The Dirt on Acne

Acne isn’t just a pimple here or there. For millions of people living with acne, it’s an every day battle. Michelle McDonald, a licensed medical aesthetician with Evolve Medical Esthetics breaks down the causes and myths surrounding acne and offers relief options for the bothersome and often embarrassing skin condition.

What causes acne?

McDonald says many different factors can cause acne. Three of the major factors are:

  • Overactive sebaceous glands
  • Abnormal shedding of skin cells
  • Proliferation of bacteria

Sebaceous glands produce a substance called sebum, which is oil that helps keep skin moist. When too many dead skin cells are shed at once, and the body produces too much sebum, this creates a “perfect storm” for the cells to stick together and become trapped in the pores of the skin. This clogs the pore and can lead to pimples. If bacteria become trapped in these clogged pores along with the oil and skin cells, bacteria can grow and cause the skin to become inflamed. This inflammation is what leads to cysts and nodules—those, hard painful lumps that reach deep into the skin.

What are some common myths about what causes acne?

“There are quite a few myths about acne,” says McDonald. “Acne is not contagious. It is actually a disorder of the hair follicle, where excess oil, dead skin cells and bacteria become trapped within the follicle, creating an impaction.”

Another area of contention is the chocolate myth. First it was out, then it was in, and now things may have come full circle. Some studies point to a link between diet and acne, pinning an increase in sebum and skin inflammation on fatty foods and foods that cause a spike in insulin. Other studies suggest a correlation between foods that can affect hormone levels. According to the American Academy of Dermatology, not enough research has been done to present strong enough evidence, but they support the idea that a diet high on the glycemic index may be linked to acne.

What are some common things people do that can actually make their skin worse?

“Cleansing with regular soap can strip the skin of essential oils, causing it to overproduce sebum,” explains McDonald. “You should always cleanse according to your skin type.” The wrong kind of cleanser can mean your body will make too much or too little sebum, creating even more problems for the acne sufferer.

“I have patients who use soap, as well as some who only use water… this creates other problems such as extreme sensitivity after prolonged periods.”

Avoid scrubbing if you have an acne flare-up, since this can actually increase inflammation and make your acne worse. The best advice is to be gentle, and wash in the morning and at night. If your body produces too much sebum and skin cells, this will ensure your pores can stay clear of debris that can become acne.

Picking a pimple is never recommended. This can lead to scarring of your skin, and touching your face is an invitation for bacteria to jump into other pores. It’s best to leave the affected area alone and continue on the treatment regimen your dermatologist has prescribed.

Can a person grow out of acne? Can they get it later in life?

“Yes, to both questions. Acne that is hormonal can end or begin at any time during which there is a change in the body chemistry. It can be very difficult to ‘cure’ acne. Managing it is the key,” says McDonald.

How can I prevent acne scars?

“The best way to prevent scarring is to avoid excoriating, or picking at lesions,” explains McDonald. “This can be tough. However, it can cause significant damage to the skin and rupture lesions, leading to cysts, scarring and even hyperpigmentation, or a change in skin shade in the effected area. Scarring can be improved with proper medical grade skin care, peels, and use of SPF to reduce risk of additional pigmentation.”

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