The Truth about Acne

Some degree of acne affects nearly everyone between ages of 15-17. BUT!

• 15-20% of young people will experience moderate-severe acne
• 85% prevalence rate in 12- 24 year age group
• 78% of girls between 8-12 have acne
• 64% of 20-29 and 43% of 30-39 have visible acne
• 3% of men and 5% of women still had a degree of acne aged 40-49

Psychological Effects of Acne

• Acne sufferers report experiencing: Shame 70% Embarrassment 63% Anxiety 63% Loss of confidence 67% & Impaired social contact 57%

Mythbusters – The Truth About Acne

Causes: Genetics

• It has been well documented that genetics have a prominent role in acne, also:
• Twin studies have estimated that acne has a heritability of up to 80%

Causes: Dietary Factors

Up until 2005 there had been no proven link between:

• Chocolate intake and acne
• Animal fat intake and acne
• Calorific, protein, carbohydrate fat or vitamin intake and acne

More recently though,

• Small random control trials showed low glycaemic index diets reduce acne severity
• Also, there is a possible association between dairy intake and acne

Causes: Environment

Hormones – Hormonal imbalances caused by puberty, premenstruation, disorders with high testosterone levels and Polycystic Ovary Syndrome. In addition, using anabolic steroids or oral steroids all can cause acne.

Increased oil/sebum on the skin – through occupation, inappropriate skincare, such as using moisturisers and oil based make up. Also, inadequate cleansing (removal of makeup/grime) causes acne.

Stress – stress increases the amount of ‘stress hormones’ in the body, such as cortisol, which in turn increases sebum production and thus to acne.

Causes: Hygiene

There is insufficient evidence that acne is caused or cured by washing. But, it is recommended that you wash your pillow case regularly to prevent transfer of bacteria from your face to your pillow, then back to your face again.

Causes: Genetic functional abnormalities  (in simple terms)

There is an abnormal follicular ‘hyperkeratinisation process’ with subsequent obstruction of sebaceous follicle

Basically, this means there is abnormal build-up of oil in the pore, and this causes a blockage.

Increased levels of androgens (hormones), increase the size of the sebaceous (oil) gland & therefore cause increased oil production.

There is a genetic susceptibility towards the C.acnes bacteria. So they are able thrive & cause inflammation in the skin.

The Stages of Acne Formation – From Blackhead to Nodular acne

Types of Acne: From Mild to Severe

1. Comedonal Acne
2. Pustular/Inflammatory Acne
3. Nodular
4. Cystic

Pathology of Acne : The Sebaceous (oil) Glands

The sebaceous glands are found within hair follicles in most parts of the body.

Acne occurs in areas of the so-called ‘sebaceous follicle’ i.e. large sebaceous gland associated with a medium–sized hair.

Androgens (hormones) increase the size of gland. This then leads to increased sebum secretion onto the skin.

The normal role of sebum is to maintain the skin’s protective (epidermal) barrier to the outside world. It has both an anti-bacterial and hydrating effect.

However, excessive sebum production and blocked sebaceous gland openings favour the colonisation of c. acnes bacteria. They just love sebum & thrive.

In the presence of the enzyme lipase, acne bacteria converts sebum triglycerides to free fatty acids. These then have an irritating, pro-inflammatory effect and intensify more follicular keratosis (pore plugging).

Therefore ! **Controlling over production of sebum (oil) is a key concern in the treatment of acne **

Actions of Anti-Acne Therapies

Vitamin A: Tretinoin, Retinol.

Actions: Normalises desquamation (de-plugs pores, increases exfoliation) & reduces inflammation.

Antibiotics: Kill bacteria.

Benzoyl peroxide (such as ZO Acne Control): This is a micro-emulsion. It has particles so small it can enter the pores & kill microorganisms, such as acne bacteria.

Oral Isotretinoin (Roaccutane): This is only used in severe acne cases due to its side effects. It:-

• Reduces sebum
• Normalises desquamation
• Inhibits C.acnes
• Reduces inflammatory response

Hormone regulation– such as contraceptives:  Reduce sebum production

At Orchard House Facial Aesthetics we offer several treatments for acne & acne scarring.

These include:

• ZO Skincare by Dr. Zein Obagi
• ZO Skin Peels
• Obagi Medical Skincare
• Blue Peel Radiance
• Hydrafacial for Acne
• LED light therapy
• BioRepeel C13
• Skinade for Acne
• Skinpen Precision
• WOW fusion
• Microneedling & Mesotherapy