Acne is a multifactorial skin condition that develops due to the combination of various factors.

1. Overproduction of Sebum: One of the primary causes of acne is the overproduction of sebum. Sebaceous glands are sensitive to hormonal fluctuations, especially androgens (such as testosterone). Higher androgen levels stimulate the sebaceous glands, leading to increased sebum production.

2. Abnormal Keratinisation of Hair Follicles: Acne development involves abnormal keratinisation of the hair follicles. Normally, dead skin cells are shed from the skin’s surface, but in acne-prone people, these cells form a plug within the follicles, blocking the normal flow of sebum. This plug, known as a comedone, can be open (blackhead) or closed (whitehead).

3. Bacterial Overgrowth: Propionibacterium acnes (P. acnes), a bacteria that naturally resides on the skin, plays a role in acne development. When hair follicles become clogged, it creates an anaerobic environment in which P. acnes can overgrow. The bacteria feed on sebum and release inflammatory substances, triggering an immune response.

4. Inflammation: The presence of a clogged follicle, bacterial overgrowth, and immune response leads to inflammation in the affected area. Inflammatory mediators, such as cytokines, are released, causing redness, swelling, and pain associated with acne lesions.

5. Genetic Factors: Genetics also contribute to acne susceptibility. Studies have shown that if your parents had acne, you are more likely to develop it. Specific genetic variations can influence factors like sebum production, hormonal regulation, and inflammation, making some people more predisposed to acne.

Other factors that can influence acne include hormonal imbalances, stress, certain medications (including corticosteroids and lithium), diet (particularly high glycaemic index foods), and environmental factors.

Understanding the causes and development of acne helps guide treatment approaches.

Yes, hormonal changes can contribute to the development of acne. Fluctuations in hormone levels can influence the production of sebum, follicular keratinisation, and inflammation, all of which are key factors in acne formation.

Puberty: During puberty, hormone levels, especially androgens (such as testosterone), increase. Androgens stimulate the sebaceous glands to produce more sebum, leading to an increased risk of acne.

Menstrual Cycle: Hormonal changes that occur during the menstrual cycle can trigger acne breakouts. The premenstrual phase, characterised by increased progesterone and decreased estrogen, can contribute to the development of acne lesions.

Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder where there is an imbalance in sex hormones, including elevated androgens (such as testosterone). This hormonal imbalance can lead to increased sebum production and acne.

Pregnancy: Hormonal fluctuations during pregnancy can cause acne in some women. These changes include elevated levels of progesterone and androgens, which can stimulate the sebaceous glands and lead to breakouts.

Hormonal Medications: Certain hormonal medications, such as oral contraceptives (birth control pills), hormone replacement therapy, and steroids, can affect hormone levels and potentially contribute to acne development.

Managing hormonal acne often involves a combination of approaches, and it’s recommended to consult with a dermatologist, for personalised advice.

Here are some common strategies to keep hormonal acne under control:

Topical Treatments: Dermatologists may prescribe topical medications containing ingredients like retinoids, benzoyl peroxide, or antibiotics to help reduce inflammation and control acne symptoms.

Oral Medications: In some cases, they may recommend oral medications, such as oral contraceptives (specifically those with anti-androgenic properties), spironolactone (an androgen blocker), or systemic antibiotics, to manage hormonal acne.

Lifestyle Modifications: Maintaining a healthy lifestyle through regular exercise, stress management, and a balanced diet may help manage hormone levels and reduce acne breakouts.

Skincare Routine: Using non-comedogenic skincare products, gentle cleansers, and avoiding excessive scrubbing or picking can help manage acne and prevent further irritation.

Professional Treatments: In some cases, it is recommended to seek professional treatments like chemical peels, photodynamic therapy, microneedling, mesotherapy or laser therapy to target acne lesions and minimize scarring.

It’s important to consult with a healthcare professional to determine the cause of acne. The most suitable approach for managing hormonal acne varies depending on individual circumstances and the underlying hormonal condition.

Some skin conditions may resemble acne and can be mistaken for it.

Rosacea: This chronic skin condition often affects the face and may cause redness, visible blood vessels, and acne-like bumps known as papules and pustules. It can be mistaken for acne, especially when the two conditions coexist.

Folliculitis: It is the inflammation of hair follicles that can result from bacterial or fungal infections. Folliculitis can cause small, red, and pus-filled bumps that resemble acne. It can occur anywhere on the body where hair follicles are present.

Perioral Dermatitis: This condition primarily affects the area around the mouth, nose, and chin. It appears as small red bumps or pustules and can be mistaken for acne or a rash. It may be triggered by the use of topical steroids or certain cosmetic products.

Allergic Reactions: Some allergic reactions to skincare products, cosmetics, or certain medications can lead to skin eruptions resembling acne. These reactions may cause redness, bumps, or even pustules and can sometimes be mistaken for acne breakouts.

This is not an exhaustive list, and there might be many other conditions that can mimic acne.

To differentiate acne from other skin conditions, it’s important to consider the following factors:

Symptoms: Acne typically presents as the formation of non-inflammatory or inflammatory lesions, such as whiteheads, blackheads, pimples, or cysts. These commonly occur on the face, chest, back, and shoulders. Other skin conditions may have different types of lesions or affect different areas of the body.

Lesion appearance: Acne lesions usually appear as raised, red or pink bumps with a central opening (whitehead) or darkened plug (blackhead). Inflammatory acne may manifest as pus-filled pustules or painful, deep cysts. Other skin conditions may have distinct lesion characteristics, such as raised, flat, scaly, or itchy patches.

Age of onset: Acne commonly starts during puberty due to hormonal changes, but it can persist into adulthood. If a skin condition develops later in life, it is less likely to be acne and may be related to other factors such as allergies, infections, or immune system disorders.

Medical history: Your medical history and any underlying conditions can provide helpful clues. For instance, acne is often associated with hormonal imbalances, polycystic ovary syndrome (PCOS), or a family history of acne. Other skin conditions may be linked to allergies, autoimmune diseases, or medications.

Duration and response to treatment: Acne can be a long-lasting chronic condition, while other skin conditions may come and go. Additionally, acne often responds to specific treatments like topical retinoids, benzoyl peroxide, or oral antibiotics, whereas other skin conditions might require alternative therapies.

Several skincare ingredients have been found to be effective in treating acne.

Benzoyl Peroxide: Benzoyl peroxide is an antibacterial ingredient that helps kill Propionibacterium acnes (the bacteria associated with acne) and reduce excess oil production. It also has anti-inflammatory properties, aiding in the reduction of redness and swelling associated with acne.

Salicylic Acid: Salicylic acid is a beta hydroxy acid (BHA) known for its ability to exfoliate the skin and dissolve excess oil. It helps unclog pores, allowing for the removal of dead skin cells and preventing the formation of comedones (clogged pores).

Retinoids: Retinoids, including over-the-counter retinol and prescription-strength derivatives like tretinoin and adapalene, are derivatives of vitamin A. They help regulate skin cell turnover, prevent the formation of new comedones, and reduce inflammation. Retinoids can also improve the appearance of acne scars.

Azelaic Acid: Azelaic acid has antibacterial properties and helps regulate skin cell turnover. It also has anti-inflammatory effects and can reduce the production of keratin, which contributes to the development of acne.

Tea Tree Oil: Tea tree oil, derived from the Melaleuca alternifolia plant, has antimicrobial properties and can help reduce acne-causing bacteria. It also possesses anti-inflammatory effects, aiding in the management of acne lesions.

Niacinamide: Niacinamide, a form of vitamin B3, has anti-inflammatory properties, helps regulate sebum production, and improves the skin’s barrier function. It can reduce the severity of acne lesions and help with post-inflammatory hyperpigmentation.

Alpha Hydroxy Acids (AHAs): AHAs, such as glycolic acid and lactic acid, can exfoliate the skin, promote cell turnover, and reduce the appearance of acne scars. They also help improve skin texture and overall complexion.

Acne can have potential long-term effects, particularly if it is severe or left untreated.

Post-inflammatory Hyperpigmentation (PIH): PIH refers to the dark spots or patches that can develop after acne lesions have healed. These spots occur due to overproduction of melanin in response to inflammation. PIH is temporary and typically resolves over time.

Acne Scarring: In some cases, acne can lead to permanent scarring, which can manifest as depressions (atrophic scars) or raised and thickened areas (hypertrophic scars). Scarring occurs due to the damage and alteration of collagen fibers during the healing process. Prevention is key to minimise the risk of scarring.

To prevent scarring and minimise long-term effects of acne, consider the following strategies:

Early and effective treatment: Treating acne promptly and effectively can help reduce the risk of scarring. Dermatologist can recommend appropriate medications, topical treatments, or oral medications based on the severity of your acne.

Avoid picking or squeezing: Picking or squeezing acne lesions can increase inflammation and trauma to the skin, leading to a higher likelihood of scarring. Keep your hands away from the affected areas to prevent further damage.

Sun protection: Protecting your skin from the sun’s harmful UV rays is crucial to prevent post-inflammatory hyperpigmentation from darkening. Use a broad-spectrum sunscreen with SPF 30 or higher, wear protective clothing, and avoid excessive sun exposure.

Gentle skincare routine: Cleanse your skin gently with mild, non-comedogenic (non-pore-clogging) cleansers. Avoid scrubbing harshly or using abrasive exfoliants that can irritate the skin and potentially worsen acne or scarring.

Professional interventions: Treatments such as laser therapy, chemical peels, mesotherapy, and microneedling are recommended to improve the appearance of acne and scars. Consult us to discuss suitable options.

It’s important to note that individual responses to treatments and scar prevention strategies may vary.

Certainly! While there is no one-size-fits-all solution for acne, there are several home remedies that may help manage breakouts. It’s important to note that these remedies may work for some people, but not for others.

Tea tree oil: It exhibits antimicrobial and anti-inflammatory properties, helping reduce acne-causing bacteria and inflammation. Dilute it before applying to the skin to avoid irritation.

Benzoyl peroxide: It kills bacteria and reduces oil production. Start with a lower concentration to avoid skin irritation and gradually increase.

Salicylic acid: It helps remove dead skin cells, unclog pores, and reduce inflammation. Look for over-the-counter products with 0.5-2% salicylic acid.

Green tea: Contains antioxidants that can help reduce inflammation.

Aloe vera: Known for its soothing properties, aloe vera can help reduce redness and inflammation. Apply a thin layer of pure aloe vera gel to the affected areas.

Honey: Its antibacterial and wound-healing properties may aid in managing acne.

Pansy, also known as Viola tricolour, has been used in traditional medicine for various purposes, including skin conditions like acne. While there is limited scientific research specifically on pansy tea’s effectiveness for acne, it contains compounds that may be beneficial for the skin. Pansy tea is rich in antioxidants, which can help reduce oxidative stress and inflammation, potentially contributing to improved skin health.

The anti-inflammatory properties of pansy tea could help calm acne-related inflammation. Additionally, the tea may have a gentle diuretic effect, possibly aiding in detoxification and reducing excess fluid retention that can contribute to skin issues.

While pansy tea may offer potential benefits, it’s important to note that individual results can vary, and it might not be as effective as other scientifically proven treatments. It’s always a good idea to consult with a dermatologist or healthcare professional for personalized advice and to discuss any potential interactions or side effects.

Consult with a doctor if you have severe or persistent acne. Everyone’s skin is unique, so what works for one person may not work for another.

Lifestyle factors and practices can play a role in aggravating or improving acne symptoms.

Diet: While research on the impact of diet on acne is ongoing, some evidence suggests that high glycaemic load diets (rich in sugary and processed foods) and dairy consumption may aggravate acne in certain people. Maintaining a balanced diet with plenty of fruits, vegetables, and whole grains is considered beneficial for overall skin health.

Skincare routine: Using harsh or comedogenic (pore-clogging) skincare products, excessive scrubbing, or not properly cleansing the skin can worsen acne. It’s important to use non-comedogenic products and follow a gentle skincare routine that includes cleansing twice daily, avoiding excessive scrubbing, and moisturising appropriately.

Stress: While stress does not directly cause acne, it can contribute to flare-ups or worsen existing acne. Stress triggers the release of certain hormones (such as cortisol) that may increase oil production and inflammation, potentially worsening acne symptoms. Implementing stress-management techniques like exercise, meditation, or engaging in hobbies can help manage stress levels.

Hormonal factors: Hormonal changes, particularly during puberty, menstruation, or hormonal imbalances in conditions like polycystic ovary syndrome (PCOS), can contribute to acne development. Consulting with a doctor who can provide appropriate hormonal management may be beneficial in such cases.

Smoking: Cigarette smoking has been associated with acne severity and delayed wound healing. Smoking can affect skin health by reducing blood flow to the skin, impairing skin repair processes, and increasing oxidative stress.

Alcohol consumption can potentially impact acne symptoms, but the relationship is not fully understood, and individual responses can vary. Alcohol may stimulate the production of sebum (skin oil). Excessive sebum production, combined with dead skin cells and bacteria, can lead to clogged pores and acne breakouts. Alcohol is a diuretic, which means it increases urine production, potentially leading to dehydration. Dehydration can affect the skin’s barrier function and promote inflammation, potentially exacerbating acne. Inflammation: Alcohol consumption can trigger an inflammatory response in the body. Inflammation plays a role in acne development, and chronic inflammation may worsen acne symptoms.

Acne is a multifactorial condition, and its causes and triggers can vary from person to person.

Several professional treatments can be effective in managing and improving acne symptoms.

Acne treatments available from your doctor or dermatologist:

Topical retinoids: Prescription-strength retinoids, such as tretinoin, adapalene, or tazarotene, are prescribed by dermatologists. Retinoids help regulate skin cell turnover, reduce inflammation, and prevent clogged pores.

Oral medications: In more severe cases of acne, dermatologists may prescribe oral medications such as antibiotics (e.g., doxycycline), hormonal treatments (e.g., oral contraceptives or spironolactone for hormonal acne in females), or isotretinoin (a powerful retinoid).

In salon professional treatments:

Chemical peels: chemical peels using solutions like salicylic acid, glycolic acid, or trichloroacetic acid. Chemical peels exfoliate the skin, unclog pores, and can help reduce acne lesions and post-inflammatory hyperpigmentation.

Laser and light therapies: Procedures like laser therapy, intense pulsed light (IPL), and photodynamic therapy (PDT) may be used to target acne-causing bacteria, reduce sebum production, and improve overall skin appearance. These treatments can also help with acne scarring.

Microneedling (Collagen Induction Therapy): Microneedling is a procedure where a device with fine needles is used to create controlled micro-injuries in the skin. It stimulates the production of collagen and elastin, which can help improve the appearance of acne scars and overall skin texture. Microneedling can also enhance the absorption of topical medications used in acne treatment. However, it’s important to note that microneedling on its own may not directly target active acne lesions but can be effective for acne scars.

Mesotherapy: Mesotherapy is a technique involving the injection of a customised mixture of vitamins, minerals, amino acids, and other active substances into the skin. It provides various benefits, such as improving hydration, reducing inflammation, and promoting skin rejuvenation. Mesotherapy has been used for various cosmetic purposes.

Deep phyto peel: The effectiveness of deep phyto peel for acne depends on various factors, including the individual skin characteristics and acne severity.

Phyto peels, also known as plant-based chemical peels, utilise natural ingredients derived from plants to exfoliate the skin, unclog pores, and improve overall skin texture. Some plant-based ingredients, such as salicylic acid (derived from willow bark) or fruit enzymes (found in papaya or pineapple), have exfoliating properties that can help remove dead skin cells and reduce acne lesions.

Deep peels, regardless of their ingredients, offer a more effective exfoliation process that penetrates deeper into the skin. They may carry a higher risk of complications, such as skin irritation, redness, or increased sensitivity, particularly for people with sensitive skin or active acne lesions.

It’s crucial to remember that the effectiveness of these treatments may vary depending on individual factors, such as the type and severity of acne, and how well people follow the aftercare.

Acne-prone skin requires a skincare routine that helps manage oil production, reduces inflammation, and prevents clogged pores.

Cleansing: Use a gentle, pH-balanced cleanser twice a day to remove excess oil, dirt, and bacteria from the skin. Look for products containing salicylic acid or benzoyl peroxide, which can help unclog pores and reduce acne-causing bacteria.

Exfoliation: Regular exfoliation helps remove dead skin cells and unclog pores. Opt for chemical exfoliants like salicylic acid or glycolic acid, as physical exfoliation can be too harsh and make the inflammation worse.

Moisturising: Contrary to popular belief, moisture is important even for acne-prone skin. Look for lightweight, oil-free moisturisers or gel-based products, preferably non-comedogenic (doesn’t clog pores). Ingredients like hyaluronic acid can help hydrate the skin without adding excess oil.

Acne treatments: Consider using over the counter or prescription acne treatments containing ingredients such as benzoyl peroxide, salicylic acid, or retinoids. These ingredients can target acne-causing bacteria, reduce inflammation, and promote cell turnover.

Sun protection: Protecting your skin from harmful UV rays is extremely important. Choose a broad-spectrum sunscreen with an SPF of 30 or higher that is oil-free and non-comedogenic. Sunscreen helps prevent post-inflammatory hyperpigmentation and ensures the skin’s natural healing process.

Avoid irritants: Stay away from harsh or fragranced products, as they may irritate the skin and worsen acne. Additionally, avoid touching, picking, or squeezing acne, as it can lead to further inflammation and scarring.

In addition to a skincare routine, here are a couple of important practices to maintain clear and healthy skin:

Clean Makeup Brushes: Makeup brushes can accumulate bacteria, oils, and skin residue over time, which can potentially worsen acne. Clean your brushes regularly by washing them with a gentle shampoo or a brush cleaner. It’s recommended to clean them at least once a week to prevent the buildup.

Change Pillowcases and Face Towels: Both pillowcases and face towels come into contact with your skin regularly and can harbour bacteria, oils, and leftover skincare products. Changing your pillowcase once or twice a week and using a fresh face towel each time you cleanse your face can help minimise the transfer of these impurities onto your skin.

Avoid Double-Dipping: When using creams, serums, or makeup foundation from jars, to prevent contamination avoid double-dipping. Instead of directly applying the product onto your skin, take the required amount of product onto a clean spatula or the back of your hand. This way, you can minimise the potential transfer of bacteria from your skin back into the jar, thus reducing the risk of contaminating the product.

Everyone’s skin is unique. By implementing this practice, you can help maintain the efficacy and hygiene of your skincare products.

Several medications and treatments are available that have been shown to effectively treat acne. The appropriate treatment for acne may vary depending on the specific condition, severity, and medical history. Consult with a dermatologist for a personalised treatment plan.

Topical retinoids: These medications, such as tretinoin, adapalene, and tazarotene, work by increasing cell turnover and preventing the clogging of hair follicles. They are effective in reducing acne lesions and preventing new ones from forming.

Benzoyl peroxide: This topical medication has antibacterial properties and helps to reduce excess oil production. It can be used alone or in combination with other treatments to treat mild to moderate acne.

Topical antibiotics: Some antibiotics can be applied to the skin to reduce the population of acne-causing bacteria. They are usually used in combination with other treatments to prevent the development of antibiotic resistance.

Oral antibiotics: When acne is more severe, oral antibiotics may be prescribed to reduce inflammation and control bacterial growth.

Isotretinoin: This medication, taken orally, is highly effective for severe acne that does not respond well to other treatments. However, it has potentially severe side effects and requires close monitoring by your doctor.

Hormonal therapies: For women with hormonal acne, hormonal therapy such as oral contraceptives or anti-androgen medications like spironolactone may be prescribed to regulate hormone levels and reduce acne.

While maintaining a balanced diet is important for overall skin health, the evidence regarding specific supplements or vitamins for treating acne is limited. However, some nutrients have been studied for their potential role in acne management. It’s essential to note that individual responses may vary.

Omega-3 fatty acids: These healthy fats, commonly found in fatty fish like salmon, mackerel, and sardines, have anti-inflammatory properties and may help reduce acne lesions and inflammation in some individuals.

Zinc: Zinc is involved in numerous skin processes and has antimicrobial properties. It plays a role in wound healing and has been suggested to have potential benefits for acne. Some studies have shown that zinc supplementation, both oral and topical, may reduce acne. However, the efficacy of zinc supplements may vary, and excessive zinc intake can have adverse effects, so it’s important to use them with caution.

Probiotics: Probiotics are beneficial bacteria that contribute to gut health. They have been investigated for various dermatological conditions, including acne. Some studies suggest that certain strains of probiotics may help reduce inflammation and improve acne symptoms.

Vitamin A and E: Vitamin A plays a crucial role in skin health and is involved in the growth and development of skin cells. It is an ingredient in some prescription acne medications (such as isotretinoin). Vitamin E has antioxidant properties and may have some effect on skin health. However, high doses of vitamin A and E can be toxic, and it is best to obtain these nutrients through a balanced diet unless advised otherwise by your doctor.

Supplements should not replace a healthy diet or proper skincare routine. If you are considering taking supplements to help with acne, consult your doctor to assess potential benefits and any risks associated with them.