Acne interrupts your social life, causes unwanted discomfort, and then makes you worry about scarring. Even with these concerns, there’s some confusion about when you should seek treatment, and what kind of treatments you should be looking for. In this article, we’ll provide all the answers you need.
Types of acne and how to treat them
To better combat an acne outbreak, you have to understand what kinds of acne there are, and what type of treatment is suitable for each acne type.
Comedonal acne is a common type of acne that often appears as small, typically non-inflammatory blemishes on the skin. Also known as whiteheads and black heads, this form of acne is typically caused by excessive oil production and dead skin cells that clog up the hair follicles.
Comedonal acne can be treated with topical retinoids to increase skin cell turnover and prevent clogged pores. Salicylic acid is also commonly used as it can penetrate the pores to dissolve excess sebum and dead skin cells.
Inflammatory acne is painful, tender, and red. This uncomfortable form of acne is the result of the immune system’s response to bacteria and dead skin cells in the pores. This type of acne often causes small, pus-filled pustules.
Treatments include benzoyl peroxide to kill acne-causing bacteria, topical or oral antibiotics to fight infection and inflammation in more severe cases, and retinoids to prevent hair follicles from becoming clogged.
Cystic acne is a more severe kind of acne that is characterised by large, painful, pus-filled cysts beneath the skin’s surface. These cysts can lead to deep, permanent scars if not treated properly. They should not be broken by hand.
Due to the more serious nature of the condition, oral antibiotics, isotretinoin (Accutane), and intralesional corticosteroid injections are often used to deal with this version of acne.
Unlike the first few forms of acne we talked about, hormonal acne comes about due to a different root cause. This form of acne is caused by fluctuations in hormones, and is often linked to menstruation, pregnancy, menopause or conditions such as polycystic ovarian syndrome (PCOS). Hormonal acne often involves flare-ups of inflammatory acne on the lower face and jawline.
Hormone related treatments like birth control pills can be used to help regulate hormone levels. Topical and oral medications like retinoids and antibiotics can also be used to deal with this issue.
This form of acne is triggered when there is excess heat, friction or pressure to the skin. Often arising from the use of athletic gear, tight clothes, backpacks, or even mask-wearing, acne mechanica can be prevented by wearing loose, breathable clothing, keeping the skin clean and dry, and avoiding unnecessary friction or pressure.
For acne mechanica, treatments include salicylic acid, benzoyl peroxide, and other acne medications.
The importance of a skincare routine
A consistent skincare routine is essential in preventing acne because it helps maintain the balance of your skin. In order to combat acne, your basic skincare routine should consist of cleansing, exfoliation and moisturisation.
Cleansing is a fundamental step in a skincare routine, particularly for acne prevention.
It involves washing your face with a suitable product to remove dirt, oil, and other impurities that accumulate on your skin throughout the day. These impurities, if left unchecked, can clog pores, leading to blackheads, whiteheads, and all the other forms of acne we mentioned earlier on.
A proper cleansing routine is typically carried out twice a day – in the morning to wash off the oil and dead skin cells that build up overnight, and at night to remove makeup, dirt, sweat, and pollutants encountered during the day. However, the frequency may vary based on your skin type and specific needs.
While cleansing, it’s crucial to use a gentle, non-abrasive cleanser that matches your skin type (oily, dry, combination, or sensitive). Some cleansers are specially formulated with acne-fighting ingredients like salicylic acid or benzoyl peroxide.
Over-washing or using harsh cleansers can strip the skin of its natural oils, leading the skin to overcompensate and produce more oil, potentially exacerbating acne. Therefore, gentle and consistent cleansing is key.
Post cleansing, pat your skin dry with a clean towel. Rubbing can irritate the skin and aggravate existing acne. Finally, follow cleansing with the rest of your skincare routine – typically, application of treatments (if any), moisturiser, and sunscreen (during the day).
While highly important, cleansing is only one piece of the acne prevention puzzle. The next piece of this puzzle is exfoliation.
Exfoliation refers to the process of removing dead skin cells from the surface of your skin. These cells, if not effectively removed, can clog pores and lead to the formation of acne. Moreover, all that accumulation of dead skin cells can make your complexion look dull and contribute to uneven skin texture.
There are two main types of exfoliation: physical and chemical. Physical exfoliation uses a scrub, brush, or other rough surfaces to manually remove the dead cells. While this can be effective, the abrasive nature of this form of exfoliation can be harsh on the skin, and may not be suitable for those with sensitive or acne-prone skin.
Chemical exfoliation (i.e. chemical peels) uses acids or enzymes to dissolve and remove dead skin cells. Alpha-hydroxy acids (AHAs), like glycolic and lactic acid, and beta-hydroxy acids (BHAs), like salicylic acid, are common chemical exfoliants. For those with acne concerns, BHAs are particularly useful for acne-prone skin as they penetrate deeply into the pores to clear out excess oil and dead skin cells.
Regardless of the method, over-exfoliation can damage your skin’s barrier, leading to dryness, irritation, and increased sensitivity. Generally, exfoliating one to two times per week is recommended, but this can vary based on your skin type and needs.
The act of exfoliation strips away the top layer of your skin, exposing a newer, and slightly more sensitive layer of skin. This is the best chance to moisturise your skin to make sure it stays fresh and well-protected.
Moisturising preserves the skin’s natural protective barrier and traps water within, resulting in a vibrant, youthful appearance. Properly moisturised skin can also reduce the likelihood of skin issues like dryness and oiliness.
In the context of acne, moisturising is especially important. People with oily, acne-prone skin might think they should skip this step, but this could actually make acne worse. If your skin is dehydrated, it might overproduce oil to compensate, which can contribute to clogged pores and the formation of acne. Many moisturisers also have ingredients that can soothe the skin, reduce inflammation, and aid in the skin’s repair process.
It’s important to choose a moisturiser that suits your skin type. For acne-prone or oily skin, opt for non-comedogenic (won’t clog pores), oil-free moisturisers. Some moisturisers also contain anti-acne ingredients like salicylic acid or benzoyl peroxide.
Moisturising should be done twice daily, ideally once in the morning and once at night, following cleansing (and toning or applying treatments, if that’s part of your routine).
The importance of good nutrition
The skin is the largest organ of the body, so its health is a reflection of your overall health. Like other organs, the skin needs key nutrients to function optimally, and these are derived from the food we consume. Consequently, good nutrition is a fundamental requirement for maintaining healthy, acne-free skin.
Certain dietary factors have been associated with the development and exacerbation of acne:
- High glycemic index foods like white bread, chips and sugary drinks spike blood sugar levels and increase insulin levels in the body
- Dairy is hypothesised to contribute to acne due to the hormones and growth factors it contains, though further research is needed to definitively establish this link
Consider increasing intake of the following for better skin health:
- Low GI foods e.g. whole grains, legumes, fruits, vegetables
- Food rich in antioxidants, omega-3 fatty acids and anti-inflammatory compounds e.g. salmon, fruits and vegetables
- Specifically look out for Vitamins A, E, C and zinc as these nutrients are involved in skin repair and renewal processes and can potentially help with acne
While a good diet is important, we should keep in mind that everyone’s body is unique. What works for one person may not work for another. If you want to use your diet as part of a larger acne control plan, you should consult with a healthcare professional or a registered dietitian to personalise dietary recommendations based on your individual needs and conditions.
When to seek professional help
If you encounter the following, it is time to seek help from a professional for acne treatment:
Severity: If your acne is severe or is causing scarring or painful nodules, it’s best to seek help from a dermatologist. Severe acne includes cystic or nodular acne, which can cause significant inflammation, pain, and potentially, scarring.
Ineffectiveness of over-the-counter (OTC) products: If you’ve tried using over-the-counter acne treatments for several weeks and haven’t seen any improvement, it might be time to see a professional. Prescription treatments might be necessary for your type of acne.
Impact on mental well-being: If your acne is causing significant distress, affecting your self-esteem, or leading to anxiety or depression, you should seek help. The psychological impact of acne is as important to address as the physical symptoms.
Persistent or worsening acne: Acne that doesn’t improve or worsens over time, despite proper skincare and diet, should be evaluated by a professional.
Hormonal reactions: If you suspect your acne might be hormonal (for instance, if it’s associated with your menstrual cycle or conditions like polycystic ovary syndrome), a healthcare provider can offer treatments to target the root cause.
Acne later in life: If you’re getting acne for the first time as an adult, it’s a good idea to see a healthcare provider as it could be a symptom of an underlying medical condition.
Treat your acne with SkinLab
Don’t struggle against acne alone. Acne treatment in Singapore is possible with the support of experienced, well-trained professionals who know all about dealing with acne. At SkinLab, Singapore’s largest medical spa chain, our highly trained therapists will use tailored solutions to give you the smooth, acne-free skin you desire.