Acne is a common, long-term disorder affecting the hair follicle and sebaceous gland, in which there is expansion and blockage of the follicle and inflammation of the pore.
A whitehead forms when excess oil and dead skin cells build up and plug the opening of a pore. 3 Over time, as the buildup accumulates and oxidises, it turns black.
When bacteria become trapped within a pore that is blocked by an accumulation of excess oil and dead skin cells, it can multiply, leading to inflammation and the formation of a pimple. In cases where the inflammation penetrates deeper into the skin, it can give rise to a tender or painful nodule or cyst. Cysts are characterised by their softer texture and the presence of pus, while nodules feel harder to the touch.
Acne breakouts can lead to permanent scars when treated poorly for an extended period of time. More commonly, acne may leave dark marks seen as red, pink, purple, black or brown spots called post-inflammatory hyperpigmentation (PIH).
Depending on how dark the spot is, it can take more than a year to fade naturally. In order to speed up to recovery, there are treatments and chemical peels available to help your skin look fresh.
Read more information on acne scars here. and our guide on PIH here.
Over-the-counter or pharmacy-sold skincare products can help to manage acne through ingredients such as salicylic acid that help to unclog pores.
There are also pills available to help manage acne. Here are some available treatments.
While it is used sparingly, steroid injections may be recommended for a large, extremely painful and deep nodule. This can rapidly relieve the pain and size of the breakout within 3 days.
Through a blue and red light combination, LED phototherapy is an effective and safe treatment for mild to moderately severe acne vulgaris.
Laser therapies are a useful treatment modality and can enhance treatment response when used in conjunction with topical and oral treatments7. Specifically, the picosecond laser is highly recommended for people unable to follow an oral or topical medication regimen.8 Patients typically require multiple sessions to achieve the desired results, with future maintenance.
Yes, you may continue to use makeup but make sure to remove all makeup before going to bed with an oil-free makeup remover and a gentle cleanser. For optimal hygiene, clean your makeup brushes every week to prevent breakouts.
Findings from a few studies suggest that following a low-glycaemic diet (low sugar level) may reduce the severity of acne. Low-glycaemic foods include most fresh vegetables, some fresh fruits, beans and oats. An American study of 2,258 patients found that a low-glycaemic diet reduced acne, with 87% of patients saying they had less acne, and 91% saying they needed less acne medication.11
In another study, 47,355 adult women were surveyed about their dietary habits. It found that women who drank 2 or more glasses of skimmed milk a day were 44% more likely to have acne than others.12
More research is needed to confirm ongoing scientific theories regarding food-related worsening of acne. In our medical experience, food intolerances or specific dietary restrictions are also highly specific to each individual. Do note that what works for you may not work for someone else.
Dr Vicki Leong, MBBS (Melbourne), MRCP (UK), Postgrad Diploma in Clinical Dermatology (Cardiff)
Dr Sarah Teo, MBBChBAO (Ireland)