Acne
Acne is a common skin condition— it’s the most common in the United States— and about 85% of people between the ages of 12 and 24 will experience it at some point. If you’re currently living with acne and are looking for treatment advice, see below for general information on this common skin issue. We’ll also cover the ways in which acne can contribute to self-consciousness, low self-esteem, anxiety, and other mental health conditions, plus tips for managing these effects.
Acne vulgaris— commonly referred to as pimples or zits— develops when the sebaceous glands or hair follicles become blocked due to a buildup of dead skin cells and an oily substance called sebum. Continued sebum production, while the hair follicle is blocked by these dead skin cells, can clog pores and result in various types of acne. Whiteheads and blackheads are the most common forms of acne and are typically milder, while papules, pustules, and nodules are considered a more severe acne. The most severe form of acne is cystic acne, which is characterized by large, painful, pus-filled lesions on the skin that may lead to scarring and permanent hyperpigmentation.
There are several different risk factors that may contribute to, cause, or trigger acne breakouts. Some of the reasons acne occurs include:
- Family history and genetics
- Hormonal changes (such as puberty and pregnancy)
- Excess production in oil glands
- Skin irritation or inflammation
- Bacteria
- A diet with lots of refined sugars and carbohydrates
- High-stress levels
- Certain medications (like birth control and corticosteroids)
- Use of oil-based cosmetic products
- Ineffective or insufficient skincare
- Certain Musculoskeletal and skin diseases
- Skin cancer
How is acne treated?
For most people, acne can be effectively managed through the use of over-the-counter treatments and simple lifestyle adjustments. This is true for teenage and adult acne. However, in some cases, medical intervention or prescription-grade acne treatments may be necessary to prevent complications from severe acne, such as skin discoloration or acne scars on the surface of the skin from a flare-up.
Some of the most effective topical medications and skin care products to treat mild to moderate acne contain salicylic acid and benzoyl peroxide. You can usually find all sorts of affordable products for treating acne with these active ingredients at a drugstore.
If you like to wear makeup, you can still do so and likely avoid triggering a breakout as long as the products are oil-free and non-comedogenic. You might use a helpful resource like cosDNA to check your cosmetics for acne-causing ingredients. Make sure to remove makeup from the surface of your skin every night before bed.
Aside from engaging in a quality skincare routine, there are some changes you can make to your lifestyle to support your acne treatment and potentially avoid developing acne. Firstly, change your pillowcase once or twice a week. Bacteria, oil, and dead skin build-up on pillowcases quickly, which can lead to clogged hair follicles. Changing yours regularly is a simple way to help combat acne breakouts. Cleaning your phone on a regular basis—especially if you hold it to your face on calls—can be helpful for the same reason.
Managing stress is also typically important while dealing with acne. This can be challenging, however, since a breakout can cause a vicious cycle: You break out, you feel stressed about the developing acne, the stress can worsen acne, and then you become even more stressed. That’s why learning healthy ways to manage emotional distress can be important. Journaling, cognitive reframing, exercising, and meditating are all examples of techniques you might explore for stress management.
If you feel like you've tried every at-home acne treatment but aren't seeing improvement, there are still options available. The next step is normally seeing a dermatologist who can diagnose acne and help you find the right acne treatment. Dermatologists will often start off with prescription-strength topical creams like adapalene cream, tretinoin, retinoic acid, topical antibiotics, or others with high concentrations of benzoyl peroxide.
Sometimes, dermatologists will also prescribe oral antibiotics to take over a period of time in addition to using topical solutions to treat acne that’s moderate to severe, such as severe nodular acne. Always speak with your doctor or dermatologist before starting or stopping any medication. For some individuals, dermatologists may also recommend birth control pills or spironolactone, which can help control hormonal acne.
A final option is an isotretinoin, which is often referred to by its previous brand name, Accutane. This is a Vitamin A-based acne medication that can have serious side effects and even make acne worse if used improperly. Skin affected by cysts or other severe forms of acne may be treated with isotretinoin. Again, make sure to speak with your doctor or dermatologist about medications like this and potential side effects.
Acne & mental health
Acne can affect more than just your appearance. Numerous studies have suggested that skin conditions like acne can have effects on mental health as well. These can range from low self-esteem and poor self-image to mental illnesses like depression and anxiety. Many people with acne also report decreased quality of life and feelings of isolation.
Acne doesn’t have to be severe for people to experience mental health effects, either. Even mild to moderately affected skin can cause distress, especially in teenagers. Finding healthy ways to cope with difficult emotions and experiences related to acne can help you support your well-being.
If you’re experiencing acne that's causing mental health challenges, you might seek out the support of a professional. Though it may not be possible to completely prevent acne, a therapist can help you reframe distorted negative thoughts and shift your self-talk in a more positive and realistic direction. They may also offer exercises or techniques that may assist you in building confidence, and discovering healthy coping mechanisms that work for you--and realizing your inherent worth—whether acne appears or not.
Acne is a common skin condition that affects many people, particularly teenagers and young adults. While some acne can be managed with simple lifestyle changes, other cases may require medical attention. Regardless of the severity of your acne, if you feel that it's impacting your mental health, you might consider speaking with a professional to help you regain your confidence and build your self-esteem.
Four main factors cause most cases of acne: inflammation, bacteria, excess oil production, and clogged hair follicles. Hormonal changes, diet, stress, and certain medications can also play a part.
Acne is most common in teenagers and young adults between the ages of 14 and 24. It typically starts during puberty and usually affects girls earlier than boys. For most people, it's at its worst between ages 15 and 17 and often improves after that point.
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