What is acne? How to recognize it? Remedies.

Acne is a common skin disorder that develops due to the blockage and inflammation of hair follicles and associated sebaceous glands. This process is often linked to excessive sebum production, accumulation of dead skin cells, and the proliferation of bacteria such as Cutibacterium acnes .

Typical skin manifestations include blackheads (open comedones), whiteheads (closed comedones), papules, pustules, nodules, and cysts, which can vary in severity and leave scars if not treated properly.

Acne mainly affects the face and neck, but can also extend to the chest, shoulders and upper back. It is particularly common during adolescence due to hormonal changes, but can persist or appear even in adulthood.

In the medical field, this condition is more precisely defined as acne vulgaris and can be treated with topical products, oral medications, or specific therapies depending on its severity.

Tips and Remedies to Fight Acne

In addition to medical treatments, there are several natural remedies and measures that can help improve the appearance of the skin and reduce the appearance of acne. Although they are not a substitute for drug therapies, these methods can promote skin health.

Daily skin care

Daily skin care is one of the first remedies to combat and/or reduce acne. Here are some tips for an effective skin care routine:

•       Gentle cleansing : wash your face twice a day with warm water and a gentle cleanser specifically designed for acne-prone skin.

• Avoid aggressive cleansers : products that are too degreasing can stimulate increased sebum production, worsening acne.
• Always remove makeup : Use non-comedogenic makeup removers to avoid residue build-up in pores.
• Dry your skin carefully : gently pat your face dry with a clean towel, avoiding rubbing which could irritate the skin.

Habits to avoid

• Don't pop pimples : This practice can encourage the spread of bacteria and the formation of scars.
• Avoid tight clothing : Especially for those who suffer from acne on the back and chest, wearing tight clothing can increase sweating and irritation.
• Protect your skin from the sun : Exposure to UV rays can make acne worse, especially if you use photosensitizing medications. It is advisable to use a sunscreen specifically designed for oily and acne-prone skin.

Useful natural remedies

• Aloe vera : Known for its soothing and anti-inflammatory properties, it can help reduce redness and promote healing.
• Tea Tree Oil : Has natural antibacterial properties and can be applied topically to blemishes.
• Clay masks : help absorb excess sebum and purify pores.
• Purifying infusions and herbal teas : green tea, burdock and nettle can have beneficial effects thanks to their anti-inflammatory and purifying properties.
• Balanced diet : Reducing your intake of refined sugars and dairy products can help control skin inflammation, while antioxidant-rich fruits and vegetables contribute to healthy skin.

Causes and triggers:

Acne is a complex skin condition that develops due to several interconnected factors:

• Overproduction of sebum: The sebaceous glands, located near the hair follicles, can produce too much sebum, an oily substance that lubricates the skin. This excess can contribute to clogged pores.
• Dead Skin Cell Buildup: Failure to effectively remove dead skin cells can lead to clogged hair follicles, resulting in the formation of comedones (blackheads and whiteheads, commonly called pimples).
• Bacterial overgrowth: Cutibacterium acnes , a bacterium normally present on the skin, can overgrow within clogged follicles, causing inflammation and the appearance of acne lesions.

Predisposing and triggering factors:

• Hormonal changes: During adolescence, the increase in androgen hormones stimulates the sebaceous glands to produce more sebum. Hormonal fluctuations related to the menstrual cycle or pregnancy can also influence acne.
• Stress: Stressful situations can alter hormonal and immune balance, contributing to the onset or worsening of acne.
• Medications: Taking certain medications, such as corticosteroids or anticonvulsants, can cause acne to appear as a side effect.
• Genetic predisposition: A family history of acne may increase the likelihood of developing this condition.

Factors that can make acne worse:

• Diet: High glycemic foods, such as refined sugars and simple carbohydrates, can increase insulin levels in the blood, stimulating sebum production and promoting inflammation.
• Using inappropriate cosmetics: Using oily or comedogenic cosmetic products can clog pores and worsen acne.
• Tight Clothing: Tight clothing or accessories can cause friction on the skin, contributing to irritation and worsening acne lesions.
• Manipulating Lesions: Popping or scratching pimples can lead to infection and permanent scarring.
• Exposure to environmental factors: Pollution and humid environments can negatively affect the skin, exacerbating acne.

Understanding these factors is essential to take effective preventative measures and properly manage acne, improving the health and appearance of your skin.

 Types of acne:

Acne is a skin condition that manifests itself in different forms, classified according to the severity and type of lesions present. Here is an overview of the main types:

• Mild comedonal acne : characterized by the presence of a few comedones (blackheads or whiteheads, commonly called pimples ), generally located on the face.
• Severe comedonal acne : In this form, numerous comedones cover large areas of the face and back.
• Papular-comedonal acne : in addition to comedones, inflamed papules appear, which are small, red and painful skin bumps.
• Papulopustular acne : characterized by the presence of both papules and pustules, the latter containing pus.
• Pustular acne : A form in which most of the papules turn into pustules, indicating widespread inflammation.
• Pustular-cystic acne : in addition to pustules, subcutaneous cysts develop, which are deeper and more painful lesions.
• Nodulocystic acne : characterized by the formation of nodules and cysts, often on the face, which can leave permanent scars.
• Acne conglobata : the most severe form, with painful subcutaneous abscesses that tend to merge, forming draining fistulas and deep lesions that can cause extensive scarring.

Another classification distinguishes acne based on the inflammatory component:

• Non-inflammatory acne : Characterized mainly by open or closed comedones, without obvious signs of inflammation.
• Inflammatory acne : presence of inflamed lesions such as papules, pustules, nodules and cysts.

It is important to note that there are also specific variants of acne, such as acne neonatorum, which occurs in newborns, and acne cosmetica, caused by the use of comedogenic cosmetic products. Correct identification of the type of acne is essential to adopt the most appropriate treatment.

Medical and Dermatological Treatments for Acne

When natural remedies are not enough or acne is particularly severe, it is necessary to resort to specific treatments, prescribed by a dermatologist.

Topical drug therapy

Local treatments are formulated in the form of creams, gels or lotions to be applied directly to the affected areas. Among the main active ingredients used we find:

• Benzoyl peroxide : antibacterial and comedolytic action, helps reduce inflammation and the number of pimples.
• Salicylic acid : exfoliating and keratolytic, it promotes cell turnover and frees clogged pores.
• Azelaic acid : has antibacterial properties and regulates the proliferation of skin cells.
• Topical antibiotics (clindamycin, erythromycin, nadifloxacin): They counteract bacterial growth and reduce inflammation.
• Topical retinoids (tretinoin, adapalene): derivatives of vitamin A, stimulate cell turnover and prevent clogging of follicles.

Oral drug therapy

For more severe forms of acne or those resistant to topical treatments, your doctor may prescribe medications to be taken orally:

• Oral antibiotics (doxycycline, minocycline): fight inflammation and reduce bacterial growth.
• Oral contraceptives (in women): Some types of birth control pills that contain estrogen and progestin can regulate sebum production.
• Oral retinoids (isotretinoin) : Used for severe acne, they work by reducing sebum production and normalizing cell turnover. This treatment requires close medical monitoring for possible side effects.

Other dermatological treatments

• Chemical Peels : Procedures performed by a dermatologist to exfoliate the skin and improve the appearance of post-acne scars.
• Laser treatments : These aim to reduce the scars left by acne and control sebum production.
• Photodynamic therapy : Uses a special light to reduce the bacteria that cause acne inflammation.