Why does acne return after teenage years?
Most women think that by the time they get through their teen years, they will be done with acne. Unfortunately, that isn't always the case. One study identifies acne as a by-product of the western diet, which can continue to plague both men and women well into their 30s.
Changes in “androgenic” or male-focused hormones are one cause of acne. Some people are particularly sensitive to these hormones.
Although women have predominantly female hormones like estrogen and progesterone, other hormones called androgens including testosterone, are also present in small amounts.
When there are changes in these levels, acne can occur.
Although acne is normal, there are reasons why it is more of an issue at certain times than others:
- a woman's “time of the month” causes changes in hormonal balance
- attempts to relieve discomfort through manipulation (squeezing) can actually cause further acne
- wearing non-breathable clothing, such as sportswear and spandex headbands, reduces skin healing.
Causes of acne
Acne is treatable. However, before you proceed with treatment, you should find out the cause of the disease.
Consult a doctor. They will gather your medical history by determining whether you are genetically predisposed to acne, specifying the age you hit puberty, analyzing your menstrual cycle regularity, finding out whether you are overweight, allergic, etc.
The doctor will also have you take some tests to check your blood chemistry and hormone levels, as well as have you undergo a pelvic and thyroid gland ultrasound.
Acne may develop due to several factors.
The hormonal causes of acne include:
- hormone level changes throughout the menstrual cycle
- taking oral contraceptives
- hormonal imbalance
- endocrine system disorders, etc.
The non-hormonal causes of acne include:
- gastrointestinal diseases
- poor hygiene
- vitamin and nutrient insufficiency
- weak immune system
Often, acne is caused not just by one reason but by a number of reasons.
Main acne triggers
Many people think that acne is caused by an unhealthy diet. However, the link between acne and food hasn’t been proven yet.
Still, researchers are convinced that sweet, fatty, smoked, and fast foods are a contributing factor that, along with other conditions, can make acne spots worse.
- stress and depression
- tight synthetic clothing which does not let your skin breathe
- inappropriate skincare products and (comedogenic) makeup
- too dry (or too humid) climate
- insufficient (or superfluous) hygiene
- cleansing with water that is too hot, which increases the production of sebum
If acne is caused by a hormonal imbalance or GIT dysfunction, eliminating the triggers won’t improve the situation. Eradicating the cause of the condition will be the only cure in this case.
Acne and dairy: what’s the corellation?
Cultures that stick to a mainly whole foods diet experience almost no acne at all, while western cultures seem to have the highest incidence rate of acne.
One of the biggest culprits in the western diet is dairy — specifically skim milk, cream cheese, and cottage cheese. Therefore, reducing the intake of dairy products may help to improve acne.
Experiment by avoiding dairy products for a definite period of time (for instance, a week or two) and assess the progress. Use the app to log your acne symptoms and to monitor any changes.
Are acne, fast food and carbonated beverages connected?
The higher the glycemic index of the product, the faster the carbohydrates in it are digested and raise blood sugar levels. Processed foods, especially those with a high glycemic index, have been known to exacerbate acne.
A list of foods that cause acne includes fast food, instant foods, milk, fizzy drinks, white bread, smoked sausages, and potato chips.
One study found that a control group consuming more fish and vegetables had a lower incidence rate of acne.
Therefore, adopting a whole foods diet and reducing the intake of dairy products may help significantly reduce acne.
How can hair affect acne?
Excessive contact between your hands, hair, and face does not help your skin get healthier.
Sebum, dust, and the remains of beauty products accumulate on your hair during the day. When these elements come in contact with the skin on your face, they clog pores which causes the appearance of pimples.
If your hair covers parts of your face, wear it in a ponytail. Having bangs is not for you if your hair gets dirty quickly, as it can cause pimples to appear on your forehead.
Hair should be washed when needed; oily hair is commonly washed every day.
You should wash and style your hair in the way that will ensure that hair products won’t get on your face, neck, and back. These products contain mineral oils that can cause pore to clog.
For the same reason, long hair should be washed with the head bent forward so that the water and foam don’t drip down the back
Helicobacter pylori: a possible cause of acne
Acne can develop due to gastrointestinal tract problems caused by Helicobacter pylori, a bacterium found in the stomach and duodenum.
Helicobacter pylori is transmitted via household contact (through water, saliva, food, utensils). Having settled in the stomach, the bacterium can live there for years without manifesting itself in any way.
However, when the body’s immune system gets weak (due to stress, illness, bad habits, etc.), Helicobacter pylori starts multiplying, which causes gastrointestinal diseases (gastritis, ulcer, etc.)
The stomach and the intestines can’t cope with digesting the food so the body suffers from a metabolic disorder, and the skin reacts with acne lesions.
You can determine whether you have Helicobacter pylori by taking a breath test.
If you have any doubt, you can additionally take a venous blood test or undergo an endoscopic examination (when gastric tissue samples are taken for testing).
To get rid of Helicobacter pylori, you should undergo treatment prescribed by a doctor and stick to a healthy diet (cut down on fried, fatty, and sweet foods).
Dysbiosis might be the cause of acne
According to research, acne and gastrointestinal problems are interrelated.
Acne can be caused by dysbiosis (also referred to as dysbacteriosis), which is when the normal intestinal flora is outnumbered by pathogens.
Dysbiosis can be triggered by an unhealthy diet or taking antibiotics.
By actively multiplying, the pathogenic intestinal bacteria generate toxins that are carried by the blood throughout the body.
One of the ways for the body to release the toxins is through the skin.
Dysbiosis puts additional pressure on the skin, and it reacts with enhanced sweat and sebaceous gland activity. Over time, the glands stop coping with the load, which is manifested in duct blockage and acne.
To avoid dysbiosis, you should take probiotics. They are found in fermented milk products and are contained in medicinal products sold by pharmacies.
You should also normalize your diet (cut down on sweets, preservatives, fatty and spicy foods).
Demodicosis and acne
If your hormone levels are normal, you have no gastrointestinal problems, and you still have pimples, this may indicate you have demodicosis, not acne.
Demodicosis is a disease caused by Demodex mites. Normally, they live inside the hair follicles and sebaceous glands of most people.
The mites can inhabit the skin for years without manifesting themselves, but as soon as there are favorable conditions (immune function decline, stress, an increase in sebum production), they start multiplying, causing skin itchiness, redness, and sloughing.
To detect demodicosis, you should take a skin-scraping test.
The disease is treated with external remedies that have an anti-demodectic effect. They disinfect the skin, clearing it of sebum and mite waste. The treatment is prescribed by a doctor.
Can acne be caused by medications?
Pimples can sometimes occur during or after therapy with certain medications, in which case, it is called drug-induced acne.
The lesions can be caused by:
- hormonal contraceptives
- anti-epileptic drugs
- anti-tuberculosis drugs
The thing about drug-induced acne is that the lesions are the same in shape and size, while with other types of acne they look different.
Drug-induced acne normally clears away after the medication is discontinued. If this doesn’t happen, be sure to see a doctor.
Sex and acne: are they connected?
According to research, sex life and acne are indeed connected, but it would be wrong to say that having sex clears acne reliably.
It is just one factor that reduces the likelihood of developing the condition.
Acne occurs for many reasons, one of them being hormonal imbalance. In particular, acne can be caused by an excess of male hormones called androgens.
Sex triggers the production of the female sex hormone estrogen in the female body, which balances out other hormones and prevents acne lesions.
After sex, the body produces the endorphins, known as the “happy hormones,” that promote epithelial cell growth and accelerate skin regeneration (when old cells are exfoliated and replaced with new ones).
Sex improves blood circulation, which oxygenates the skin. It has also been proven that it enhances the production of collagen, the skin’s building material, which makes it elastic.
Acne diagnosis and development
Human skin consists of several layers.
The outer layer (epidermis) is imbued with tiny holes (pores) that let skin breathe.
Thin tubules (follicles) connect the pores with sebaceous glands located in the deeper inner layer (dermis). These glands secrete sebum, a natural oil that protects the skin and makes it elastic.
Due to hormonal changes, genetic predisposition, and other factors, your skin may produce more sebum than necessary. As a result, it doesn’t come out and ends up clogging the follicles, which leads to inflammation.
The skin surface is normally populated by bacteria, including Propionibacterium acnes. Once they enter the site of inflammation, they multiply and cause acne, an inflammatory skin disease.
Types of acne lesions
Any acne lesion is commonly known as a pimple. However, this is not entirely accurate.
Acne lesions have specific names, depending on their size, color and soreness.
- comedones: sebum plugs clogging up pores. They look like black dots (open comedones called blackheads) or white subcutaneous tubercles (closed comedones called whiteheads). They are painless.
- papules: small pinkish bumps rising above the skin surface. They turn pale when you apply pressure to them.
- pustules: white bumps filled with pus. They are painful and can be easily squeezed, but you shouldn’t do it, as this may lead to infection.
- nodules: dark red solid bumps up to 3 cm in diameter that are embedded deep in the skin. These are painful.
- cysts: several nodules located next to each other. They can be connected by fistulas under the skin.
The type and severity of acne determines the treatment strategy.
Acne can affect not only the face, but also other parts of the body such as the neck, chest, back, stomach, and buttocks where there are many sebaceous glands.
Face acne is often caused by bodily malfunctions (hormonal imbalance, gastrointestinal tract problems, etc.)
Body acne is in most cases associated with the skin being subject to irritants: wearing tight synthetic clothing, scarves, tight collars, or a backpack; depilation; poor hygiene; allergic reactions to washing powder, ingredients contained in bath and shower products, etc.
However, internal causes, including hormonal issues, can’t be ruled out either.
If eliminating any irritating factors doesn’t clear away the lesions, you should consult a doctor to find out the reasons and get treated.
How do you assess acne severity?
Acne treatment depends on its severity, and to determine it, the skin is subject to visual assessment.
There are three forms of acne:
- mild, when there are up to 20 closed or open acne lesions (comedones) and 15 acne foci with insignificant inflammation signs (papules)
- moderate, when there are 20–100 acne lesions (comedones) and 15–50 inflammation foci (papules and pustules)
- severe, when besides numerous lesions, there are more than 5 inflamed bumps (nodules) and cysts.
The mild form is usually treated with external remedies. You can fight it on your own.
The medium and severe forms require a combination of locally applied remedies and oral medications. In such cases, it is best that you seek a doctor’s help.
Testing hormone levels to determine causes of acne
Hormonal imbalance is one of the possible causes of acne. To confirm (or refute) the hormonal nature of the disease, take a blood hormone test.
The most common cause of acne is an excess of male hormones called androgens. Laboratory testing will determine the levels of the main androgen called testosterone.
Excess testosterone makes sebaceous glands more active, which leads to duct blockage and acne formation.
Besides testosterone, it is important to check the levels of the luteinizing (LH) and follicle stimulating (FSH) hormones, as well as estradiol.
This will determine if the endocrine system is functioning properly as disorders of the endocrine system lead to acne.
Testing for the sex hormones (testosterone, LH, FSH, and estradiol) is best taken on day 5–7 of the menstrual cycle.
If your test results show that your hormone levels do not correspond to the norm, the doctor will prescribe medications to stabilize them.
How to use face mapping for acne
Acne spots in different areas of the skin can indicate issues with certain organs with high probability. By analyzing the location of acne lesions, the cause of their appearance can be determined much quicker.
Pimples on the forehead can be the result of problems with the digestive system.
If there are a lot of them between the eyebrows, it might be that the liver is not functioning properly. You should cut down on sugar, fatty, and smoked foods.
If pimples are located around the eyes and ears, you should pay attention to the kidneys. Perhaps, the body is dehydrated and needs water.
Acne spots on the nose can be linked to the cardiovascular system. You need to check your blood pressure and cholesterol.
Pimples located on the cheeks are probably a sign of lung problems. Chin pimples are often related to gynecological problems.
You should not view this pattern as a diagnosis. Each case must be considered individually and under the supervision of a specialist.
How to use body mapping for acne
Pimples appearing on certain parts of a human body can indicate the malfunction of some of the organs.
For example, if acne appears on the neck, it would be wise to check the reproductive system.
Shoulder pimples are a possible sign of a malfunction in the nervous system. In this case, you should adjust your daily routine and emotional state.
If acne is located on the chest, back, and buttocks, you should pay attention to your digestion. Perhaps, your diet includes too many greasy, spicy, or sweet foods.
If there are multiple spots on your belly, it wouldn’t hurt to check your blood sugar.
However, these signs shouldn’t be viewed as a diagnosis. Each case is different. These are simply possible ways of determining the cause of acne.
You can improve your acne and complexion by changing your diet and adding a few micronutrients to it.
Modern research shows that foods high in sugar will aggravate acne. If you want to improve your skin, try eating foods high in zinc, omega-3 fatty acids, selenium, vitamin A, E, and others.
These are found in shellfish, beef, poultry as well as cheese, nuts, and spinach.
Track your acne symptoms and dietary changes throughout your cycle with the help of our app. You can discover patterns and foods that work well to reduce your acne.
Best acne treatment is the one prescribed to you by a doctor
If the breakout is extensive, or there are signs of inflammation and an underlying depressed state, you should consult a specialist.
Acne is treated by a dermatologist, but given the wide range of its causes (including hormonal ones), there are times you should be concurrently examined by an endocrinologist and a gynecologist.
Acne treatment can begin only when the causes of the disease are pinpointed. To do this, the doctors will have you undergo examinations and, based on the results, choose an adequate therapy.
Treatment methods and duration depend on age, menstrual cycle regularity, skin properties, condition severity and other factors. For that reason, therapy is done on a case-by-case basis.
Don’t use medications that have been prescribed for someone else with a similar condition. This can make your situation worse.
Treating acne externally: what aspects should you be aware of?
Acne treatment can be long term, and its methods depend on the severity of the condition.
The mild form (without inflammation signs) is treated with externally applied remedies that destroy the bacteria causing the inflammation, clean out and tighten the pores, reduce the sebum production, and dry out the pimples.
External medical creams, gels, and other products contain:
- retinoids. These are vitamin A compounds.
- benzoyl peroxide. When applied to the skin, it provokes oxygen production, killing anaerobic bacteria.
- azelaic and salicylic acids. These have antimicrobial and anti-inflammatory effects.
- zinc or sulfur
Any medication should be prescribed by a dermatologist.
Moderate or severe acne can be treated with externally applied medications containing antibiotics. Those are selected by the doctor on a case-by-case basis!
Can zinc treat acne?
Zinc is a trace element essential for keeping your skin, hair, and nails healthy. It successfully fights Propionibacterium acnes. It has antioxidant properties and helps relieve acne inflammation.
Zinc makes wounds heal faster and is a good detoxifier because it removes harmful substances from the body.
This nutrient is abundantly found in seafood, red meat, beans, and pumpkin and sunflower seeds.
It is contained in many externally applied skin products. There are also special zinc-based ointments and medications. However, those can only be prescribed by a doctor.
Zinc overdose can trigger gastrointestinal tract problems and increase testosterone levels, which will aggravate the acne.
Flo will help you get rid of acne!
Track your cycle and log symptoms in the app to find possible correlations between your hormone level and skin symptoms.
Vitamins for acne: which ones should you take?
Acne can be caused by a vitamin deficiency. Replenishing it will reduce the risk of developing the condition.
Retinol, or vitamin A, is one of the most important vitamins that help with acne.
It is contained in large quantities in carrots, parsley, and liver. Retinol is best absorbed when taken with zinc. If the level of the latter is low in the body, taking vitamin A will be useless.
B vitamins (B2, B5, B6, and B12) improve blood circulation in small vessels and promote acne scar healing. Vitamin B3, or nicotinic acid, slows down the sebaceous glands function. B vitamins are found in beans, liver, mushrooms, and chicken.
Vitamin C boosts the skin’s protective function and makes the damaged areas heal faster. It is contained in citrus fruit, fresh berries, cabbage, and leafy greens (spinach, parsley, etc.)
Vitamin E helps maintain skin elasticity and prevents negative environmental impact. It is found in abundance in sea buckthorn, nuts (hazelnuts, almonds, and pistachios), and dried apricots.
Remember: vitamin supplements for acne should be prescribed by a doctor. Self-medication can aggravate the condition.
Can antibiotics treat acne?
The main indications for using antibiotics in treating acne are:
- lesions affecting a large skin area
- numerous lesions of different types (papules, nodules, cysts)
- active inflammation
- ineffective locally applied medications
Antibiotics can have bactericidal (killing bacteria) and bacteriostatic (preventing bacteria growth) properties.
They can be administered locally through ointments or creams and orally.
When taking antibiotics, your skin condition may get better within a few days. However, there may be adverse effects (gastrointestinal problems, candidiasis, allergies).
Long-term antibiotic therapy can sometimes lead to bacteria developing an antibiotic resistance.
Antibiotics can only be prescribed by a doctor on a case-by-case basis according to examination results. Self-medication is not an option.
Can oral contraceptives treat acne?
Hormonal imbalance is one of the possible causes of acne. In most cases, excessive sebum production is due to a high level of androgens (i.e., male hormones).
Taking hormonal contraceptives can fix the situation as they normalize male hormone production, helping clear away the lesions.
When other treatment methods are ineffective in the event of severe acne, this kind of therapy is resorted to with caution. Its adverse effects include weight gain, migraines, high blood pressure, etc.
Choosing the right contraceptive and its dosage is important.
This can only be done by a doctor based on your hormone blood test results, age, menstrual cycle regularity, medical history, and other factors.
Self-medication using oral contraceptives can be dangerous.
Acne scar treatment
Ignoring acne, using ineffective (wrong) medications, and squeezing the pimples can lead to the skin becoming cyanotic and marked with post-acne scars.
Adequate therapy helps treat acne successfully, but creams and oral medications are useless in minimizing the post-acne marks.
- chemical peeling, when dead skin cells are removed with a weak solution of lactic, pyruvic, or salicylic acid
- mechanical peeling, when the top layers of the epidermis are removed using special nozzles or products containing dermabrasive particles
- injections of collagen, a protein that makes up most of the body’s connective tissue
- laser skin resurfacing, when scar tissue is removed layer by layer and the skin is smoothed out
A dermatologist or a cosmetologist can assess the extent and depth of the post-acne scars and prescribe adequate treatment.
Acne scar removal is quite time-consuming and not always possible. For that reason, acne shouldn’t be neglected, but treated promptly.
How do you get rid of large pores?
Large pores occur when follicle walls get thicker and consequently expand in diameter. This phenomenon is caused by sebum, keratinized epithelium, and leftover makeup accumulating in pores.
You can’t shrink the clogged pores without cleaning them out. This can be done by using special products matching your skin type, as well as washing your face every morning and evening.
You can get rid of dead skin cells using an exfoliating scrub (no more than once a week) or products containing fruit acids.
Clay masks absorbing excess fat can help shrink the pores. To prevent large pores, drink at least 2 liters of water per day and rub your face with ice cubes.
If you can’t get rid of the large pores, consult a doctor, who will select an effective method for you, for example, hardware cosmetology, or cosmetic or medicinal products.
How to prevent acne
It is impossible to hedge against pimples completely, but preventive measures might help reduce your breakouts.
Here are a few hygiene tips to prevent acne:
- You should wash your skin in the morning and in the evening, using warm (not hot!) water. Your hands should be clean. Use cleansing products appropriate for your skin type.
- Don’t use washcloths and face sponges that accumulate dirt and can cause an infection.
- Makeup should be removed before going to bed because beauty products clog pores.
- Your face doesn’t “like” being touched. There are a lot of bacteria on your hands that can get on your face. The same goes for mobile phones (you shouldn’t completely press it against your cheek) and pillowcases (it is advisable to change them every week).
- Personal hygiene items (towels, makeup brushes) are for your personal use only.
Your skin is the mirror of your body. Good sleep, healthy diet, and positive emotions will help your skin remain clean and healthy.
Acne skincare routine: the main stages
Facial skin (especially problem skin) requires proper care. It is important that you do everything consistently.
- Cleansing: removing sweat, dirt and dust from skin pores every morning and evening. The cleanser should match your skin type and have a pH of 4 to 6.
- Toning: softening the cleanser’s effect and restoring the skin’s pH balance. It is best that you use alcohol-free toners.
- This stage may include the following options:
- moisturizing: saturating the skin with moisture. Moisturizing creams (selected according to your skin type) create a coating that prevents water evaporation and keeps your skin taut.
- nourishing: saturating the skin with essential ingredients by applying nourishing masks before going to bed or using night creams.
- protection: reducing environmental impact on the skin. This can be done by applying a day cream with an SPF factor, which protects the skin from the harmful effects of UV radiation.
Should you pop pimples?
Popping pimples doesn’t solve the problem of acne. If anything, it makes it worse. Popping leads to abrasions through which infection can get into the body.
Sometimes, squeezing will cause small capillaries to burst, which leads to cyanotic spots. Popping pimples is likely to cause scars (post-acne), which are difficult to get rid of.
Sometimes, the pus will partially come out while the rest of it gets deeper inside. Once it enters the bloodstream, it can lead to tissue inflammation, causing more pimples.
If a pimple shows up on your skin, apply ice to it for 20–40 seconds. It will narrow the pores and relieve the reddening.
Then apply a medication containing salicylic acid or benzoyl peroxide (prescribed by a dermatologist or a cosmetologist). This will eliminate the bacteria and stop the inflammation. The pimple will then disappear in a few days.
To not be tempted to pop the pimples, try not to touch your face.
Pore extractions: pros and cons
Pore extraction is a cosmetic procedure aimed at cleaning out facial pores.
It involves cleansing the skin, opening up the pores (using steam or cosmetic products), removing the pore contents, and applying pore-narrowing and soothing products.
The process may damage capillaries, which leads to edema, redness, and a higher risk of infection.
Pore extraction works for non-irritated skin without pustules and inflamed lesions.
Otherwise, you should eliminate the inflammation first and only then extract the dried out elements to avoid the spread of infection.
The procedure should be approved by a dermatologist.
Regular extractions can’t make problem skin healthy. It is important to find out and eliminate the internal acne causes.
Can you wear makeup if you have acne?
It is okay to wear makeup if you have acne, but it is important that you follow certain rules in order not to harm the skin.
Before applying makeup, cleanse your face and apply a moisturizing cream.
It is best that you use non-comedogenic makeup products because they don’t clog pores. Their labels say “non-comedogenic” and “for problem skin.”
Choose makeup for acne with a light texture.
Give preference to water-based (rather than oil-based) foundations, which are applied to the skin in a thin layer.
Alcohol-containing products often overdry the skin.
Before going to bed, remove all makeup, preferably in several stages: with a washing foam, plain water, or micellar water. (It contains micelles, tiny particles that remove grease residue other cosmetic products can’t.)
Continue the daily skin care routine.
Makeup is just cover-up. A proper treatment with external remedies and, if necessary, oral medications will help you get rid of the acne lesions.
Acne is a problem you can handle!
Acne is often the reason for you to experience an inferiority complex and lack of self-confidence. However, acne spots should not be viewed as a tragedy.
Everybody has had pimples at least once in their lifetime. Statistically, about 10% of the planet’s population constantly suffers from acne. Therefore, you are not alone with your problem.
Try to think positively. In any situation, try to keep your spirits up, smile, and be happy with yourself. Then people won’t notice the pimples.
They will notice your shining eyes and your smile, and will see you as a confident person.
Getting rid of pimples is a real challenge. Try approaching it as a test that you can overcome.
Modern medicine has all the necessary means for this purpose. The main thing is to find the cause of the condition, work up a plan together with your doctor, and fight for your ideal skin.