All You Ever Wanted To Know About Your Acne

Acne, pimples, outbreak, breakout. They are all synonyms of ‘distress’, especially if they are unwanted guests that outstay their welcome on your precious face. Just like some of us wonder why vile creatures like cockroaches exist, I am sure those of us afflicted with acne must wonder the same about, well, those cursed clogged pores on our countenance.

Adult acne, as indicated by a study published in the Journal of the American Academy of Dermatology, affects more than 50% of women in their 20s, more than 35% of women in their 30s, and over 26% of women in their 40s. This surge in recent times is troubling and could be due to hormonal changes, as well as factors that lead to hormone fluctuations, like sleep deprivation, high-stress levels and a diet composed of refined sugars, dairy products and excessive salt. Although we do not have local statistics, about 40–50 million people in America suffer from acne every year.


How Does Acne Form?

A pimple develops when your pore is clogged with excess sebum or oil, dead skin cells and in the case of inflammatory acne, bacteria called Propionibacterium acnes or P. acnes. This clogging happens when dead skin cells are not able to be shed from the pore, due to more dead skin cells or sebum being produced by your skin. Sebum can also cause dead skin cells to stick together in your pores, contributing to clogged pores.

P. acnes bacteria in the pores have the perfect environment to multiply and lead to the pores being inflamed. In the case of nodules and cystic acne, the inflammation has reached deep into the skin.


Types of Acne

The scientific name of this affliction is called acne vulgaris that covers the entire gamut from the mildest comedones like blackheads and whiteheads, and moderate forms like papules and pustules, to the most severe forms of nodules and cysts.


Blackheads are non-inflammatory acne lesions or what look like small bumps with ‘black heads’. They are clogged pores with sebum and dead skin cells and are open at the surface. The contents of the clogged pore are exposed to air, which turns them dark.


Like blackheads, whiteheads are non-inflammatory acne lesions. They look like small, raised bumps on the skin. Unlike blackheads, these clogged pores with sebum and dead skin cells are closed at the top, hence are called closed comedones. Although they do not cause scarring, the presence of these small white bumps is clearly visible, and anyone who has them will attest to the fact that they are seemingly (and ironically) the biggest obstacle to smooth, flawless skin.


Papules are raised red or pink bumps that are considered inflammatory acne lesions, which tend to cause scarring. This happens when the clogged pores filled with oil and dead skin cells are pushed deeper into the skin and when combined with bacteria, cause an inflammation that breaks down the walls surrounding your pores. This leads to swelling, redness and tenderness.


Pustules are what are known as ‘pus-filled pimples’. They are tender, larger and inflamed red- or pink-ringed bumps with white or yellow heads, and occur when the walls around your pores are broken down.


Nodules fall under moderate to severe acne. These are larger, inflamed bumps that feel hard and painful to the touch. They are located deeper within your skin and damage cells and tissues, possibly leading to scarring and dark blemishes.


Cysts, like nodules, are considered moderate to severe acne, which have a high tendency to cause permanent scarring. They form very deep within the skin and are a result of severe inflammation due to the pores being clogged by bacteria, dead skin cells and sebum. They manifest as the largest kinds of acne lesions and are red or white bumps filled with pus, which are very painful and tender.


Be Clear About Acne

What should you do, when faced with acne? While it may be tempting to let your acne run its course, many dermatologists would agree that this is not the best way to resolve your acne issues.

Moreover, if you are one of the unfortunate ones who is battling acne, you would be no stranger to feelings of low self-esteem and depression, which can affect your functioning in social and work or school settings. Seeking treatment early would also reduce the risk of having to live with unsightly dark spots (post-inflammatory hyperpigmentation) and acne scars, left behind by your harrowing ordeal with acne.

Not getting professional help to zap those zits can sometimes lead to your acne worsening. While mild to minor acne like blackheads and whiteheads may see improvement with over-the-counter topical remedies like benzoyl peroxide washes or salicylic acid products, moderate to severe acne like papules, pustules, nodules and cysts are sometimes treated with topical or oral antibiotics, or retinoids prescribed by dermatologists.

Remember, acne can sometimes last for long periods of time and can progressively get worse, leading to scarring, both physically and emotionally. The best way to deal with acne is to nip it in the bud and seek professional help early.