Acne is an enigma – complex, multifaceted and often frustrating to understand. No two people are exactly alike when it comes to their acne. So when it comes to managing this chronic inflammatory condition, it is pivotal to remain armed with knowledge, stay consistent and above all stay kind to your skin.
Acne Causes
While acne may be complex, at its core results from a combination of biological processes. These include an overproduction of sebum, altered sebum lipid quality and abnormally rapid shedding of skin cells. This trio of factors lead to a build up inside the pores causing them to become clogged. This ‘clogged home’ is perfect for the acne-causing bacteria, Cutibacterium acnes to thrive and multiply. Triggering inflammation and leading to the manifestation of breakouts.
Sebum Quality
Composition or quality of sebum is different in people with acne vs people without acne. There is a decreased concentration of linoleic acid and an increased concentration of squalene. Linoleic acid is the building block for the production of certain ceramides in the skin. Ceramides are the major component of the outer skin layer keeping the skin barrier intact. In acne, the lower-than-normal levels of linoleic acid leads to a lower-than-normal concentration of ceramides. This contributes to skin barrier dysfunction. There is data showing that the lower the levels of ceramides the more severe the acne. This is thought to be due to skin barrier dysfunction that directly contributes to follicular hyper-keratinisation.
Genetics and Hormones
Beyond the surface-level causes, genetics, hormones and diet may also influence the development and progression of acne. Numerous studies confirm the genetic component of acne. Individuals with acne-prone parents and siblings are three times more likely to develop acne themselves. This is not just statistical data, but a warning sign to be more proactive if you have a family history of acne. Hormonal fluctuations also play a role as well. Particularly during transitional phases like puberty in teenagers, pregnancy, menopause and at certain phases of a woman’s menstrual cycle.
Diet
The link between diet and acne is a topic of ongoing research. While the relationship isn’t fully cemented, there is enough evidence to suggest a link. Foods that incite internal inflammation or contain high levels of hormones, proteins and sugars are often flagged as culprits. Refined carbohydrates and sugars are considered to have high glycemic index which spike your blood sugar levels. Causing a ripple effect that increases inflammatory processes which then stimulate sebocyte proliferation and sebum production leading to acne. Dairy products due to their hormone content, have also been implicated in exacerbating cystic acne. One of the most severe forms of acne.
Dry Skin and Acne
Despite acne being very closely associated with oily skin types, dry skin is not exempt from acne’s clutches. While Dry skin may not exhibit an overproduction of sebum, it is susceptible to follicular hyper-keratinisation. A condition where skin cells stick together within the follicles or pores creating a bottleneck/blockage within the follicles. The alteration of sebum lipid quality, clogging of pores and acne bacteria growth and multiplication, culminates in acne breakouts even in dry skin types.
The most important thing to know about acne is that it is no respecter of age or gender. Whether you’re a teenager grappling with the ups and downs of puberty or an adult navigating life, acne can strike. It is a very widespread skin condition and virtually everyone experiences breakouts at some point in their lives. Statistics are alarming: 85% of people between the ages of 12- and 24-years’ experience acne and up to 20% of adult women face this challenge. Thus, combating acne is a shared struggle, necessitating a unified, well-informed approach towards treatment.
Acne Treatment
Treatment protocols for acne remain consistent across ages, yet their application demands a fine-tuning according to the acne type, its severity, and the individual’s skin type.
Skincare For Oily Acne Prone Skin
For those burdened with oily acne prone skin, the treatment regimen needs to focus on products that absorb excess sebum, unclog pores, and harbour antibacterial and anti-inflammatory properties. It should also be acne type dependent.
For Mild to moderate acne salicylic acid and adapalene work wonders, while benzoyl peroxide and azelaic acid are potent against Inflammatory acne. Retinoids and niacinamide are versatile, catering to mild, moderate and inflammatory acne. Nodular or cystic acne may be managed with azelaic acid, benzoyl peroxide and topical retinoids including adapalene.
Nodulo-cystic acne can be notoriously difficult to treat and have a propensity for acne scarring, so dermatological intervention may become necessary for a more robust treatment approach. Treatment with a dermatologist would often involve a mix of topical and oral antibiotics, corticosteroid injection, oral contraceptives or spironolactone, oral isotretinoin and prescription retinoids. Oily acne prone skin may also benefit from using alpha hydroxyl acids (AHAs) like glycolic acid and lactic acid once or twice a week.
Best Picks: Differin Gel, Isispharma Teen Derm A.Z, Balance Active Formula AHA 10% plus BHA 2% Retexturizing Serum, Cerave Renewing SA Cleanser, Some By Mi AHA.BHA.PHA 30 Days Miracle Toner
Skincare For Dry Acne Prone Skin
The key to treating dry, acne prone skin lies in choosing products that can address the underlying causes of acne without further disrupting the skin’s protective barrier. When you have acne prone skin that is dry, hydration is paramount because your acne treatments may lead to further dryness or flaking, opt for ceramide-rich, non-comedogenic and fragrance-free moisturisers.
Rinse-off products containing acne actives like salicylic acid and benzoyl peroxide may be preferable over leave-on products to avoid extra dryness.
The ‘Sandwich method’ – applying your moisturiser, then your acne treatment, and topping it off with more moisturiser – may also be adopted to buffer the skin against potential dryness or irritation when using products that may be drying and sensitising like retinoids, azelaic acid, salicylic acid or benzoyl peroxide. Employing less sensitising AHAs like mandelic acid can be a prudent choice for individuals with dry, acne-prone skin, ensuring exfoliation without exacerbating dryness.
Best Picks: Cerave Acne Foaming Cream Wash, Paula’s Choice Skin Perfecting 6% Mandelic Acid + 2% Lactic Acid Liquid Exfoliant, Naturium Azelaic Topical Acid 10%, Reviva Labs Light Skin Peel Mild Exfoliant, Vanicream Daily Facial Moisturizer.
Conclusion
Understanding that acne is a common adversary for both oily and dry skin types is crucial for effective management. Tailoring your skincare routine to both your skin type and the specific type of acne you are facing is the best approach. In this ongoing journey toward clearer skin, your knowledge and the strategies you employ will be your best allies.
