Skin Solutions: All About Acne

When it comes to skin there are so many areas of concern – and new areas seem to “pop” up with every passing season of life. In younger years it’s often acne, but as we age we get more concerned about fine lines, wrinkles, pigmentation and texture…. and then sometimes even acne again.

Yes, adult acne is a thing. How cruel to be dealing with both acne and ageing at the same time!!

Today I’m sharing my space with my Skin Solutions guest author, Dr Tarryn Jacobs, a Pretoria based specialist dermatologist. Her clinical interests include complex medical dermatology, skin cancer (melanoma), and skin aging.

Today she is sharing her knowledge all about acne…

What is acne?

Acne is simply the medical name for “spots” or pimples. It is a disorder of the hair follicle and its associated sebaceous or oil gland. When this unit gets blocked it results in acne. Acne is caused by multiple factors including an abnormal shedding of skin cells where skin cells become sticky and blocks pores. There is also a role for bacterial colonisation with a bacteria called p.acnes as well as abnormal inflammation in the skin. Androgens or male sex hormones present in both males and females can contribute to acne by overstimulating the oil glands to produce more oil.

Why am I still getting acne in my adult years?

Adult acne can either occur in adolescence which persists into adulthood or it can be late-onset acne typically occurring for the first time after the age of 25 years. Fluctuating hormone levels play a large role and an imbalance can lead to breakouts. Women often experience fluctuating hormones around their periods, during pregnancy, peri-menopause and after discontinuing birth control pills. Additional causes can be related to stress, genetics, cosmetics and certain medications.

Can what I eat cause breakouts?

Newer research has looked at the possible link between certain foods. These studies show that a low glycemic diet may improve acne. In contrast, eating high glycemic index foods may lead to acne through effects on growth hormones and sex hormones.

There is also some evidence showing a possible link with dairy, particularly skim milk. It’s unclear what the mechanism behind this association is but growth factors and hormones in dairy may play a role. It’s important to note that diet shouldn’t be used as a single treatment but rather as a complement to acne treatment.

What treatments are available for acne scarring?

It’s important to first treat the acne effectively to prevent scarring before scarring treatment is started. Acne scars are generally depressed or elevated and treatment depends on the type. Options include microneedling (collagen induction therapy), fillers, lasers, subcisions (inserting a needle under the skin to break up fibrous scar tissue) and chemical peels.

Is there a treatment for the dark marks that are left from acne?

These dark spots are called post inflammatory hyperpigmentation . It is important to use sunscreen to prevent the spots from becoming darker from UV exposure. This usually resolves over time by itself but a dermatologist can prescribe a lightening agent cream to treat it more effectively.

What can I do about blackheads?

I commonly hear from patients who try to over scrub and over-cleanse their skin in the hope of getting rid of the “blocked dirt”. But blackheads are dark in colour due to the pigment called melanin that is contained in the skin sebum or oil. The melanin oxidises and then turns black. The appearance of blackheads can be minimised by using retinoid creams (Vitamin A ) or salicylic acid. In terms of in-office procedures, chemical peels can also be helpful.

Can I wear makeup when I have acne?

Absolutely! Cosmetic camouflage of acne is an important coping mechanism and can increase a person’s self-esteem. However, acne can also be caused by cosmetics and its important to use proper non-comedogenic products. Look for oil-free mineral-based cosmetics.

What products should I use for acne?

Firstly I would recommend avoiding rich and thick facial moisturisers and facial oils. Look for ingredients such as:

  • Salicylic acid
  • Benzoyl peroxide
  • Glycolic acid
  • Tea tree oil
  • Retinol
  • Niacinamide
  • Zinc

If you are not seeing an adequate response then consult with a doctor for medical treatment.

How do I treat acne when I’m pregnant?

Certain acne treatments have not been proven to be safe in pregnancy and breastfeeding. Do avoid ingredients such as retinoids, benzoyl peroxide and salicylic acid. Azelaic acid and glycolic acid is considered to be safe.

If you develop a huge pimple before an important event – what can be done?

There is nothing worse than this happening to you before a big event but the good news is that there is help available! Dermatologists can inject acne cysts with a small amount of a corticosteroid to help the lesion go down very quickly.


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Dr Tarryn Jacobs

Dr Tarryn Jacobs is a Pretoria based specialist Dermatologist practising at NoviSkin. Her clinical interests include complex medical dermatology, skin cancer (melanoma), and skin aging. Dr Jacobs is passionate about the education and promotion of skin health in her local and social media communities.

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