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Acne: Understanding the Causes, Exploring Treatment Options, and Dispelling Myths


    Acne has a way of showing up unexpectedly, regardless of where or when. It tends to manifest most commonly on the face, neck, shoulders, back, and chest.

    Our skin, being the body's largest organ, possesses tiny openings known as pores, which can get blocked by sebum, bacteria, dead skin cells, and dirt. This creates ideal conditions for the development of pimples. If pimples occur frequently, especially in clusters, it could be a sign of acne.

    Research suggests that a notable 9.4% of the global population grapples with this skin issue.

    While acne itself doesn't pose a serious threat to health, it can cause unpleasant, and at times painful, sensations on the skin, especially in more severe forms. Prolonged acne often leaves behind permanent scars and post-inflammatory marks.

    In addition to the physical discomfort, we shouldn't overlook the emotional consequences. Acne and scars on the face and other visible parts of the body can impact self-confidence and trigger feelings of anxiety or even depression.

    The good news, however, is that there are quite a few effective treatments available nowadays that help reduce the occurrence of pimples and prevent scarring. If you're dealing with this issue, remember that you're not alone.

    It's important to know that solutions exist, and acne is treatable. With perseverance and the right approach to skincare and lifestyle, achieving clear and healthy skin is possible.

    Causes of Acne

    Acne arises from the clogging of hair follicles. Sebaceous glands, small glands located near the skin's surface, are connected to hair follicles—tiny openings in the skin from which hair grows. These glands nourish and protect hair and skin to prevent dehydration by secreting an oily substance called sebum.

    In acne, sebaceous glands start producing an excess of sebum. The surplus sebum combines with keratinized or dead skin cells, leading to a blockage in the follicle.

    Four basic factors contribute to acne:

    • Increased production of skin oil (sebum)
    • Clogged hair follicles due to excess sebum and dead skin cells
    • Bacteria
    • Inflammation

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    Certain factors can trigger or worsen acne

    Hormonal changes: During puberty, both boys and girls experience an increase in the production of androgen hormones, leading to enlarged sebaceous glands and heightened sebum production. Hormonal shifts in mid-life, especially in women during menopause, can result in occasional acne outbreaks.

    Certain medications: Drugs containing corticosteroids, testosterone, or lithium. Acne outbreaks often occur after discontinuing contraceptive pills, as the skin undergoes a cleansing cycle and the body establishes a new hormonal balance.

    Diet: Research indicates that consuming specific foods, such as simple carbohydrates and dairy products, can exacerbate acne.

    Stress: While stress doesn't directly cause acne, it can worsen existing acne if already present.

    Types of Acne

    Acne can manifest in various forms and conditions, largely influenced by the cause of their occurrence and the overall skin condition. The following types are recognized:

    Non-inflammatory types of acne:

    Closed and open comedones (blackheads and whiteheads) are non-inflammatory acne lesions. They are generally the mildest forms and do not cause swelling or discomfort.

    • Closed comedones: Small white dots or bumps that typically do not leave scars.
    • Open comedones: Small, dark-colored spots that may appear as slightly raised bumps. They darken due to exposure to air.
    • Papules: Bumps beneath the skin's surface, with a diameter of less than 1 centimeter. Papules themselves appear firm, sensitive, and raised. The skin around papules is usually inflamed.
    • Pustules (pimples): Larger, sensitive bumps with a defined circular center filled with whitish or yellowish pus. The area around the pustule is red and painful.

    More severe stages;

    • nodules are firm, inflamed lumps situated deep within the skin. Similar to papules, nodules lack a visible head. They signify a graver manifestation of acne, often leading to skin complications like dark spots or scars. This type of acne evolves through the blockage of pores and subsequent drainage beneath the skin surface.
    • Cysts; these are notably large, painful, either red or white masses residing deep in the skin. In contrast to nodules, cysts fill with purulent fluid and typically feel soft to the touch. Cysts represent the most serious form of acne. In severe instances, surgical intervention may be necessary for treatment. If left untreated, cysts can result in visible and enduring scars.

    Addressing and preventing acne:

    Numerous approaches exist for treating acne, each varying based on age, acne type, and severity. Dermatologists may recommend oral medications, topical treatments, or medical therapies for skin treatment. The goal of treating acne is two-pronged: preventing the formation of new blemishes and correcting existing skin irregularities.

    Topical Treatments for Acne

    Your physician might suggest using topical medications to address skin concerns. These treatments can be directly applied to the skin, similar to lotions or moisturizers. Some formulations include ingredients like:

    • Benzoyl peroxide: Effective against surface bacteria that often exacerbate acne. Lower concentrations and cleansing formulations are gentler on the skin.
    • Salicylic acid: Aids in removing the top layer of damaged skin. Salicylic acid dissolves dead skin cells, preventing follicle blockage.
    • Azelaic acid: A natural acid found in various grains, such as barley, wheat, and rye. It combats microorganisms on the skin and reduces inflammation.
    • Retinoids (vitamin A derivatives): Break down blackheads and comedones, helping to prevent clogged pores and the initial signs of acne.
    • Antibiotics: Topical antibiotics manage surface bacteria that contribute to the worsening of acne.

    Here are some tips for minimizing acne:

    • Consistently cleanse your skin daily with lukewarm water and a mild cleanser, avoiding harsh foaming agents.
    • Steer clear of aggressive skincare products containing alcohol, astringents, or mechanical particles, as they may irritate the skin.
    • Make it a habit to thoroughly remove makeup and impurities each evening.
    • Use an appropriate moisturizer that offers ample hydration and antioxidants.
    • Minimize touching your face, and resist the urge to squeeze or scratch acne lesions.

    CBD Cannabinoid – Natural Solution for Acne

    CBD is one of the many cannabinoids found in hemp, known for its positive properties in restoring skin balance and alleviating skin issues. It is highly effective in regulating sebum production and preventing inflammation, which is often the main cause of acne and related conditions. The growing popularity of CBD products or CBD skincare for combination and oily skin can be attributed to excellent results without causing side effects such as dryness and skin reactivity. The essence of skincare lies in restoring the balance of the skin, and hemp itself is a master in this regard.

    How CBD Works on the Skin

    Sebum, the skin's natural oil, is produced to shield the outer layers of the epidermis from external factors and moisture loss. While its role is essential, an excess of sebum can quickly lead to the trapping of dead skin cells and dirt, creating an environment ideal for inflammation and acne.

    A 2014 study delved into the impact of CBD on sebocytes, the foundational cells of sebum. Researchers discovered that CBD prevents excessive cell division, contributing to rebalancing impure skin. Additionally, the presence of CBD in the cells triggered an anti-inflammatory response.

    In a 2016 summary, the focus was on hemp's antibacterial and antifungal effects, which play a role in preventing infections caused by environmental impurities.

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    Myths and Misconceptions About Acne

    Despite being one of the most widespread skin issues, acne is also one of the least understood conditions. There are numerous myths and misconceptions surrounding it:

    1. "Acne is caused by dirty skin and poor hygiene."

    Most biological reactions that trigger acne occur beneath the skin's surface, so the cleanliness of the skin fundamentally does not impact acne. In fact, excessive face washing can worsen the condition.

    • "Squeezing pimples is the best way to improve the condition."

    This action can significantly worsen the condition and leave permanent scars on the skin.

    • "Sunbathing and visiting tanning beds can improve acne symptoms."

    While it may seem that the sun helps dry out pimples, unfortunately, it does not aid in acne treatment. Sun exposure can inflame and dry the skin, leading to increased sebum production and consequently worsening the condition.

    • "Acne is contagious."

    Acne cannot be transmitted to other people.

    • "Only teenagers have acne."

    Acne is the most common skin condition. People of all races and ages face acne. 30% of adults, both men and women, also experience acne in adulthood. Although 85% of teenagers get some form of acne, they are not the only ones who can suffer from it.

    • "Toothpaste dries out pimples."

    While toothpaste contains antibacterial substances, it also contains ingredients that can irritate and damage the skin, making it an unsuitable choice for the skin.

    • "Acne will disappear on its own, so it doesn't need treatment."

    Acne is a chronic condition, meaning it can last for an extended period. It is a condition that develops beneath the skin's surface and requires special attention and care.

    Potential Complications and Long-Term Impact of Acne

    Formation of scars is a common consequence of acne, often lingering well beyond the resolution of the acne itself. Scarring can result from various acne types but is more prevalent in severe cases, such as nodules and cysts, which can rupture, causing damage to the surrounding skin, or when pimples are squeezed. There are two primary types of scars associated with severe acne:

    • Atrophic scars, resulting from tissue loss.
    • Hypertrophic scars, resulting from excess tissue.

    Following acne treatment, the treated skin may experience hypopigmentation (lightening) or hyperpigmentation (darkening) compared to its previous state.

    • Persistent scars; Long-lasting indented scars and thick keloids may persist on the skin post-acne treatment.

    Acne management requires time and patience.

    In cases of prolonged acne episodes, consulting with a doctor is crucial to identify the most suitable treatment options. Beyond acne control, healthcare professionals can assist in preventing or minimizing scarring and other skin damage.

    Discovering the optimal treatment and navigating the acne elimination process may span months or even years, emphasizing the importance of patience.

    Confidence and its Influence on Mental Well-being

    The presence of acne can bring about emotional distress and difficulties, stemming from its impact on one's appearance and self-perception. The onset of acne is frequently beyond our control, particularly when hormones play a significant role. This can lead to stress, potentially influencing the occurrence of future breakouts. Acne often poses challenges for teenagers and young adults. If acne is causing anxiety or hindering your engagement in social activities, consider discussing your concerns with individuals who are experiencing similar issues—you'll discover that you are not alone.


    Written by Barbara Novak on October 27, 2023, updated on December 4, 2023.

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