The biggest cause of acne formation is genetic predisposition. However, acne formation can be exacerbated due to hormonal changes, stress caused by school or work, eating habits and poor skin care habits.
Acne is a sebaceous follicle disorder. It occurs as a result of keratinization irregularity of the cells surrounding the sebaceous (oil) glands. The cells in here lose their ability to exfoliate themselves, the dead skin cells that are not removed become sticky by mixing with the secreted oil, and this sticky substance closes and clogs the sebaceous glands, channels and pores. Even if the channels and pores are closed, the sebaceous glands continue to secrete oil. Excess oil and lack of oxygen, which begin to accumulate because it is not excreted in the clogged areas, prepares a perfect environment for the development of Proprioniabacterium acnes (P. acnes), which is constantly present on the skin. P. acnes is a very slow growing, anaerobic (living in an oxygen-free environment), gram-positive bacterium. It uses dead cells and metabolic wastes as a source of energy and nutrients. P. The growth of acnes bacteria causes inflammation in the sebum (oil) glands. Sebum ducts are blocked, excess sebum cannot go out, and the sebaceous glands fail after inflammation caused by bacteria. This situation manifests itself as inflamed red lesions, acne or cysts on the skin surface.
Diet and Acne: In a study conducted by Colorado University, the dietary habits of women living in Papua New Guinea and Paraguay were examined. The people living in these regions traditionally consume low-carbohydrate foods and have no acne problems. On the other hand, in North America and Western Europe, the situation is the opposite, since 79% - 95% of young people between the ages of 15-25 have acne concerns, while 40% - 54% of adults aged 25 and over have acne concerns. Based on these findings, the research team revealed that foods with a high glycemic index (fast-digesting sugar and starches) increase the insulin level, and as a result, sebum (oil) production is triggered and indirectly causes acne. Contrary to what is known, the foods consumed do not cause acne because they contain fat, they cause acne because foods are loaded with processed carbohydrates.
Types of Acne Lesions
Open Comedones: open comedones are also generally defined as 'blackheads'. They occur as a result of dead keratin (skin) cells combining with sebum and hair particles and clogging the pores. It is possible to get rid of these structures with regular BHA exfoliation. When exfoliation processes are not continued, they are likely to occur again.
Closed Comedones: They are structures that are also generally referred to as 'white dots'. They occur as a result of keratin (dead skin cells) and sebum trapped under the skin, in the follicles and covered by skin cells. The best solution for closed comedones is exfoliation. It is possible to get rid of closed comedones by purifying the skin surface from dead cells with AHA or BHA exfoliants. Open and closed comedones are common in oily areas of the skin (forehead, nose, and chin).
Punchy pimples (papule): They are small and hard structures with a red structure and no inflammation (pus). These structures should not be tightened.
Pustule: are small white-tipped structures that are red, inflamed and contain pus
Nodule and Cystic Structures: They are structures formed as a result of inflammation of the sebaceous (oil) glands under the skin surface by catching microbes. In general, they create a very disturbing image. They can leave scars and marks on the skin.
Before starting the acne treatment and choosing the treatment method, it should be graded between 1-4 according to the severity of acne and the number of lesions. Grade 1 is the mildest form of acne with very few lesions. Grade 4 is the most severe form of acne.
The purpose of all acne treatment methods is the same: to kill bacteria by using antibacterial products or drugs. Reducing excess sebum (oil) production. Opening clogged pores. Reducing inflammation.
- For 2nd degree acne concerns, a good skin care routine should be established that includes deep cleansing of the skin using a double cleansing method and regular exfoliation (BHA).
For the exfoliation process, products containing 0.5% - 2% BHA (Salicylic acid) should be used. Salicylic acid has comedolytic (acne prevention) activity and also has antibacterial properties. It helps to dry acne structures by exfoliating the inside of the pores.
BHA exfoliants need to be well-formulated to take maximum advantage of their antimicrobial and anti-acne activity. In order not to damage the skin and cause irritation, they should not contain essential oils and ethyl alcohol.
In severe acne concerns, support should be obtained from various medications. With the decision of the dermatologist, the following methods can be used as prescription:
- Antibiotics (help kill bacteria and reduce inflammation)
- Hormone therapy
- Retinoid-based drugs
Retinoic acid is the most effective solution known. The most common Retinoid-based drugs: Roaccutane, Avita, Differin, Retin-A, Tazorac can be counted. The most effective antibiotics taken orally are Clindamycin, Doxycycline, Erythromycin, Minocycline, Tetracycline and Bacterin.
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Salicylic acid should be done at a pH of ~3 to maximize its antimicrobial and keratolytic activity. A 2 percent SA lotion will reduce inflamed and noninflamed lesions by around 50 percent after four weeks, on average.
Cosmetic approaches for treating acne include the use of antimicrobial agents and oil-control ingredients to reduce sebum. It is estimated that a 30 to 50 percent reduction in sebum will reduce acne by as much as 50 percent..