ACNE TYPES

  • Whiteheads are a mild form of acne that can appear on the face, shoulders, neck, chest, and back. They are small, round, white bumps on the surface of the skin. Whiteheads come out when dead skin cells collects on the skin. The pore becomes clogged with sebum, dead skin cells, and other waste products. The white colored blemish that appears upon the skin’s surface is composed of trapped oil and dead white blood cells. [1]

    [1] Ramli R1, Malik AS, Hani AF, Jamil A. Acne analysis, grading and computational assessment methods: an overview. Skin Res Technol. 2012 Feb;18(1):1-14.

  • White heads and black heads are very similar. Blackheads are small bumps that appear on skin due to clogged pores. Blackheads get their name because the surface looks dark or black. The difference between whiteheads and blackheads is if the pore is open or closed. With blackheads the pore remains open. When the pore is open the oxygen makes the trapped oils and skin cells and turns them black. Blackheads are also black because of an accumulation of melanin (the dark pigment of skin). [1]

    [1] Ramli R1, Malik AS, Hani AF, Jamil A. Acne analysis, grading and computational assessment methods: an overview. Skin Res Technol. 2012 Feb;18(1):1-14.

  • When clogged pores get very irritated sometimes their walls break. This can cause bigger blemishes. These big blemishes are called papules and pustules. Papules are small firm cone-shaped bumps. They contain no pus and are tender to touch. Pustules have a yellow or white center with a red base. Pustules are created when a plug deep inside the pore traps oil and bacteria. White blood cells are attracted to the site of the infection and this causes inflammation.[1]

    [1] Ramli R1, Malik AS, Hani AF, Jamil A. Acne analysis, grading and computational assessment methods: an overview. Skin Res Technol. 2012 Feb;18(1):1-14.

  • When clogged pores get irritated they can grow and get big. The inflammation also goes deeper into the skin. This can create nodules and cysts. Nodules and cysts are more severe forms of acne. Nodules are large and hard. Cysts are softer and have pus. Both can be very painful.[1]

    [1] Ramli R1, Malik AS, Hani AF, Jamil A. Acne analysis, grading and computational assessment methods: an overview. Skin Res Technol. 2012 Feb;18(1):1-14.

ACNE SCARS

  • Your acne scars are most often the result of a papule, pustule, nodule, or cyst. These more severe forms of acne are caused when there is a break in your follicle wall. A follicle is a sac from which a hair grows. The follicle is connected to the oil glands. If the follicle wall breaks close to the surface of the skin, your scars are likely to be less severe and will generally heal quickly. Your more severe acne scars can occur when there is a deep break in the follicle wall. Your healthy skin can be destroyed when this happens. Once the infection is gone the tissue can’t always be restored and this can leave you with a scar.[1]

    [1] Sánchez Viera M., Management of acne scars: fulfilling our duty of care for patients. Br J Dermatol. 2015 Jul;172

  • You may have noticed that different people experience acne scaring to different degrees and in different ways. Some people are more prone to scarring than others. Genetics can play a role in how you scar. Scarring can run in the family. [1] Your scars may stay with you your whole lives. However, you may find that your scars fade over time.

    [1] Schnopp C, Mempel M. Acne vulgaris in children and adolescents. Minerva Pediatr. 2011 Aug;63(4):293-304.

  • If you have severe or very severe acne you are likely to have acne scares. Also scaring is more likely if you have acne and wait a long time before beginning your acne treatment. When you first notice you have acne you should begin treating it. Males are more likely to experience scaring than females. [1]

    [1] Tan J, Kang S, Leyden J. Prevalence and Risk Factors of Acne Scarring Among Patients Consulting Dermatologists in the Unites States. J Drugs Dermatol. 2017 Feb 1;16(2):97-102.

  • The best way to avoid acne scarring is to prevent the acne by taking Noacnin

  • Each scar is different and each person scars in different ways. It can depend on how deep the
    scar is rooted under your skin. It is best to speak to your dermatologist and they will be able to
    give you an expert opinion. [1][2]
    [1]Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad
    Dermatol. 2001 Jul;45(1):109-17.
    [2] Alison Mlayton, Acne vulgaris and similar eruptions, Elsevier, Volume 33, Issue 1, 1 January 2005, Pages 44-48

ACNE AND AGE

  • Acne is primary caused by changes in hormones. It is generally affected by changes in the male hormone testosterone. (Women also have some levels of testosterone.) So, your teenage acne may be caused by changes in your testosterone levels. These changes in your hormones can affect your acne and cause breakouts [1]

    [1] Degitz K, Ochsendorf F. Acne. J Dtsch Dermatol Ges. 2017 Jul;15(7):709-722.

  • Hormonal changes are common during the teenage years. If you are an adult, however, you can also experience changes in your hormone levels. [1] If you are a woman you may experience hormonal changes during certain times, for example during your menstrual cycle, pregnancy and menopause. Your acne can be the result of these changes. You may also be more likely to get acne because of your genetics. Adults with acne normally have someone else in the family who suffer from acne, like a parent or child. [2]

    [1] da Cunha MG, Fonseca FL, Machado CD.Androgenic hormone profile of adult women with acne. Dermatology. 2013;226(2):167-71

    [2] Joshua A. Zeichner, et. al. Emerging Issues in Adult Female Acne. J Clin Aesthet Dermatol. 2017 Jan; 10(1): 37–46.

  • It is common to get acne during or following menopause. Acne during your menopause years is due to changes in hormones. Androgens, a group of male hormones (including testosterone) are the cause of hormonal acne. If you have too much androgens in your body you will over produce oil and this can result in pimples. [1] When you go through menopause the level of female hormones, within your body, drop, in particular estrogen. [2] This drop in female hormones heightens the effect of androgens. Pimples and acne appear because your skin becomes oilier and your pores become clogged. Sometimes menopausal women experience rosacea so you should check with your dermatologist for an accurate diagnosis.

    [1] Uysal G , Sahin Y , Unluhizarci K , Ferahbas A , Uludag SZ , Aygen E, Kelestimur F. Is acne a sign of androgen excess disorder or not? Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:21-25.

    [2] Brincat MP, Baron YM, Galea R. Estrogens and the skin. Climacteric. 2005 Jun;8(2):110-23.

  • Rosacea is a rare inflammatory condition. It causes redness, flushing and blushing, papules, pustules, nodules and draining sinuses. [1] Dr. Hilary Baldwin, associate professor of dermatology at the State University of New York-Brooklyn says that rosacea usually occurs in the central portion of the face. [2] Rosacea can also affect the eyes and can even cause a bulbous nose. Acne mainly affects teenagers, while rosacea generally affects people later in life. Acne also causes black heads while rosacea does not. Unlike rosacea, acne can also appear on the body.

    The cause of these conditions are also different. Acne is caused by many factors involving: hormones, oil gland cells and bacteria, and hair follicles. Rosacea is thought to be linked to problems with the immune system. [1] [3]

    [1]Walsh RK, Endicott AA, Shinkai K. Diagnosis and Treatment of Rosacea Fulminans: A Comprehensive Review. Am J Clin Dermatol. 2017 Jun 27.

    [2]https://www.rosacea.org/weblog/acne-or-rosacea-diagnosis-key

    [3] Picardo M, Eichenfield LF, Tan J. Acne and Rosacea. Dermatol Ther (Heidelb). 2017 Jan;7(Suppl 1):43-52.

  • Your acne is not caused by dirt or oil on your skin. Washing does not prevent or improve your acne. In fact, washing your skin too much can aggravate existing acne and cause more acne to form. You should not use high heat such as a hot face-cloth compress, facials or saunas. These things can stimulate your gland activity which can cause ruptures underneath closed comedones (whiteheads). Harsh abrasive soaps can also inflame your acne. Ideally, you should wash your skin a maximum of twice a day with a mild non-perfumed soap. [1]

    [1] Turgeon EW. Adolescent Skin: How to Keep it Healthy. Can Fam Physician. 1986 Nov;32:2427-33.

  • You should treat your acne first with Noacnin and then focus on an anti-aging regime. As you
    get older you may find that you have adult acne, more dark spots and aging skin. This is
    common and is often caused by sun damage, stress and improper skin care. Make sure you
    you use a gentle cleaner and a moisturizer to help you skin looking young and healthy. It is
    important to wear sunscreen every day to help prevent damage from UV rays.[1] [2]
    [1] https://www.aad.org/public/diseases/acne-and-rosacea/adult-acne
    [2] http://www.skintherapyletter.com/2017/22.3/2.html

  • Adult acne is the same type of acne that you may have experienced during your teenage years.
    It is extremely common for acne to occur in adulthood. [1]
    [1]https://www.aad.org/public/diseases/acne-and-rosacea/adult-acne

  • Acne is most prevalent in teenagers and young adults. For the majority of people their acne will
    go away or improve in their thirties. However, for some people their acne persists into their
    forties and even fifties. [1]
    [1] Ramos-e-Silva M, Ramos-e-Silva S, Carneiro S. Acne in women. Br J Dermatol. 2015 Jul;172 Suppl 1:20-6.

ACNE, HEALTH AND LIFESTYLE CONCERNS

  • Unfortunately, makeup can make your facial acne; blackheads, whiteheads, pimples and inflammation worse. If you are an adolescent female and frequently use cosmetics your acne can become more severe. [1] Makeup can clog your skins pores and this can lead to more breakouts. You should not use excess concealers or powders if your skin is acne prone.

    [1] Perera MPN, Peiris WMDM, Pathmanathan D, Mallawaarachchi S, Karunathilake IM., Relationship between acne vulgaris and cosmetic usage in Sri Lankan urban adolescent females. J Cosmet Dermatol. 2017 Sep 22.

  • The short answer is yes. Authors of a study found that the following food can make your acne worse: chocolate, bread, green tea, milk, white sugar, ripe banana, ice cream, apple, orange, and red meat consumption. [1]

    If you have moderate acne, plant-based foods and supplements may be a good alternative to treatments like antibiotics. [2] A study published in 2002 in Archives of Dermatology shows evidence that specific foods can cause breakouts. Authors of the study say that acne is primarily a “Western” disease. They studied people who ate a diet of fresh plant foods and lean meat and found that these people had no acne. [3]

    [1] Karadağ AS, et al. The effect of personal, familial, and environmental characteristics on acne vulgaris: a prospective, multicenter, case controlled study from Turkey. G Ital Dermatol Venereol. 2017 Jul 11.

    [2] Clark AK, Haas KN, Sivamani RK,. Edible Plants and Their Influence on the Gut Microbiome and Acne.Int J Mol Sci. 2017 May 17;18(5).

    [3] Thiboutot DM, Strauss JS. Diet and acne revisited. Arch Dermatol. 2002 Dec;138(12):1591-2.

  • Studies have provided evidence that your acne symptoms might be worse if you live in a place that has high air pollution. [1]

    [1] Krutmann J et al. Pollution and acne: is there a link? Clin Cosmet Investig Dermatol. 2017 May 19;10:199-204

  • Lack of sleep can and will make your acne worse. Getting enough rest and sleep is important if you want to keep your skin clear. [1] The right amount of sleep is crucial. Sleeping too much is also not good. A healthy amount of sleep will help you to ward off those unwanted bumps. A study published in 2015 in the journal Acta Dermato Venereologica showed that if you are tired when you wake up you will be more likely to have acne breakouts. [2]

    [1] Roberts J, Ludford J. Skin conditions of youths. Vital Health Stat 11. 1976 Aug;(157):1-66.

    [2] Misery L. Consequences of acne on stress, fatigue, sleep disorders and sexual activity: a population-based study. Acta Derm Venereol. 2015 Apr;95(4):485-8.

  • Exercise can have both a positive and negative effect on your acne. Apple A. Bodemer, MD, UW Health dermatologist says that physical activity can help control blood sugar levels in your body. These blood sugar levels help to deal with acne. “Blood sugar surges cause your insulin to go up and when your insulin is up, it increases androgens which are the hormones that act on the oil glands,” she explains. [1] The oil glands then produce too much oil and this can result in pimples and acne. Exercise can also reduce stress which can have a positive effect on your acne.

    Your acne can breakout, however, if you wear makeup during exercise. Dr. Lisa Airan explains that “If you are wearing makeup at the gym it can get trapped under oil and dirt and cause pimples and cysts”.[2] You should take off your makeup and wash your face before you work out. If your skin is unclean before you exercise you are likely to push the dirt into your skin when you wipe away sweat. You run the risk of pushing all the makeup, dead cells, dirt, debris and oil into your pores if you do not wash your skin before a workout. This is what causes an outbreak of acne. The sweat itself is just water and salt and should not cause acne outbreaks. [2]

    [1] http://www.uwhealth.org/health-wellness/exercise-and-acne-how-to-balance-the-breakouts/49025

    [2] https://www.acne.com/types-of-acne/adult-acne/exercise-cause-acne-shouldnt-wear-makeup-gym/

  • If you are a teenage girl you may be able to prevent or improve your acne by watching your diet and your weight.

    A Norwegian study found that overweight or obese adolescent girls were two times as likely to have moderate to severe acne. Boys are not more likely to have moderate or severe acne if they are overweight, according to this study. [1] Another study published in The Archives of Dermatology also found that if you are overweight you are more likely to get acne. Overweight teenage girls were again seen to be more likely to develop acne than overweight boys. [2]

    [1] Seleit I, Bakry OA, Abdou AG, Hashim A. Body mass index, selected dietary factors, and acne severity: are they related to in situ expression of insulin-like growth factor-1? Anal Quant Cytopathol Histpathol. 2014 Oct;36(5):267-78.

    [2]https://well.blogs.nytimes.com/2012/01/23/really-the-claim-excess-weight-raises-the-risk-of-acne/

  • The short answer is yes. It is a well-accepted fact that both smoking and alcohol can damage your immune system. A poor immune system doesn’t have the strength to fight against the bacterial infections that cause acne. So if you smoke you may find you have more acne and pimples. If you consume alcohol in excess you may also experience more breakouts. [1] [2] If you do have acne, it’s best to try to avoid smoking and drinking. Marijuana can also lead to acne breakouts. Renowned dermatologist Dr. Amy Wechsler says, “marijuana has been linked to an increase in testosterone, which may lead to acne”. [3]

    [1]Kazakevich N1, Moody MN, Landau JM, Goldberg LH.Alcohol and skin disorders: with a focus on psoriasis. Skin Therapy Lett. 2011 Apr;16(4):5-6.

    [2] Schäfer T, Nienhaus A, Vieluf D, Berger J, Ring J. Epidemiology of acne in the general population: the risk of smoking. Br J Dermatol. 2001 Jul;145(1):100-4.

    [3]https://www.teenvogue.com/story/why-smoking-bad-for-skin

  • You may feel hesitant to put sunscreen on your face when you are having a good skin day. After a day in the sun your skin may look clear and pimple free. However, in general UV exposure is terrible for acne. Staying too long in the sun will lead to skin damage and irritate the skin. When your skin is irritated and dry it can react by producing acne. Your pores become blocked when the dry skin over produces oil in response to the skins dryness. Also, the inflammation from sunburn can make acne worse. [1] Some sunscreens may cause acne so it is important to buy the right one. A study showed that the best options for young, oily, acne-prone skin tend to have a water or light liquid base. [2] Dr. Elizabeth Tanzi, co-director of the Washington Institute of Dermatologic Laser Surgery in Washington, DC says that if you have acne prone skin look for “noncomedogenic” on the sunscreen label. This means that it will be less likely to clog the pores of your skin. [3]

    [1]Allen HB, LoPresti PJ. Acne vulgaris aggravated by sunlight. Cutis. 1980 Sep;26(3):254-6.

    [2] Goodman G. Cleansing and moisturizing in acne patients. Am J Clin Dermatol. 2009;10 Suppl 1:1-6.

    [3] http://stylecaster.com/beauty/acne-and-sunscreen/#ixzz4v6VHelBw

  • Marina Peredo, MD, dermatologist and associate clinical professor of dermatology at Mount Sinai Hospital in New York says “When a patient walks in with breakouts on their hairline, upper forehead, jaw, or sideburn area, my first question is, ‘What hair products are you using?'” [1] “Pomade acne” is a breakout caused by your haircare products. Conditioners, shampoos, gel and hair spray all fall under this category. The oils for the products can be absorbed by your skin. Acne-causing bacteria can get trapped in your pores. The acne usually appears around your hairline.

    [1] http://www.refinery29.com/hair-products-skin-break-outs

  • You may want to think twice before you buy your next chocolate bar. A 2016 study found that eating chocolate can make your acne worse. The study compared a group of student who ate chocolate to a group of students who ate jelly beans. They found that the chocolate eating group had more facial acne lesions after eating chocolate instead of jelly beans. [1]

    [1] Delost GR, Delost ME, Lloyd J. The impact of chocolate consumption on acne vulgaris in college students: a randomized crossover study. J Am Acad Dermatol. 2016;75(1):220–221.

  • If you suddenly experience an outbreak of acne, or if you are at an unusual age for the onset of acne you may be experiencing side effects of a medication. Certain medications such as Corticosteroids, anabolic steroids, testosterone, halogens, isoniazid, lithium, and some new anticancer agents are linked to acne. [1] If you are experiencing side effects please see your doctor.

    [1] Kazandjieva J, Tsankov N. Drug-induced acne. Clin Dermatol. 2017 Mar – Apr;35(2):156-162. doi: 10.1016/j.clindermatol.2016.10.007. Epub 2016 Oct 27.

  • If your acne is extremely severe and is not improving with treatment, it is time to see a
    dermatologist.[1]
    [1] https://www.webmd.com/skin-problems-and-treatments/acne/teen-acne-when-see-doctor

  • You can try exercising. Exercising increases blood flow, which promotes skin health.
    Furthermore, exercise has been proven to help reduce stress levels. High stress can have a
    bad effect on your complexion and cause your acne to flair up. You may also like to try yoga as
    a form of exercise. Yoga is great for alleviating stress and keeping your skin looking young. [1]
    [1] https://www.webmd.com/skin-problems-and-treatments/acne/features/lifestyle#1

  • You can avoid the following:
    • hair styling gels and leave-in conditioners
    • rub sweat off your skin when you are exercising
    • share makeup or sleep in your makeup
    • try a new acne treatment ever week
    • avoid the temptation to touch and pick acne spots. [1]
    [1] https://www.aad.org/public/diseases/acne-and-rosacea/skin-care-habits-that-worsen-acne

  • Getting a facial is very luxurious and relaxing. If you suffer from blackheads on the nose and
    across the forehead you may benefit from a facial. Also, if you have the occasional spot on the
    cheeks or chin, then a facial may work well. However, a facial may leave you with irritated skin,
    especially if your skin is sensitive. Find out first if your skin type is suited to a facial before you
    book yourself an appointment.[1]
    [1] http://www.thedermreview.com/do-facials-help-acne/

  • You may be able to reduce the presence of a blemish in one day. However, acne is a complex
    skin condition that can be managed and contained with Noacnin over time. [1]
    [1]https://www.webmd.com/skin-problems-and-treatments/acne/features/acne-treatment-mistakes#1

  • Actually, the opposite is true. Keeping your skin hydrated is critical for healthy looking skin. No
    matter how old you are or what type of skin you have you need to make sure your skin is well
    moisturized. [1]
    [1]https://www.aad.org/public/diseases/acne-and-rosacea/moisturizer

  • Anything that touches or rubs against the skin can contribute to pore-clogging, which can result
    in more acne. Try to avoid wearing tight apparel, such as headbands, caps, and scarves, or
    wash them regularly if used. If acne is on the back, shoulders, or chest, try wearing loose
    clothing. Also, try to avoid touching your face as much as possible. [1]
    [1] https://www.medicalnewstoday.com/articles/107146.php

  • No, acne is not contagious. Although acne is caused by a bacteria, it cannot spread like other
    bacterial infections. Factors aside from bacteria play a role in the formation of acne, including
    stress, sun exposure, lack of proper hygiene, hormones, genetics and diet . Therefore, it cannot
    be contracted from a friend or boyfriend. [1]
    [1] Guy F Webster, Acne vulgaris BMJ. 2002 Aug 31; 325(7362): 475–479.
    [1] Arora MK, Seth S, Dayal S. The relationship of lipid profile and menstrual cycle with acne vulgaris.
    Clin Biochem. 2010;43(18):1415-20.

ACNE AND EMOTIONAL HEALTH

  • Acne can negatively affect your quality of life. It may cause you to feel differently about yourself. You may find it hard to connect with loved ones. You may also have social problems as a result of your acne. [1] You may feel depressed and sometimes have suicidal thoughts. If this is the case please see your doctor.

    A study published in 2016 in the Indian Journal of Dermatology found that acne in adolescents can add to the emotional and psychological challenges that this age group experiences. It you are an adolescent with acne you may find you have a poor body image. You may also feel embarrassed, self-conscious and have a lack of self-confidence. [2] Your acne scars can also lead to low self-esteem and poor psychological well-being. [3]

    [1] Chilicka K, Maj J, Panaszek B. General quality of life of patients with acne vulgaris before and after performing selected cosmetological treatments. Patient Prefer Adherence. 2017 Aug 4;11:1357-1361.

    [2] Hazarika N, Archana M. The Psychosocial Impact of Acne Vulgaris. Indian J Dermatol. 2016 Sep-Oct;61(5):515-20.

    [3] Pavlidis AI, Katsambas AD. Therapeutic approaches to reducing atrophic acne scarring. Clin Dermatol. 2017 Mar – Apr;35(2):190-194.

  • Yes. A 2017 study found that psychological stress can trigger your acne. [1] In addition, a 2003 Stanford University study published in the Archives of Dermatology found that college student’s acne became worse during exam periods. This is a period in which the students said they experienced more stress, than non-testing times. The researchers concluded that acne becomes worse when stress levels increase. [2]

    [1] Karadağ AS, et al. The effect of personal, familial, and environmental characteristics on acne vulgaris: a prospective, multicenter, case controlled study from Turkey. G Ital Dermatol Venereol. 2017 Jul 11.

    [2] Chiu A, Chon SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol. 2003 Jul;139(7):897-900.

  • Studies have show that around the time of your period your immune system tends not to work
    as efficiently as usual. When your immune system is down acne can result. [1] [2]
    [1] Wira CR, Rodriquez-Garcia M, Patel MV. The role of sex hormones in immune protection of the
    female reproductive tract. Nat Rev Immunol. 2015;15(4):217-30.
    [2] Polansky H, Javaherian A. 3-Econsystems: MicroRNAs, Receptors, and La tent Viruses: Some
    Insights Biology Can Gain from Economic Theory. Front Microbiol. 2016;7:369.