Acne: Causes, Diagnosis, Home Remedies Medical Treatment And Preventions

Acne: Causes,  Diagnosis, Home Remedies Medical Treatment And Preventions.

What is Acne?

Acne (acne vulgaris, common acne) is a disease of the hair follicles of the face, chest, and back that affects almost all teenagers during puberty, the only exception being members of a few primitive Neolithic tribes living in isolation. It is not caused by bacteria, although bacteria play a role in its development. It is not unusual for some women to develop acne in their mid- to late 20s.

Acne vulgaris is typical teenage acne which is characterized by three types of lesions:

the comedo or blackhead;

the inflammatory papule; and

the pustule or pimple.

Acne appears on the skin as:

occluded pores ("comedones"), also known as blackheads or whiteheads,

tender red bumps also are known as pimples or zits,

pustules (bumps containing pus), and occasionally as

cysts (the deep pimples and boils of cystic acne).

One can do a lot to treat acne using products available at a drugstore or cosmetic counter that does not require a prescription. However, for tougher cases of acne, one should consult a physician for treatment options.

Acne is approximately affecting 85% of young adults and it is among the most common skin problem worldwide.

Conventional acne treatments like salicylic acid, niacinamide, or benzoyl peroxide are proven to be the most effective acne solutions, but they can be expensive and have undesirable side effects, such as dryness, redness, and irritation.

This has prompted many people to look into remedies to cure acne naturally at home. In fact, one study found that 77% of acne patients had tried alternative acne treatments.

What causes acne?

Acne starts when the pores in your skin get clogged with oil and dead skin cells.

Each pore is connected to a sebaceous gland, which produces an oily substance called sebum. Extra sebum can plug pores, causing the growth of a bacteria known as Propionibacterium acnes, or P. acnes.

Your white blood cells attack P. acnes, leading to skin inflammation and acne. Some cases of acne are more severe than others, but common symptoms include whiteheads, blackheads, and pimples.

Many factors may contribute to the development of acne, including:

Genetics

Hormone changes

Stress

Infections

Diet.

How is acne diagnosed?

A dermatologist will examine your skin and determine if the lesions are consistent with acne or another dermatologic process

How are acne scars diagnosed?

A dermatologist will examine your skin and determine if you have acne scarring and what type it is.

Are there any tests performed to diagnose the type of acne scar?

A visual examination by a dermatologist is enough to determine a diagnosis. Your dermatologist may also determine how severe your acne scarring is. One measurement system has four grades of acne scarring: macular, mild, moderate and severe. Grade one, macular, is a scar that’s red but flat. Grade two, mild, is a scar that can easily be covered by makeup or facial hair. Grade three, moderate, is “obvious at a social distance.” It is not as easily covered by makeup or facial hair. Finally, grade four, severe, is scarring that is very evident at a social distance greater than 50 centimeters (1.64 feet). It is unlikely that facial hair or makeup will completely cover up these scars.

What are the home Remedies to get rid of Acne?

Many home remedies lack scientific backing, and further research on their effectiveness is needed. If you’re looking for alternative treatments, though, there are still options you can try.

1. Fish oil supplement

Omega-3 fatty acids are healthy fats that offer a multitude of health benefits.

You must get these fats from your diet, but research shows that most people who eat a standard Western diet don’t get enough of the fats

Fish oils contain two main types of omega-3 fatty acids — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

High levels of EPA and DHA have been shown to decrease inflammatory factors, which may reduce the risk of acne.

In one study, 45 individuals with acne were given omega-3 fatty acid supplements containing both EPA and DHA daily. After 10 weeks, their acne decreased significantly.

There’s no specific recommended daily intake of omega-3 fatty acids. The 2015–2020 Dietary Guidelines for Americans recommends that healthy adults consume around 250 mg of combined EPA and DHA each day.

You can also get omega-3 fatty acids by eating salmon, sardines, anchovies, walnuts, chia seeds, and ground flax seeds.

2. Salicylic acid is a naturally occurring compound that is often an ingredient in acne skin care products. Salicylic acid helps clear dirt, skin cells, and other debris that leads to acne from the pores of the skin.

It also helps reduce swelling and redness in the area, which may minimize the appearance of scarring.

Salicylic acid is beneficial for all scar types. It makes a good addition to a daily skin care routine for most people who live with acne.

People with sensitive skin may need to test a product containing this acid on a small area of skin before using it on their entire face, as it may cause dryness or irritation.

3. Lactic acid

Lactic acid pull away dead skin cells by acting as a gentle peel. It may help reduce the appearance of scars and smooth the overall texture of the skin.

Lactic acid may also help lighten dark scar tissue, although it sometimes causes hyperpigmentation. Due to this possible adverse effect, it is best to test products that contain lactic acid on a small patch of skin before using them to treat acne scarring.

Many products for acne contain lactic acid. It is also present in diluted apple cider vinegar, which makes for a more natural, cost-effective treatment.

4. Retinoids

Some topical retinoids may help get rid of acne scars. As the authors of a review in the journal Dermatology and Therapy note, topical retinoids block inflammation, reduce acne lesions, and speed up cell regeneration.

The authors also stated that, retinoids could help lighten hyperpigmented acne scars, including those in people with darker skin tones

It is important to note that retinoids can make the skin sensitive to the sun. Anyone using retinoids for acne or scar treatment should wear sunscreen when going outdoors.

5. Alpha hydroxy acids

Alpha hydroxy acids (AHAs) can help get rid of dead skin cells and prevent clogged pores. Doctors may recommend AHAs for treating acne and reducing the appearance of acne scars.

AHAs are a mild form of acid that scrapes away the outer layer of skin to reveal fresh, new skin underneath. This process may help with discoloration due to scarring.

What are the Natural remedies for Acne?

Many people use natural remedies to help clear up acne scars, but the science behind them is unclear. Some may cause further irritation or other problems so people should use them with caution.

These include:

I. Reguler Exfoliation

Exfoliation is the process of removing the top layer of dead skin cells. You can use chemicals to achieve this, or exfoliate mechanically by using a brush or scrub to physically remove the cells.

Exfoliation may improve acne by removing the skin cells that clog pores.

It may also make acne treatments for the skin more effective by allowing them to penetrate deeper, once the topmost layer of skin is removed.

Currently, the research on exfoliation and its ability to treat acne is limited.

Some studies suggest that microdermabrasion, a method of exfoliation, can improve the skin’s appearance, including some cases of acne scarring.

In one small study, 38 patients with acne received eight microdermabrasion treatments at weekly intervals. The participants with acne scars showed some improvements following the treatments.

Another small study found that six weekly microdermabrasion treatments helped stimulate skin repair.

While these results indicate that exfoliation may improve skin health and appearance, more research is needed on acne.

There are a wide variety of exfoliation products available, but you can also make a scrub at home using sugar or salt.

Note that mechanical exfoliation, such as with harsh scrubs or brushes, can be irritating and damage the skin. As such, some dermatologists recommend gentle chemical exfoliation with salicylic- or glycolic-acid-based products.

If you choose to try mechanical exfoliation, be sure to gently rub your skin to avoid damaging it.

How to make a scrub at home

Mix equal parts sugar (or salt) and coconut oil.

Gently rub your skin with the mixture and rinse well.

Exfoliate as often as desired, up to once daily.

II. Another natural remedies to get rid of Acne are by using:

Shea butter

Honey

Lemon juice

Coconuts oil.

   Medical Treatment for Acne

Standard clinical treatments are the most effective for reducing acne. You can also try home treatments, though more research on their effectiveness is needed. 

It's best to consult a primary health care provider or dermatologist if an individual is unable to adequately control his or her acne. The goal of treatment should be the prevention of scarring (not a flawless complexion) so that after the condition spontaneously resolves there is no lasting sign of the affliction. Here are some of the options available:

1. Topical (externally applied) antibiotics and antibacterials: These include erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), clindamycin (BenzaClin, Duac), sulfacetamide (Klaron), azelaic acid (Azelex or Finacea), and dapsone (Aczone).

2. Microneedling

Microneedling is the process of inserting tiny needles into the skin surrounding the scar to stimulate the body to make more collagen. This collagen may reduce the appearance of acne scars by smoothing out the skin.

In a 2017 review, microneedling provided an improvement of 31 to 62 percent in the appearance of acne scars.

However, microneedling can cause side effects. Many people experience redness, pain, and inflammation after the treatment, but these effects subside over time.

3. Retinoids 

Retin-A (tretinoin) has been in use for years, and preparations have become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and a mild increase in sensitivity to the sun. Adapalene 0.1% is now available without a prescription. With proper sun protection, however, they can be used even during sunny periods. The combination medication is known as Epiduo gel -- which contains the retinoid, adapalene, along with the antibacterial, benzoyl peroxide -- is applied once a day.

4. Oral medications 

Doctors may start antibiotic treatment with tetracycline (Sumycin) or one of the related "cyclines," such as doxycycline (Vibramycin, Oracea, Adoxa, Atridox, and others) and minocycline (Dynacin, Minocin). Other oral antibiotics that are useful for treating acne are cefadroxil (Duricef), amoxicillin (Amoxil, DisperMox, Trimox), and sulfa drugs.

Problems with these drugs can include allergic reactions (especially sulfa), gastrointestinal upset, and increased sun sensitivity. Doxycycline, in particular, is generally safe but can sometime cause esophagitis (irritation of the esophagus, producing discomfort when swallowing) and an increased tendency to sunburn.

Despite the concern that the long-term use of tetracycline antibiotics for acne might "weaken the immune system" or induce bacterial resistance, these concerns seem to be unwarranted.

5. Chemical peels

A dermatologist can recommend medical treatments for acne scarring.

A dermatologist can recommend a type of peel that is suitable for a person’s skin type, acne severity, and scarring.

The authors of a 2017 review on treatments for acne scarring note a study that found that six of 10 participants using a specific type of chemical peel called trichloroacetic acid (TCA) had at least a 70-percent improvement in their acne scarring.

Other chemical peels may be less effective. For instance, 25 percent of those who used glycolic acid did not see any reduction in the appearance of scars.

A person may need to try different types of peel to determine which one works for them.

6. Oral contraceptives

Oral contraceptives (birth control pills), which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been shown to have modest effectiveness in treating acne. Those that have been U.S. FDA approved for treating acne are Estrostep, Ortho Tri-Cyclen, and Yaz. Most dermatologists work together with primary care physicians or gynecologists when recommending these medications.

7. Spironolactone (Aldactone) 

This drug blocks androgen (hormone) receptors. It can cause breast tenderness, menstrual irregularities, and increased potassium levels in the bloodstream. It can help some women with resistant acne, however, and is generally well-tolerated in the young women who need it.

8. Cortisone injections 

To make large pimples and cysts flatten out fast, doctors inject them with a form of cortisone.

9. Isotretinoin

Accutane was the original brand name; there are now several generic versions in common use, including Sotret, Claravis, and Amnesteem. Isotretinoin is an excellent treatment for severe, scarring, persistent acne and has been used on millions of patients since it was introduced in Europe in 1971 and the U.S. in 1982. It should be used for people with severe acne, chiefly of the cystic variety, that has been unresponsive to conventional therapies like those listed above. If taken in sufficient dosage, it should eliminate the need to continue the use of prescription drugs in most patients. 

The drug has many potential serious side effects and requires several unique controls before it is prescribed. This means that isotretinoin is not a good choice for people whose acne is not that severe but who are frustrated and want "something that will knock acne out once and for all." Isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for five to six months at a dosage that has a high likelihood of preventing the return of acne.

 

Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, substances related to cholesterol, which often rise a bit during treatment but rarely to the point at which treatment has to be modified or stopped.

Even though isotretinoin does not remain in the body after therapy is stopped, improvement is often long-lasting. It is safe to take two or three courses of the drug if unresponsive acne makes a comeback. It is, however, best to wait at least several months and to try other methods before using isotretinoin again.

Isotretinoin has a high risk of inducing birth defects if taken by pregnant women. 

Women of childbearing age who take isotretinoin need two negative pregnancy tests (blood or urine) before starting the drug, monthly tests while they take it, and another after they are done. Those who are sexually active must use two forms of contraception, one of which is usually the oral contraceptive pill. Isotretinoin leaves the body completely when treatment is done; women must be sure to avoid pregnancy for one month after therapy is stopped. There is, however, no risk of childbearing after that time.

Other concerns include inflammatory bowel disease and the risk of depression and suicide in patients taking isotretinoin. Recent evidence seems to indicate that these problems are exceedingly rare. 

Government oversight has resulted in a highly publicized and very burdensome national registration system for those taking the drug. This has reinforced concerns in many patients and their families have that isotretinoin is dangerous. Large-scale studies so far have shown no convincing evidence of increased risk for those taking isotretinoin compared with the general population. It is important for those taking this drug to report changes in mood or bowel habits (or any other symptoms) to their doctors. 

Even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients with severe disease.

10. Light treatments

Recent years have brought reports of success in treating acne using special lights and similar devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective, but it is not clear that their success is lasting. At this point, laser treatment of acne is best thought of as an adjunct to conventional therapy, rather than as a substitute.

11. Injections

Injections of corticosteroids may help with the treatment of raised acne scar tissue if a person has either hypertrophic or keloid scars.

The treatment typically consists of a series of injections. A dermatologist can do these injections in their office once every few weeks, monitoring the results.

12. Dermal filler

In some cases, dermatologists may recommend using soft tissue fillers to reduce the appearance of scars.

Dermatologists may choose a filler that consists of a collagen-based product, which may require allergy testing. Alternatively, removing fat from another part of the body to use may be an option. They can also use other commercial fillers, such as polymethylmethacrylate (PMMA), hyaluronic acid (HA), and poly-L-lactic acid (PLLA).

Dermal fillers work best for atrophic scars, but many are temporary. Treatment typically lasts between 6 and 18 months.

There are some permanent options, however, that a person can discuss with their dermatologist.

13. Laser treatment

Laser treatment resurfaces the skin without the use of chemicals or scrubs. It removes the uppermost layer of skin to reveal the younger skin cells underneath, which can help reduce the appearance of scarring.

Laser treatment is not suitable for everyone, however, as its success is mostly dependent on the acne scarring that a person has and their skin type. The treatment may also cause a reaction in some people, especially those with sensitive skin.

  Treatment of acne scars

For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.

How to prevent Acne?

The best preventives measures of Acne  is complete treatment with the best treatment options.

Sources:

www.medicalnewstoday.com

www.mayoclinic.org

www.healthline.com