I’ve been there, you’ve been there…the misery of waking up and finding a big zit right in the middle of your nose on the day of your first date with your long-time crush. Relate much? Acne (acne vulgaris) affects nearly everyone. Each year, it continues to be one of the top three dermatological problems for why patients go to the clinics.
Acne ranges from mild, occasional breakouts to more severe conditions such as humongous yellow cysts and nodules. It affects mainly teens and late preteens with up to 95% of boys and 82% of girls. However, the number of adults having breakouts is rising, especially in women 25 years of age or older. The Philippine Dermatologic Society says that 16 million Filipinos, mostly teens 10 to 18 years old, have acne. Most people get breakouts on the face, six of 10 get it on the back and butt, and 15% get it on their chests.
Acne is defined as a disorder affecting the oil or sebaceous glands of the skin and hair follicles. The pores or the small holes in your skin are linked to the oil glands. These glands, which are under the skin, produce an oily substance called sebum. The follicle, where hair also grows, acts as a canal that connects the pores and glands. Inside it, oil carries dead skin cells upwards to the top of the skin. The hair, sebum, and skin cells form a plug which swells when loads of bacteria (Propionibacterium acnes) enter it. When this plug breaks down, voila – a pimple ensues.
Acne differs in size, color, and level of pain. It comes as whiteheads, blackheads, papules (your typical pimple), pustules (contains pus), nodules (large, solid, and painful), and cysts (larger with more pus). The good news is acne is not linked to peanuts, chocolate, pizza or soda, but may be triggered by stress, diet, and lifestyle.
This skin problem doesn’t just cause physical scars, so please, never ever pop that zit! The stigma is all too real and the mental toll is staggering – almost all acne sufferers report feeling depressed and half of them tend to develop self-esteem issues over their complexions, making them choose to stay at home rather than to show their face in social activities. Worse, one of four even contemplated suicide!
Cream of the crop
A long time ago, it was widely believed that having pimples meant you displeased the gods or that you lied. The remedy? Chant magical spells and charms. Thanks to modern medicine, we don’t have to do that anymore. But with the plethora of over-the-counter (OTC) anti-acne products out there – no, toothpaste isn’t one of them – the path towards clear and healthy skin may be confusing. Let me make it clear.
Research has shown that 3 of 10 acne sufferers reach for OTC products for their condition. What are these? Treating acne normally starts with cleansers and leave-on products, which often contain active ingredients such as benzoyl peroxide, antibiotics, and hydroxy acids (glycolic acid, lactic acid, salicylic acid, etc.) that thin the upper layer of the skin to smoothen it and do wonders for the quality of elastin and collagen. When the acne lesions are inflamed and infected, topical antibiotics will help cut down the number of acne microbes.
OTC topicals or products that you slather on your skin come in different forms – creams, lotions, gels, soaps, pads, and so on. In the treatment of acne, the vehicle for delivery may be as important as the active agent. The American Academy of Dermatology (AAD) recommends OTC creams that contain benzoyl peroxide, salicylic acid, and sulfur. Cream contains a water base and is essentially a preparation of oil in water so it is less irritating and non-drying. Creams are best for patients with sensitive or dry skin because of its moisturizing effect. They are suitable for use on most skin areas because of their ‘spreadability’ factor. Skin absorbs creams more quickly since it penetrates the outer layer of the skin well.
Patients with oily skin may complain of an oily ‘feel’ with creams so gels might be better. However, there are reports of burning, itching, dryness, irritation, peeling, or redness of the skin (<1% of patients) in using gels.
Lotions may contain propylene glycol and may have burning or drying effects. Ointments suit patients with very dry skin but are insoluble in water, making them difficult to wash off. Some patients complain of ointments being greasy or messy to apply. Pads, which are easy to use, may cause redness, peeling, and flaking after cleansing and may make your skin more sensitive and more vulnerable to sun exposure. Solutions, mainly used with topical antibiotics, are often dissolved in alcohol and may sting or exacerbate dryness and irritation. Heard of the newer anti-acne sprays? Although it can treat larger areas of affected skin, there have been reports of a few cases of redness, scaling, dryness, stinging/burning, and lack of smoothness.
Prescription medications, both topical and oral, that are available only through a physician are warranted for more severe cases. Please remember that acne treatment needs patience – it’s not an overnight thing. It takes several months for the meds to start working. Talk to your doctors about your acne; you don’t have to face it alone!