People of all walks of life can be affected by acne, especially amongst teenagers and young adults. According to The American Academy of Dermatology, acne is the most common skin condition in the United States. Many have it, but how does it happen? Let’s clear up the nature of acne, as well as provide tips and dermatologist-approved products and routines for healthy, blemish-free skin.
There are two common misconceptions about acne: one, it’s just a pimple, and two, it only affects teenagers.
According to the University of Miami Health System’s dermatology department, acne is a skin disorder that results in inflammation, pimples and cysts which are commonly found on the face, back and shoulders. Acne occurs when sebum, an oily substance found in the subcutaneous layer, gets clogged within pores of the skin along with dead skin cells. As sebum and dead cells accumulate, bacteria begin to source — resulting in inflammation and a cluster of pimples and blemishes.
In addition, acne can be categorized into different types depending on severity. Yale Medicine classifies the three types as: comedonal, papular and cystic.
Comedonal acne is the most general and least painful form of acne, where hair follicles, also known as comedo, are blocked by bacteria, sebum and dead skin cells. This develops into a small, hollow bump.
Papular acne is slightly larger and more inflamed than comedonal acne, often caused by the constant presence of bacteria. Papules can evolve into another subtype of acne called pustules which, like the name suggests, are filled with white-yellowish pus at the tips.
The most painful and severe type of acne is cystic acne. Cystic acne happens when sebum, dead skin and bacteria stockpile under the skin developing a series of painful papules and pustules across the face. Furthermore, because cystic acne typically forms under the skin, there is more inflammation and pressure built up surrounding the pustules — creating its boil-like appearance and uncomfortable sensation.
Contrary to popular belief, sebum is beneficial to the skin. According to Nivea, a German personal care brand, sebum is a composition of fats that assists in UV protection, moisturizing and overall protecting the skin from most bacteria. An overproduction of sebum can lead to acne. So, that begs the question, what causes sebum to overproduce? It’s something that we’ve had the pleasure of going through: puberty and hormonal imbalances.
The AAD report states that approximately 85 percent of people between the ages of 12 and 24 experience at least minor acne. In addition, outside of dermatology offices, acne treatments are readily available throughout the country, in common stores such as Walmart and CVS.
Stella Bilder, a sophomore at UM, noticed her acne in eighth grade. Like many young girls, Bilder went through a string of possible solutions to help her case
“[It] started in the eighth grade; everyone has acne, it’s definitely something you think about a lot,” said Bilder. “[I’ve] went to the dermatologist for years, experimented with different medications, including Proactiv.”
Proactiv, now called Alchemee, is among the many popular skincare brands that were incessantly advertised during the 2010s. The brand’s advertisements often featured celebrities such as Jessica Simpson, Katy Perry, Justin Bieber and Kendall Jenner to target the young female demographic.
According to Verywell Health, Proactiv’s active ingredient is benzoyl peroxide, a highly effective topical antiseptic used to fight acne. Although many acne-base skincare products include benzoyl peroxide, some Proactiv products also include glycolic acid, an alpha hydroxy acid or AHA responsible for removing surface layers of dead skin and improving skin tone.
Despite its overwhelming popularity at the time, Proactiv is most effective on mild, typical comedonal acne and is not strong enough for moderate to severe acne. For Bilder, like many other products, they only provided a temporary solution.
At their wit’s end, Bilder’s dermatologist gave her the green light for one of the strongest forms of medication — Accutane.
Isotretinoin capsules, regularly known as Accutane, are a prescribed retinol-based medication to treat severe cases of acne. Often a last resort remedy, Accutane is well-known to be an aggressive and heavy medication which is why it’s only prescribed when no other acne-based prescriptions and over-the-counter medications work.
And that was the case for Bilder, who took Accutane in 2020 during her sophomore year of high school, from January to July.
“Accutane is very heavy medication, very aggressive,” she said. “It dries out your skin [and] creates mood swings. It gets worse before eventually it gets better.”
It took approximately four months until Bilder saw her skin improve, and by July, her acne was nearly eradicated.
Accutane is taken daily and is only meant to be short term, with a variety of sources and testimonials saying that skin improvement occurs between one and three months of treatment. Wanting to make sure that her treatment was used to its full effect, Bilder used Accutane for a total of six months.
However, despite Accutane’s combative effects, another reason dermatologists find the medication as a last option — apart from the typical physical side effects such as headaches, dry skin and body aches — is that the medication is known for its psychological ramifications.
“Accutane caused a lot of mood swings, but my confidence has improved a lot because of it,” Bilder said. She goes on to say that she wouldn’t recommend the medication to someone who has a predisposed mental or emotional condition, such as depression, anxiety and even psychosis.
“Acne is an unfortunate evil,” Bilder jokes.
Indeed, but proven time and time, acne is not a forever deal.
The Dos and Don’ts of Acne
Do invest in some good quality products for acne-prone skin. No need to break the bank: there are plenty of affordable acne products stemming from well-known skincare brands like Neutrogena, the Ordinary, Cetaphil and many others.
Don’t flip-flop between products and treatments. The skin is a complex organ. It takes time for our beautiful skin to become responsive to ingredients. Therefore, AAD recommends using products for six to eight weeks. From there, if your acne is not improving, switch to the next product.
Do clean your face regularly. After a fun night, it’s highly suggested that you wipe and cleanse your face. Not only would you be cleaning away your cute makeup, but also all the dirt, oil and sweat you’ve accumulated from such a busy day. Besides, sleeping with makeup on — even accidentally — can cause your acne to get worse.
Don’t squeeze the life out of your acne. As tempting as it is, squeezing or attempting to pop your acne will further inflame your clean — even leaving scars. Resisting the urge may be difficult, however.
But definitely do visit a certified dermatologist to address any concerns, especially if your acne worsens after taking over-the-counter medications and other products. From there, your dermatologist can provide the necessary treatments to alleviate your acne and look your best self.
words_tamia mclean. photo_sharron lou. design_lizzie kristal.
This article was published in Distraction’s Winter 2023 print issue.
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