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Acne: Skin Disease or Esthetic Problem?
Acne is a very common inflammatory condition of the sebaceous glands. According to studies, up to 90% of the teenagers suffer from acne, and up to 40% of the adults continue struggling with it well into their 20s, 30s or even their 40s.
While the oily skin, enlarged pores, blackheads, and pimples of acne are primarily thought of as an esthetic problem, swollen infections that lie underneath the skin can also be painful. Cystic acne is a physically and socially debilitating experience for the sufferer that may leave both literal and psychological scars. Salma Hayek once blamed acne for causing her severe depression.
Most current dermatological treatments are very effective in battling acute inflammation and bacterial infection in acne, but do little to address other issues dealing with the skin's appearance such as oiliness, enlarged pores, increased sensitivity and acne scars and blemishes.
There is a wide range of cosmetic products, ranging from low-cost drug store brands to very expensive boutique serums. As a result, you are left surrounded by a bewildering assortment of acne treatments, all with varying actives and price points. Many of their ingredients are hard to pronounce. You may have a mental list of things to look for in an acne product such as ease of use, purity, safety, and effectiveness. You want to improve your unique acne-related symptoms such as uneven skin texture or redness and avoid chemical pollutants such as parabens, oxybenzone, and formaldehyde-releasing agents.
You've been told to avoid cosmetic products with too many aggravating chemicals because inflammation is a primary cause of many acne breakouts. You also know, as an informed and intelligent acne sufferer, that your makeup must contain no ingredients that are above a one on the comedogenic rating scale. Finding a cosmetic that is appropriate for your skin type consequently becomes demanding and time-consuming.
Harmful and irritating ingredients aggravate acne and increase skin oiliness. Common heavier emollients that are helpful for many dry-skinned people like cocoa butter and coconut oil, both high in oleic acid, are sometimes bad for acne-prone consumers who need more lightweight hydration. Acne products must have careful thought and consideration given to both percent concentration of medication and pH, and they should not cause excessive dryness. "Can I even cure this disease?", you wonder, "or should I go straight to covering it up with makeup?"
So where to start?
Help to Control Acne Breakouts
Try a simple, natural regimen that is tough on acne, but gentle on skin. If you want to reduce acne scars, you need to avoid new breakouts - Here's how:
1. In the morning, wipe your face with a 2 percent salicylic acid pad (available at drugstores). Salicylic acid penetrates pores without over-drying skin, clearing blemishes and preventing new ones from forming.
2. After the salicylic acid pad, apply a copper peptide serum that also contains a small amount of salicylic acid and leave it on. Copper peptides help to heal wounds and reduce inflammation. Start with a maximum of four drops daily, and then slowly increase the amount. If you have sensitive skin, it is strongly suggested to start with GHK copper, which is found to be mild and biocompatible. See? A nice and easy routine with little time commitment and no pain at all.
3. Later, in the evening, apply a light amount of a mix of lactic acid and salicylic acid (in a supportive oil-free liquid) and leave it on. Exfoliating acids resurface skin by gently ungluing and dissolving dead skin cells that trap bacteria. Lactic acid, an alpha hydroxy acid, works on the skin's surface and enhances natural moisturizing factors with the skin. Salicylic acid, a beta hydroxy acid, works on the surface and inside the pore, but is mild enough for sensitive skin and will not cause any redness or irritation. AHAs and BHAs are most effective at a pH of around 3-4 and are considered a necessity by most skin care experts.
4. For pitted scars and some severe forms of acne, stronger hydroxy acids and/or retinoic acid may be used at night.
5. About every two weeks, use pore-cleansing strips (available at drugstores) on acne-prone areas. Be careful not to overuse the strips to the point of irritation.
6. Some people use this method one day and anti-acne products on alternate days.
7. Anti-acne products can be somewhat drying to the skin. Biological healing oils, such as emu oil, soothe and calm skin by deeply penetrating its layers without clogging pores or increasing breakouts. You can also use squalane oil (not squalene - the difference is one letter) which is a light, stable oil that mimics your skin's own natural oil. These oils have anti-bacterial properties and are brimming with antioxidants.
If Your Skin is Oily and Blemish-Prone
If your skin is oily with enlarged, clogged, pores and frequently has acne breakouts, you may not be inclined to treat it very gently. After all, it looks thick and tough – so why be delicate when you need your results as quickly as possible!
In reality, oily skin is just as sensitive and delicate as skin that produces much less oil.
Moreover, cosmetic products that are irritating and toxic to your skin will inevitably worsen its condition (even though they may appear to improve it in the short term). Choose a regimen that will keep your face beautiful all summer long by using years of dermatological research to your advantage.
Ouch, It Stings!
If you are tired of greasiness and an oily sheen, you may welcome anything that makes your skin drier. And if you have annoying acne breakouts right before an important event, you may not mind applying a product that stings or burns as long as you believe it is working. This is why nowhere but in the cosmetic world will you find such a wide assortment of burning, stinging, drying and overall irritating substances.
These “acne treatments” may clear up your skin for a little while and make it a bit less oily; but the results seldom last. Often, after spending a small fortune on acne products and enjoying some brief improvements, you notice that your skin becomes even worse with more comedones, enlarged pores, oiliness and breakouts! When skin is exposed to excessively drying products such as some alcohols or creams with an inappropriate pH measure, it may compensate by producing more oil while, at the same time, developing patches of dry and flaky skin. Sometimes you may even notice that your nose and cheeks become red and puffy after applying some of those irritating products – this all can be a sign of another skin condition that often accompanies acne – rosacea.
Stop the War on Your Own Skin!
No matter what you believe about your skin, the truth is: You’ll never make your skin prettier (or healthier) by stinging or burning it. Also avoid physical irritation from harsh scrubbing or creams with exfoliating beads; this may intensify or begin new acne breakouts.
Just as in case of other skin conditions, you will get better results and have better luck improving your appearance if you start listening to your skin's needs and taking care of it as if were a baby.
Only by nurturing the skin’s own protective and reparative mechanisms (by babying it back to health), can you truly make it look smooth, clear and radiant.
But don’t just take our words for it – read further to learn what causes problems of oily skin and why avoiding irritation is so important.
The Root of the Problem
1. Skin oil production increases: The skin of children is never visibly oily – it is clear and smooth and fresh. However, in adolescence the level of sexual hormone testosterone spikes and triggers excessive oil production. Both girls and boys have increased production of testosterone, but at different degrees. By itself, testosterone is not a problem; but when it gets to the skin, it transforms into a different chemical – DHT or dihydrotestosterone – which increases oiliness and makes oil glands bigger, increasing the pore size. When you were a kid, your skin appeared perfectly smooth, but now you can see the pore openings clearly (especially on the nose), and your skin may look bumpy and uneven.
Up until recently, scientists had no idea why Mother Nature made this strange link between male sex hormones and skin oil. Now we know that oil is a great vehicle for human pheromones that get carried from oil glands on the skin's surface. Some pheromones are even produced right on the skin from sweat and skin oil. Additionally, oil has antibacterial properties, contains important antioxidants, preserves skin moisture and improves wound healing. However, in some cases where DHT produces severe acne breakouts, women may be treated by a doctor with a prescription testosterone-blocking drug called spironolactone.
2. Thick oil clogs the pores: As oil production increases, its composition may change. The reason is that all thick, saturated fats are produced locally in your skin cells, while more liquid, unsaturated fats need to be consumed with food. Most people find that a diet high in Omega-3 oils improves their acne; a few find that avoiding dairy products is helpful. When skin is too oily, pores are packed with sebum and dead skin cells; they eventually enlarge and become more visible.
Oftentimes, skin cells that normally exfoliate from the surface form a plug, blocking the pore and impeding its drainage. The resulting clog in the oil gland causes swelling and infection. This enlarged, clogged pore is called a comedone.
3. Whiteheads turn into blackheads: At first, the sebum is white and the comedone is called a whitehead. If exposed to air, the sebum becomes oxidized (impregnated with melanin and other pigments) and turns an unpleasant dark color, creating a blackhead.
4. Infection and inflammation: Acne is now viewed as a primarily inflammatory disease that becomes worse due to the presence of bacteria. Excessive sebum provides a fertile breeding ground for these oil-eating bacteria – Propionibacterium acnes. Those tiny pests break down the oil, releasing skin irritating fatty acids that trigger more swelling and inflammation. This leads to the development of inflamed comedones or acne.
5. Acne marks: Usually after inflammation takes its course, the skin reverts to its original state. But sometimes, the lasting inflammation leaves red marks – often called acne scars (even though they are not real scars). In some especially severe cases, inflammation runs so deep that it does not heal properly and leaves an actual scar that may be extremely difficult to fade.
Why Avoid Irritation?
As you already know, increased oil production, disrupted exfoliation and inflammation are the three main factors that cause enlarged pores and acne. What you may not know that every time your skin gets irritated, it starts producing a special kind of chemicals called neuropeptides.
They are first response molecules that cause your skin to itch and burn. It may be annoying, but it serves as a warning signal that something potentially dangerous has come into a contact with your skin. For example, if you spill some acid on your skin, you need to wash it off as soon as possible, before it damages the skin too much. Neuropeptides alert you to the fact that there is an unpleasant chemical on your skin, so you can take action.
However, neuropeptides can also trigger inflammation and increase oil production.
Your Skin Can Look Beautiful
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Your skin may remain oily until your early 20s or even longer. And even as you pass the turbulent teenage years, you still may have some areas of increased oiliness on the nose, forehead and chin (the T-Zone). Even when your skin becomes normal or dry, some oil glands may continue producing excessive oil which can clog pores and create problems. With smooth and beautiful skin, you can improve your social skills, become a movie actor, or even start dating again. It is possible to clear oily, blemished skin. Yes, even yours! All it takes is attention to its needs and an understanding of its basic processes.
There are several areas on which you will need to focus to restore your skin’s beauty:
1. Reducing oiliness
2. Unclogging the pores
3. Regular exfoliation
4. Reducing inflammation
5. Reducing acne marks
Reducing Oiliness
You may be very tempted to battle excessive oiliness with cosmetic products that contain drying solvents such as alcohol or acetone. As you dissolve and wipe away the oil, your skin becomes drier and feels so smooth and pleasant. Unfortunately, it is not for long. Very soon the oil is back and you have to dry and wipe it out again. In desperation, you wash your face in hot water with soap several times a day, and you keep wiping it with alcohol based cleansers in hope that this pesky oil will go away for good. Only it never happens. In fact, in a long run it makes your skin even oilier, since by wiping your skin with alcohol and washing it with hot water and soap, you disrupt its barrier, opening gates for irritants. As your skin gets irritated, you trigger production of neuropeptides, which increase oiliness.
There are three main ways to reduce oiliness without worsening your skin’s condition. First, you can lower the level of DHT in your skin. A number of plant phytochemicals contain natural substances that can inhibit DHT. Second, you can lower oil production directly in the oil glands. For example, retinoids and the copper peptide GHK work by reducing oiliness. Finally, you can avoid an increase in oil production caused by neuropeptides if you help your skin to build a stronger barrier and avoid irritation.
Unclogging the Pores
You probably tried many products that claimed to refine and unclog pores. Unfortunately, many of them contain substances like camphor or menthol that produce temporary tightening and skin refreshing effect, however, really do nothing to your pore size and may be irritating.
Omega 3 fatty acids are found to reduce pore size and improve texture of skin. Even though it seems strange to you to apply oil based products on oily skin, oils help purge your pores and cleanse your skin while balancing skin's oil production. Emu oil is almost identical to the fatty acids found in your skin, so it is unlikely to cause negative reactions. Carrier oils that are high in linoleic acid are safe to use with acne prone skin; those with acne must use only oils that do not have tightly packed molecules. When your pores are free from excess oil, you may tighten them with collagen stimulating agents such as copper peptides. When skin becomes firmer, the pore size will visibly decrease.
In addition, clay and mud masks can be used to soften the pore plugs and to absorb oil excess.
Skin Exfoliation
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When you have comedones and clogged pores, you need to apply substances that can unglue the skin cells. You also need to remove dead skin cells from your skin’s surface to prevent further clogging. It can be achieved by exfoliating acids such as salicylic and lactic acid.
To avoid irritation, use low concentration of acids – around 10 percent. Lactic acid is a normal component of your skin’s acid mantle. This mantle creates a favorable acidic environment for beneficial skin bacteria that keeps bad germs away. When you wash your skin with soap, you can make it alkaline, and this may give advantage to harmful bacteria.
By applying lactic acid, you strengthen your skin’s defense system. Also it is a good exfoliator that is much less irritating than glycolic acid. Anti-inflammatory salicylic acid dissolves in oils well, therefore it can penetrate oil glands, helping to dissolve the plugs in your pores.
Reducing Inflammation
Copper peptides may help by reducing inflammation and improve antioxidant defense of your skin. Dry, inflamed skin ages faster, and inflammation is seen as a primary cause of acne. Copper peptide GHK-Cu lowers TGF-beta and TNF-alpha – two cytokines that trigger inflammation. It also increases superoxide dismutase – the master antioxidant, and prevents inflammation by blocking iron release from ferritin. Nature has generously given us some of our best medicines; many plant substances that have anti-inflammatory and antioxidant effects such as Aloe Vera gel, beta-carotene, lutein, lycopene, lavender oil, tea tree oil, and white willow bark extract. If you want to be creative, mix some aloe vera gel, witch hazel, and carefully chosen essential oils in a spray bottle to freshen up oily skin!
Reducing the Appearance of Acne Marks (Blemishes & Scars)
When you have acne marks, you may reduce them by alternating controlled skin damage and stimulators of regeneration. First, you apply exfoliating agents such as lactic or salicylic acid or use microdermabrasion cloth. Then you use substances that stimulate skin regeneration and reduce scar formation. Copper peptides have been proven to speed up skin healing and remodeling. They reduce risk of scarring by increasing decorin (anti-scarring protein) and decreasing TGF-beta (a cytokine that increases scarring).
BE GENTLE
If you want long-term improvement in your skin appearance, you must learn to be gentle and patient. Avoid irritating and drying substances, don’t fall for quick-fix solutions, wash your face using mild cleansers with neutral or slightly acidic pH, nourish it with omega 3 oils, don’t forget to exfoliate regularly, use skin remodeling copper peptides to speed up skin regeneration, and you will enjoy blemish-free and smooth complexion regardless of your skin’s type.
NOTE: If you have severe acne and acute inflammation, you may need to seek medical treatment such as
prescription antibiotics or retinoids before expecting results from over-the-counter from cosmetics.
If you have acne, always consult a physician or dermatologist first.
Information provided on this website is for educational purposes only.
Any suggestions mentioned are not for the treatment or prevention of any skin disease or condition.
Questions or Advice?
Ask Dr. Loren Pickart: drlorenpickart@gmail.com
Call us at 1-800-405-1912 Monday through Friday (8 am to 6 pm) PST