humectant offers lightweight hydration that doesn’t sit on the skin or clog the pores. 

Vitamin A can reduce sebum production and balance the skin whilst salicylic acid is a go-to acne ingredient, as it helps to dissolve the dead skin cells and sebum that cause congestion and trigger the formation of spots. 

SPF protects skin and can help to stop any acne-related pigmented scarring from getting worse.

If you are concerned about blemishes, you could try speaking to a pharmacist or a skin therapist but if your acne is chronic and painful, contacting your GP should be your first step. 

Remember that help is out there, and much can help to manage acne alongside medical intervention.