Got Breakouts? You’re Not Alone!
A self-love trend is afoot on social media – the movement to normalize acne. As a dermatologist, I think it’s brilliant! Teens and young adults are sharing pictures of their makeup-free faces with acne and calling for acne to be accepted.
It’s part of a #skinpositivity https://www.instagram.com/explore/tags/skinpositivity/ movement, and it’s a much needed balance to the perfection-obsessed photos typically seen in the media and shared selfie images.
Em Ford may have started it all back in 2015 with her powerful video, “You Look Disgusting,” which went viral, garnering 27 million views and some really mean comments. She now has 2 million follows and continues her message of self-acceptance on Instagram and YouTube.
Acne is Normal.
Elle captured the stories of Em Ford and others recently, and the trend is growing. It’s great news – acne is normal, and a movement to minimize the emotional pain of this stigmatizing skin problem is a welcome change sure to help many.
The powerful message – there is nothing wrong with you if you have acne, acne is normal.
How common is acne/Incidence of acne vulgaris?
Acne is called acne vulgaris and the word “vulgaris” translates into “common” – acne is common!
People all over the world suffer from acne. It is a normal part of adolescence and can linger well into adulthood.
85% of young adults aged 12-25 suffer from acne.
Acne starts at puberty and peaks at age 15… after which it slowly improves. Girls often enter puberty earlier than boys and get acne earlier, too.
What causes acne?
We are still not entirely clear on what causes acne. We do know that the rise at puberty of androgens (one of the sex hormones present in both males and females) correlates with the development of acne.
We also know that eating the traditional Western diet poses a risk factor for acne. More specifically, studies have shown that people who eat high glycemic foods and a lot of dairy products are more likely to suffer from acne.
The glycemic index is the measure of a food’s ability to raise blood sugar upon digestion. Refined carbs like white flour, sugars, sugary drinks and juices, and traditional junk foods are higher glycemic foods than whole foods, veggies and whole fruits. There is also a higher risk of acne in developed countries than in developing countries.
Dermatologists previously viewed acne as a problem of bacteria and clumping of dead cells within the pores. Now, we are considering acne to be a more generalized inflammatory condition that manifests in the pores; that even if the pores appear normal, an inflammatory predisposition can exist that leads to a sudden flare with something as simple as a the use of a new product or an increase in stress.
A predisposition for acne can also be genetic. Many people who have acne also have relatives that suffered from acne.
Acne occurs equally in lighter skin and darker skin complexions. The incidence of post inflammatory hyperpigmentation is higher in darker complexions, however, meaning the lasting impact of acne lesions is longer.
Smoking may also predispose someone to acne, especially after adolescence.
Comorbidities of Acne
Comorbidities mean other medical conditions that go along with a disease. In the case of acne, the biggest comorbidity is emotional destress. It’s why the movement to normalize acne is brilliant, in my opinion!
Acne takes a toll on a person’s sense of well-being.
Many studies show that people with acne are prone to emotional difficulties including poor body image, anxiety, decreased self-esteem, social isolation, depression, and suicidal thoughts. Reframing how we look at our own acne, and acne in other people, is long overdue. Many people will feel supported by this movement.
What can a person do to help heal their acne on their own?
You can’t change your genetics, but you can take steps to lower your risk for acne and even treat it on your own.
Diet and lifestyle:
Eating a diet that is rich in low-glycemic whole foods like fresh fruits and veggies and coarsely milled grains, nuts, beans, and lean proteins will help both your complexion and overall health and vitality.
Avoid junk foods, sugary foods and refined carbs. Don’t eat a huge amount of dairy based foods either if you want to help your body fight acne.
Stress and lack of sleep also worsen acne which means that moderating stress and getting a good night’s sleep will help. Not smoking will also help.
Many good acne-fighting ingredients are available in non-prescription skin care products. The best include benzoyl peroxide (2.5% is as effective as 5 or 10% and much less irritating). This ingredient both reduces P. acnes bacteria and treats blackheads.
Other skin care ingredients that help fight acne include azelaic acid, salicylic acid, glycolic acid, and retinoids.
These ingredients will also help lighten post-inflammatory hyperpigmentation. Many non-prescription products are available that include these ingredients.
The most effective ingredient combination is found in my Ultimate Acne Solutions Kit which includes benzoyl peroxide at 2.5%, and glycolic acid and salicylic acid cleanser and treatment pads.
Retinoids such as non-prescription retinol or prescription retinoids like tretinoin are another “first-line” topical treatment that treat both blackheads and inflammation associated with acne. They also help lighten post inflammatory hyperpigmentation. You can use Retinol at night and the Ultimate Acne Solution Kit during the day to fight acne.
Sunscreen is important for darker complexions to help prevent hyperpigmentation of acne lesions.
An ideal choice for acne is my Sheer Strength Pure Mineral Sunscreen which is tinted, mattifying to reduce oily shine, and provides broad spectrum sun protection to fight hyperpigmentation.
What can a dermatologist do to help improve acne?
In addition to guiding you towards the right acne-fighting skin care routine for your complexion, a dermatologist can incorporate prescription topical and systemic treatments, too.
Prescription oral antibiotics have been used for many years to treat acne. New concern over the impact on the important beneficial microbes in the gut and skin make this a more-complex treatment choice than was previously appreciated.
Antibiotics treat acne primarily by reducing P. acnes bacteria. Blu light treatments also reduce P. acnes bacteria and provide a non-antibiotic alternative.
Oral Accutane/isotretinoin is, in my opinion, a true miracle treatment for severe acne.
It can even stop acne from happening in the future. It does have serious side effects which have to be balanced carefully. Another systemic treatment approach includes hormones – either oral contraceptive pills, which can lower a body’s production of androgens, or androgen-blocking medicines like spironolactone.
Dermatologists and non-medical skin care professionals such as aestheticians can perform acid peels to reduce pore blockages from blackheads, and lighten post inflammatory hyperpigmentation.
Extractions of blackheads helps clear pores, too. Dermatologists can use lasers to help reduce acne scarring and improve post inflammatory hyperpigmentation.
Acne is normal, and there are many treatments available.
If you have acne, know that many others do, too, and it’s normal. And today, there are many ways to treat it depending on your specific needs. To learn more, check out the information here.
And for the latest skin care tips to look your best, sign up for our free eNewsletter here (new subscribers get a special discount!).
Darren D Lynn, Tamara Umari, Cory A Dunnick, Robert P Dellavalle, The epidemiology of acne vulgaris in late adolescence, Adolesc Health Med Ther. 2016; 7: 13–25.
Capitanio B, Sinagra JL, Ottaviani M, Bordignon V, Amantea A, Picardo M., Acne and smoking., Dermatoendocrinol. 2009 May;1(3):129-35.