I’m starting to get pimples!” “I look horrible! I hate getting zits!” If you are a teenager, then you have probably had acne at some point in your life. Acne is so common that a lot of people take it as a normal part of growing up. In fact, acne affects about 8 in 10 adolescents and young adults aged 11 to 30. Boys are more prone to acne than girls. Severity can range from mild to severe – and it’s no secret that a severe breakout can affect not only your skin, but it can also take a toll on your confidence and affect your life as a whole. Bottom line, acne sucks. The bad news is – acne has no cure. The good news? It usually clears up as you get older.
Understanding Normal Skin
How skin functions normally can help you understand why people become more susceptible to acne during adolescent years compared to when we were a child. Small sebaceous glands found under the skin surface keep skin smooth and supple by producing oil called sebum. Pores (tiny holes in the skin where hair grows) allow sebum to come to skin surface. As you say hello to your teenage years, hormonal changes triggered by puberty cause the sebaceous glands to produce more sebum. As a rule, the more sebum you make, the greasier your skin feels. Some people produce more sebum than others, and these people are more likely to develop acne.
Why Do You Get Acne?
We know that if you have acne, you’re not alone in this battle. But most importantly, let’s find out what are the common reasons why you break out.
Acne is the common cause of spots. Having an acne-prone skin can be hereditary, but genetics is not really the number one culprit why it seem impossible to have flawlessly, smooth skin. When the overproduction of oil and blocked follicles happen at the same time, there goes your primary offender. In fact, this unfortunate duo often results in a clogged pore. Excess oil gets trapped in the pore, resulting in acne-causing bacteria called P.acnes. Acne usually causes spots to develop on the face, chest and back.
Surprising Acne Triggers
So what are the most common habits or ways that can trigger the overproduction of sebum? Some of them may not be what you are expecting.
1. Using Skin Care Products That Contain Pore-Clogging Ingredients – when choosing a facial cleanser, moisturizer, toner, sunscreen and makeup, watch out for ingredients that can clog your pores, such as mineral oil, petrolatum and silicones.
How to deal with it: Noncomedogenic skin care is key to clearer skin. Always check the label and look for those noncomedogenic “heroes” that your skin will love. Noncomedogenic simply means non-pore clogging.
2. Concealing Your Spots – If you think that heavy makeup to hide your spots is a quick solution to even-toned skin, think again. It can, in fact, sabotage it. Occlusive, heavy coverage may give the illusion of clear skin, but it can clog your pores, break you out and make acne worse in the long run.
How to deal with it: Opt for a mild coverage skin care and only use heavier cosmetic whenit’s only needed. You may also look for a compact makeup with antibacterial ingredients to help keep bacteria at bay and your face clear.
3. Overdoing Your Spot Treatments – Spot treatment is good, but only to some extent. Overusing topical salicylic acid, sulphur or benzoyl peroxide can dry out your skin, signalling your sebaceous glands to produce more oil than what’s necessary. In addition, using these drying ingredients can somewhat burn your skin’s top layer (epidermis) if used too frequently.
How to deal with it: If overdoing your spot treatments can backfire, then do only what’s advised. It’s as simple as that.
4. Quitting Too Soon – Bear in mind that there’s no silver bullet to clear skin. Acne treatments take weeks to start kicking in, says Dr. Joshua Zeichner, dermatologist of Mt. Sinai Hospital in New York who specializes in treating acne.
How to deal with it: Be consistent with your acne treatment since acne products you can buy over-the-counter usually take effect within 2 to 4 weeks. If your acne does not improve within this time frame, then it’s best to see a dermatologist.
5. Washing Your Face Too Often – If you have acne, you may tend to wash your face as often as possible thinking that your face is dirty, which is the primary reason why you are getting acne. However, washing too much can strip your skin of essential oils, which prompts your oil glands to produce more oil. This is the last thing you want.
How to deal with it: Limit washing your face to twice a day. Also make sure to use a clean washcloth when cleansing to avoid any bacteria build-up.
6. Scrubbing Your Skin Too Hard – Do not scrub your skin with rough exfoliants or cleansing brushes because you might accidentally scrub or pop an active acne, which can then spread puss and bacteria across the skin, making your condition worse.
How to deal with it: Rather than exfoliating your skin like crazy, simply cleanse, tone and moisturize your skin with pore-clearing ingredients, such as alpha hydroxy acids (AHAs), glycolic acid and lactic acid. Limit exfoliating your skin to twice weekly, and go with gentle, noncomedogenic or non-acnegenic foaming gel.
7. Stress – It’s finals week and you are super tired and stressed out about all those tests. Well, not only your brain goes into overdrive, your skin can stress out right along with you too, erupting more pimples and acne. Be warned that your skin produces more cortisol when you’re stressed. Cortisol is a hormone that stimulates excessive oil production, which clogs pores that causes acne flare-ups.
How to deal with: Don’t stress yourself too much and get enough sleep.
What Does Acne Look Like?
Acne is not only limited to red, giant zits that seem to mock you when you look in the mirror (yeah, and ironically they seem to pop up right before a big event!) Acne vulgaris is the type of acne that a lot of teens get. Vulgaris means “of the common type.”
It includes whiteheads, blackheads and tiny pimples. When sebum combines with dead skin cells and bacteria, it can block or plug pores. Although mild-to-moderate acne is annoying, it is the easiest type to treat. In many cases, acne does not progress beyond this stage.
- Blackheads – when some pores become blocked, you can see tiny spots called blackheads and whiteheads (comedones). If a pore stays open, you will be left with a blackhead. Unlike what many people think, the black of blackheads is because of a skin pigment and not trapped dirt.
- Whiteheads – on the other hand, a whitehead is also form of acne that occurs when oil, dead skin cells and bacteria become trapped within the pores and bulge out of the skin. However, unlike blackheads, whiteheads are usually not red or sore, but tiny white, clear or flesh-colored bumps under the skin. They can appear anywhere on your body, but the T-zone (forehead, nose and chin) is more susceptible to acne as it is one of the oiliest parts of the face.
- Pimples or papules – If a sebum gets accumulated under a blocked pore, a small (less than one centimeter around), raised pimple or swelling may occur. Pimples or papules are inflamed bumps but they don’t produce pus. Sometimes, pimples cluster together to form a rash.
This form of acne includes larger spots and inflammation. Acne becomes severe when clogged sebum is infested by a bacterium called Propionibacterium acne. Small numbers of this bacterium normally live on skin and are not harmful. However, as soon as they thrive in a large number in the trapped sebum, it may cause the immune system to react, resulting in inflammation. At this point, you will notice that surrounding skin becomes red and acne becomes larger, deeper and filled with pus. Worst, pustules may form into cysts.
Why Do Some People Get Acne and Others Don’t?
It’s mind-boggling sometimes why acne attacks your skin while other teens of your age maintain a flawless skin. Although the answer is not yet clear, a UCLA study conducted by researchers at Washington University in St Louis and the Los Angeles Biomedical Research Institute may now have a clue.
The researchers discovered that not all acne bacteria trigger acne – one strain may help your skin to stay healthy. “We were extremely excited to uncover a third strain of P. acnes that’s common in healthy skin yet rarely found when acne is present,” said principal investigator Huiying Li, an assistant professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA. Li is also a member of UCLA’s Crump Institute for Molecular Imaging.
“We suspect that this strain contains a natural defense mechanism that enables it to recognize attackers and destroy them before they infect the bacterial cell.” It appears that this P.acnes strain may protect the skin, much like yogurt’s live bacteria aid in defending the gut from bad bacteria.
Let’s just say, some teens are lucky to have a P.acnes strain that protects rather than destroys.
7 Skin Conditions That Are Often Mistaken for Acne
When a skin condition you thought was acne is not really acne, you can’t help but feel upset and discouraged. After all, seeking treatment is not easy – and cheap. So before the acne battle drives you nuts, it’s best to know the seven common acne mimickers and how to differentiate them from one another.
1. Rosacea – Dr. Heidi Waldorf explains that acne rosacea may be confused with acne vulgaris. It certainly looks a lot like acne, which is characterized by pus-filled bumps, but it is often associated with flushing, dilated blood vessels, bloodshot eyes and facial redness. Rosacea occurs in the central part of the face. Its primary triggers include stress, diet changes, spicy foods and extreme temperatures. Genetics plays a big role why people develop rosacea.
2. Allergic reactions – Characterized by red, scaly patches and intense itching, allergic reactions may come in various shapes and forms. It can be triggered by food, pet danders, hot temperature, harsh substances found in detergents and other allergens. Conversely, acne, particularly large cysts, can be painful but usually doesn’t itch, which is the key differentiator.
3. Pseudofolliculitis – Also known as ‘razor rash’ or ‘razor bumps,’ pseudofolliculitis is caused by shaving too closely, causing growing hair to twist into the skin, which then results in painful bumps.
4. Acneiform eruptions – This skin condition usually looks like fine red bumps, which appear on the forehead. In most cases, acneiform eruptions are caused by oil-containing hair products and are treated as a type of an allergic reaction.
5. Chloracne – It resembles an acne breakout since chloracne can also cause blackheads, pustules and cysts. However, its primary cause is exposure to an environmental pollutant called dioxin. When dioxin is inhaled or contracted, chloracne typically occurs on the face, arms or groin.
6. Basal Cell Carcinoma – Although this skin condition looks a lot like pimples, it’s actually a form of skin cancer. It appears as pearly or lustrous reddish bump that can bleed and scalp. You will know it’s not just an acne cyst if you’re “giant pimple” has been around for months. If this is the case, it’s best to see your doctor for testing.
7. Folliculitis – Pimples that appear in other body parts, such as the abdominal area, buttocks or legs may not be acne, but folliculitis or inflamed follicles.
What Can You Do About Acne?
While acne is often mild, approximately three in 10 teens and preteens have acne that is bad enough to need treatment to prevent scarring. So just in case you’re thinking of waiting it out and letting nature take its course in healing your acne, know that acne can last for months or even years, if left untreated. Yes, that’s quite a long wait!
Treatment for acne depends on whether you have mild, moderate or severe type of acne.
Mild Acne (whiteheads, blackheads, or pimples)
- Cleanse your skin with warm water and mild soap. Again, look for noncomedogenic formulation and stay away from oil-based cleansers.
- Apply non-prescription topical treatments. Salicylic acid (such as propa pH or stridex), sulphur and benzoyl peroxide (such as triaz or brevoxyl) are the most common ingredients found in this treatment option. Since it is applied on the skin, which is quick and easy to do, a non-prescription topical treatment is the most sough-after treatment for mild acne. Results are usually visible within four weeks of use.
- Applying a clay mask to the spot and leaving it overnight can often dry out acne.
- Never try to squeeze your acne, especially when it is not yet inflamed as it could stick around for a lot longer and become an uglier mess.
If you have acne that has not gotten better with the above treatments, the next best move is to talk to your dermatologist. A prescription for stronger formulations may be given to help unclog pores, soothe the inflammation and clear your skin.
Moderate to Severe Acne (nodules and cysts)
- Take oral antibiotics as prescribed by your doctor. As nodules and cysts are more likely to leave acne scars, an oral antibiotic may be given to rev the healing process.
- Applying benzoyl peroxide may also be helpful by itself or when combined with other treatment options.
- Applying prescription topical treatments, such as acne-fighting gels, creams or lotions. These are stronger versions of non-prescription topical treatments.
- Applying prescription retinoids. When applied on skin, retinoids can reduce acne breakouts and formation of acne scars. They can also unclog pores, preventing dead skin cells, oil and dirt from clogging your pores, as well as allow other skin care formulations to work better.
- Taking prescription oral retinoids, such as isotretinoin. Retinoid pills control oil production and bacteria build-up that cause acne and inflammation.
- Applying azelaic acid. It may come in gel and foam and is frequently used to clear pimples and alleviate inflammation caused by teen acne.
Can Acne Affect Teens Emotionally?
Dr. Jon A. Halvorsen, MD.m of the University of Oslow in Norway says, “But depression and suicidal [thoughts] in acne reflects the burden of acne, rather than being a side effect of isotretinoin.”
For many teens, acne impacts self-esteem and quality of life. In fact, it can potentially trigger psychological disorders, such as depression and suicidal thoughts, according to a recent research published by the Dermatology Online Journal.
It’s true that this profound negative impact on a teen’s social and psychological health is a case-by-case basis, we can’t ignore the fact that it has become a huge concern for a lot of people. We all know that the adolescent period is a crucial period when teenagers are developing their personality and how they perceive themselves. Body image plays a big role in peer acceptance, and we all know that when you are a teenager, you always wanted to belong. Suffering from acne makes it really difficult to accomplish that “goal.” Worst, cruel taunts and bullying make the experience traumatic.
Some acne sufferers:
- Avoid eye contact
- Cover their faces often. Girls resort to concealing acne with heavy makeup (which can backfire as it can aggravate acne).
- Refuse to attend social gatherings or social withdrawal
- Do not want to participate in sports, such as swimming
- Find it hard to form new relationships
Apparently, teen acne may not just be a cosmetic problem, but something that requires attention and effective treatment.
As the adage goes, prevention is better than cure. Here are some top tips on how you can stop breakouts before they start.
1. Don’t touch your face – this is a habit that is often overlooked. Your fingers carry millions of bacteria, triggering a breakout. Plus, the oil from your hands can’t help!
2. Cleanse your face twice a day – cleansing your face as often as possible to keep skin squeaky clean can prevent acne is a myth. In fact, over-cleansing can dry out skin or trigger breakouts. Keep it simple. Unless you had a sweat-drenched work out at the gym or the oil on your face feels horrible, washing your face twice a day is enough. Cleanse your face with a gentle cleanser in the morning and before going to bed.
3. Wipe away oil – If your face is oily then you are more susceptible to acne breakouts. In most cases, the T-zone becomes greasy as an oil slick. Unfortunately, waiting until you get home to degrease may be too late. Excess oil could already seep into your pores, which is a breeding ground for acne-causing bacteria. This is when a pre-moistened salicylic acid-soaked cleansing cloth can come in handy.
4. Hydrate your skin – Quenching your skin with a lightweight and oil-free face cream provides it with just the right amount of hydration. Humectants, ceramides and squalene are good choices. If you have acne-prone skin, use a much lighter gel or serum, not cream.
5. Ease irritated or inflamed skin – Despite having a great skin day (aka acne-free skin), you may still notice some redness. Botanicals, such as aloe vera extract, licorice and chamomile have calming effects that can relieve skin inflammation.
6. Exfoliate your skin (but not too much) – Smooth your skin up a notch by exfoliating it once a week. This will help speed up cell turnover and keep pores free of dead skin cells, bacteria and debris. Opt for exfoliating creams that contain salicylic acid and gentle, all-natural fruit enzymes.
7. Try spot treatment – It can work wonders for your skin as long as you do it correctly. Use over-the-counter skin care products that can reduce excess oil in the skin surface. When you look at the label, you should see common acne-fighting ingredients, such as colloidal sulphur, zinc oxide, benzoyl peroxide, glycolic acid, salicylic acid and lactic acid. Spot treatments with the right active ingredients can help clear up acne in two to four weeks.
8. Use a retinol – apply a thin coat of retinol, a Vitamin A derivative, which is the gold standard of anti aging. It acts as a skin-restoring ingredient. Retinol-based spot treatment must be done at night after cleansing and toning your skin because it will make your skin more sensitive to the sun.
Will Acne Return After Treatment?
So you finally have the clear skin that you always wanted – is it okay to stop treatment? You can. Be warned though: acne may flare up again if you stop treatment. Combating acne and finding yourself panicking when a a flare up happens and you are back to square one can be frustrating. That is why it is highly recommended to carry on with a maintenance treatment for 4 to 5 years to keep acne under control. Acne typically clears up when you reach your 20’s and only a small number of cases persists into the 30s and beyond.
If it’s of any consolation, maintenance treatment doesn’t require a tedious acne solution. In most cases, it only requires rub-on preparation, such as a retinoid or benzoyl peroxide. Also, a low-strength preparation may also be enough to keep spots at bay.
Foods You Should Watch Out For
Although teen acne is mostly triggered by hormonal changes, certain dietary factors can also flare you up or make your acne worse. However, contrary to what many people believe, acne is NOT caused by fried foods, candies and chocolates per se. Instead, it is associated with a spike in hormonal levels that stimulate the fat glands in skin to boost production of sebum.
Studies so far have focused mostly on foods that can aggravate acne. Try to avoid these culprits for a week or two, and see if you notice a difference.
1. Sugar – This doesn’t mean though that when you eat a chocolate or a cookie, you are going to get a pimple. The amount of your sugar intake in a day, specifically at any one time, is the main factor that can trigger a breakout. Basically, it comes down to how often you give in to sugary drinks and treats, including soda, candy bar, sweet pastries and more.
2. High glycemic foods – It sounds too complicated, but it only means foods that break down quickly in the body, causing your insulin levels to spike, which raises your blood sugar levels. It is a perfect recipe to hormonal fluctuations and inflammation – both of which trigger a breakout. High glycemic foods include white rice, potato chips, cakes, white bread, popcorn, pretzels, processed breakfast cereals, most fruits and all liquor except red wine.
3. Cow’s milk – In 2005, researchers have found that participants who drank more cow’s milk as teens had severe acne than those who had little or no milk as teens.
4. Junk food – It’s a no-brainer, really. Junk foods can cause blood sugar levels to spike and make your hormones go out of whack. When we say junk food, it also includes most food you can buy from a fast food, including burgers, pizza and fries.
Foods to Eat
Cutting out the acne-triggering foods can help reduce your spots or keep them at bay. But if you are a healthy-eater, what can you add to your diet that could give you the edge against acne?
1. Fish – The key component that you want is omega-3 fatty acids, which can help curb inflammation and clear your acne. Salmon, fish roe (caviar) and oysters are good sources of omega-3 fatty acids. If you hate eating fish or seafood, you may take fish oil supplements, or consume other sources, such as flaxseeds, Chia seeds, walnuts, soybeans and spinach.
2. Green tea – High in antioxidants, green tea can protect you from acne-causing environmental stressors. Nowadays, green tea, also also called matcha is now making waves in the food industry. Aside from brewing green tea leaves, it now gives a distinctively sweet and tangy flavor to chocolates, ice cream, cakes and breads.
3. Probiotics – Known to reduce inflammation in the gut, probiotics may also help clear acne spots. Some of the best sources of probiotics are yogurt, miso soup, dark chocolate and pickles.
4. Juicing – A low sugar juice helps keep your blood sugar levels and hormonal levels normal. Green (veggie) juices are anti-inflammatory. Carrot is loaded with beta-carotene that helps control acne. Citrus fruits, especially lemon can help heal your skin and are considered a superfood for healthy and smooth skin. A lot of delicious juicing recipes can be prepared quickly.
Some teenagers rarely get a pimple (those lucky ducks!) as they hit the wonderful period of puberty. But if you see acne, don’t panic. Acne, zits, blemishes, pimples – no matter what you call them, they can be a real bummer! This is no secret, but at least you know there are ways to get rid of them. Acne treatments can be confusing and overwhelming though, so it’s always best to talk to your doctor. Once you have started a treatment, bear in mind that it may take time to see visible results. Beating acne for good will take a ton of patience and expect to put in a consistent effort, so don’t you quit. Did you know that the most common reason why an acne treatment fail is quitting too soon? Remind yourself every day that you can win this fight.