Acne is a skin condition that causes skin blemishes. Typically, acne affects individuals during their teenage years; however, a person can develop acne any time in life. Acne can be triggered by dietary choices, and influenced by genetics, bacteria, and hormones. The most common form of acne is acne vulgaris. This type of acne affects approximately 50 million Americans each year. Let’s take a look at the symptoms, causes, risk factors, and what you can do to reduce acne.

Symptoms of Acne

Acne can cause a variety of skin blemishes, including whiteheads, blackheads, pimples, nodules, and cysts. Acne can occur anywhere on the body; however, the most common locations for acne development are the face, neck, chest, shoulders, and back.

  • Whitehead – A whitehead is an acne that is not inflamed. Whiteheads happen when bacteria, oil, and skin cells combine and create a closed, white tip over the top of a pore. A whitehead looks like a pimple without redness and inflammation.
  • Blackhead – A blackhead is acne without inflammation. Blackheads form when pores become clogged. A plug sits at the top of a pore and appears black. Many people think blackheads are caused by dirt getting stuck in the pore; however, this is not true.
  • Pimples – Pimples are clogged pores that have become infected. This infection creates a white, pus filled tip atop the affected pore. The area around the pore becomes sensitive, red, and inflamed.
  • Nodules and Cysts – If an infection persists this can lead to a nodule or cyst which can become extremely sore and painful. Both nodules and cysts are located deep within your skin.

Causes of Acne

Acne occurs when pores become blocked by dead skin cells, oil, or bacteria. Each pore is an opening for a follicle. A follicle contains a sebaceous gland and a hair. The sebaceous gland releases sebum, which is a type of oil. The sebum travels up the shaft of the hair follicle until it reaches the skin. The sebum oil is used by the skin to keep it soft and subtle.

Acne often shows up on the upper back, the shoulders, the forehead, face, neck, or chest because these areas contain the most sebaceous glands. The wall of the follicle can bulge and cause a whitehead, bacteria, and oil can clog the pore. When the oil and bacteria clog the surface of a pore, and the clog is exposed to air, it turns brown, resulting in a blackhead. Finally, pimples are caused by a blocked follicle that has become inflamed or infected. If the block occurs deep inside the follicle, cysts or nodules can occur.

There are several triggers for acne outbreaks. There are also several myths surrounding acne. Let’s look at the triggers of acne and learn which factors are myths.

  • Diet – Consuming carbohydrates increases the risk of developing acne. Breads, chips, bagels, etc. worsen acne. The belief is that carbohydrates increase the production of sebum and contribute to systemic inflammation, which leads to more severe and frequent breakouts.
  • HormonesHormonal changes in the body affect sebaceous glands. Androgens are hormones that increase during puberty and cause the skin to produce an overabundance of sebum. In addition to puberty, hormonal changes during pregnancy and perimenopause can increase a woman’s risk of acne.
  • Medications – Certain medications, including androgenic steroids, anticonvulsants, barbiturates, DHEA, lithium, and medications containing bromides and iodides can cause acne.
  • Stress – Stress impacts every organ in the body, including the skin. When enduring chronic or acute stress, the adrenal glands activate and in turn release cortisol and epinephrine. The circulation of these hormones can increase the frequency and severity of breakouts.
  • Hygiene – Acne is not caused by a lack of hygiene. In fact, using harsh soaps and scrubbing your skin too hard can actually worsen acne. Harsh soaps, chemicals, and cleaning agents can strip oils from your skin, causing the sebaceous glands to produce even more oil.

Influence of Hormones on Acne

The main hormone that increases the risk of acne is testosterone. Sebaceous glands are very sensitive to testosterone. When levels of this hormone increase, sebum production increases as well. Testosterone typically increases during puberty and is used by the body to strengthen bones and muscles.

Women can experience increased acne during their menstrual cycle or during pregnancy. As estrogen levels fall during perimenopause, the risk of acne increases. Certain conditions, including polycystic ovary syndrome can trigger hormonal acne.

Hormone Self Assessment Quiz female hormone quiz

Here are a couple of hormone self-assessment questionnaires that can help evaluate your hormone levels. There is no substitute for consulting with your healthcare practitioner.

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How to Reduce Acne Outbreaks

Over the counter acne medications typically do not help hormonal acne. Oral medication like anti-androgen drugs and oral contraceptives can balance hormones and reduce acne breakouts. Birth control pills and anti-androgen drugs decrease the body’s production of androgens.

Retinoids are topical treatments derived from vitamin A. Retinoid lotions, creams, and gels are available over the counter as well as with a prescription. Retinoids prevent dead skin cells from clogging the pores.

Tea tree oil is a natural remedy that reduces inflammation and promotes healing. This potent oil is diluted in a carrier oil and can be used as a spot treatment, toner, or facial cleanser. Green tea can also be used as a holistic skin regimen. Green tea helps to reduce systemic inflammation. It can also be applied topically to help decrease acne. Finally, washing the face with a gentle cleanser in the morning and evening, wearing sunscreen, consuming a healthy diet, and avoiding refined carbs, sugar, red meats, and dairy products will decrease overall inflammation in the body and decrease the risk of developing acne.

Hormonal acne can occur at different times throughout life, including during puberty, pregnancy, perimenopause, and periods of stress. Our integrative practitioners specialize in holistic treatment of acne and other skin issues. This includes dietary and lifestyle modifications that also help reduce inflammation, improve skin tone, and reduce acne flareups.