When you are an adolescent, you kind of expect to be blindsided by pimples. But what we didn’t sign up for is adult acne or breakouts. As if it wasn’t bad enough breaking out as an adolescent!

Acne Vulgaris is characterized by pimples, cysts and abscesses, which occur due to the pores in the skin becoming blocked which in turn traps oil, dead skin and bacteria in the hair follicles. When the skin is in a normal condition, the sebaceous glands which are attached to hair follicles secrete sebum which is an oily substance which travels up the hair follicle and onto the skin. If the hair follicle is blocked and the sebum can’t get out, a blackhead can form. A blackhead forms due to oxidation of oil which causes inflammation and an inrush of white blood cells. At the same time, bacteria which is normally present starts to break down the trapped sebum, which causes more inflammation due to the white blood cells trying to attack the bacteria. It then becomes a whitehead as pus enters the lesion.

What are the different types of Acne Vulgaris lesions?

Blackheads – a lot of people panic when they see a blackhead on their skin because they think their pores are clogged with dirt. Blackheads don’t mean your pores are dirty, it means that the open hair follicle is congested with sebum, dead cells and bacteria which turn black due to oxidation.

Whiteheads – this stage forms after the formation of blackheads, skin cells and oil completely obstruct the opening of a hair follicle and pus is present.

Nodules – these are solid, inflamed lesions that reach deep into the skin, which can cause
tissue damage and scarring if not treated.

Papules – these are basically whiteheads which have become inflamed and can also be red and swollen.

Cysts – are sac-like lesions containing white blood cells, bacteria and dead skin cells within a liquid. They are known for becoming inflamed and painful and can result in scarring.

Pustules – this is a whitehead which has become inflamed and filled with pus, once they rupture into the skin they form pustular heads.

What causes Acne Vulgaris?

Acne Vulgaris is predominantly caused by genetics but environmental factors also play a role. During puberty, the formation of Acne Vulgaris is definitely apparent due to hormones. There is a spike in the formation of male hormones (present in both males and females), causing the sebaceous glands to enlarge and produce more sebum. Extreme washing or exfoliation of the skin, can worsen acne due to it causing an overproduction of sebum. Any overly oily skincare product can add to the oiliness of the skin and block the pores causing congestion.

How do I treat Acne Vulgaris?

Most individuals who develop mild to moderate Acne Vulgaris choose to treat themselves by using over the counter products which are either topicals or oral. More severe Acne Vulgaris should be treated with more of a professional approach from a Doctor or Dermatologist.

The most commonly used over the counter ingredients are benzoyl peroxide (which kills
bacteria), salicylic acid (encourages the desquamation of cells), alpha hydroxy acid ( AHA’s, encourages the desquamation of cells), sulfur (which breaks down blackheads and whiteheads),
azelaic acid (an antibacterial and anti-inflammatory agent), retinoids (suppressing sebum production, desquamating and antiaging), antioxidants (to fight free radical damage), and antibiotics. Any topical products used need to be applied to the skin accordingly for 4-6 weeks minimum in order to see results.

Another industry favourite are topical retinoids, which are either naturally occurring or synthetically produced. Mild Acne Vulgaris responds well to tretinoin, which reduces clogged pores and works on the oil glands.

Then comes the oral medications. Personally, I think there is definitely a time and place for oral medications but I would only recommend these in extreme cases when everything else has been tried. There are a massive amount of side effects with the more potent oral medications and some can be long-lasting and in some cases even permanent.

My favourite way to treat Acne Vulgaris orally is as natural as possible by using supplementation. This can help reduce inflammation, infection and reduce lesions. There are a bunch of supplements that can be used for the treatment of Acne Vulgaris, but I am just going to focus on my favourites.

Zinc – This mineral is a triple threat, it reduces inflammation, kills the acne bacteria (Propionibacterium acnes) and alters the skins environment to optimally fight against the bacteria. It has also shown to help reduce the secretion of sebum.

Niacinamide – Helps build cells in the skin, helps to fight against environmental stresses, helps with the barrier function of the skin, could minimize the pore size over an extended period of time, anti-inflammatory and helps in the reduction of acne lesions.

Essential Fatty Acids – These help with the reduction of inflammation and are known as either omega 3 or 6.

Probiotics – Probiotics is a term given to a group of microorganisms in the form of bacteria or yeast. Your body has its own probiotics which are found in the digestive system known as your gut flora. Over time, with many internal and external factors involved, the healthy bacteria in your gut can become depleted. When this occurs, your body struggles to absorb nutrients, fight off infection and just generally keep the body healthy. Taking a probiotic daily also helps to reduce the inflammation in the gut which will, in turn, reduce the inflammation of Acne Vulgaris. My take on it is, if your gut is happy everything else is happy.

I only want to use natural products!

One of the most frequent questions I receive is “I want to use natural products, will they work?”.
The answer is Yes, the fine print is that it takes time. Most people who struggle with Acne Vulgaris or just breakouts, in general, want instant gratification. Natural products rarely give off that effect, it’s a slow process. They are a great way to treat the skin as well as not breaking the bank. But if you want quick results cosmeceuticals are the way to go along with medical-grade products. Another thing to consider before deciding to go natural or medical is the severity of the acne lesions. If your condition is moderate to severe you need to treat that as quickly as possible with the help of professionals, if not you can cause some serious damage to the skin e.g scarring.

Vitamins A, C, and E assist in repairing damaged tissue and help fight free-radical damage. Creams that contain chamomile, tea tree and geranium extract help to reduce inflammation and infection. Facial washes which contain fruit and vegetable extracts as well as herbal extracts like green tea assist in cleansing the pores. Tea tree oil is a natural wonder as it contains chemicals (terpenoids) which kill bacteria. Witch hazel and herbal extracts help to remove excess oil from the skin.

What facial treatments will help?

Microdermabrasion – This is a method of superficial resurfacing. Microdermabrasion helps to remove the excess dead skin cells off the surface of the skin by means of crystals. I wouldn’t recommend this treatment for active acne where there is a lot of inflammation and pustules. This is a great option for people who are struggling with breakouts, mild acne, excessive keratinization on the skin, sun damage, resurfacing, ageing and blemishes left behind after breakouts (post-inflammatory hyperpigmentation/ PIH).

Laser therapy and resurfacing – When most people hear the word ‘laser’ they think my face is going to be burnt off and I’m going to end up leaving this place looking like ‘burn victim barbie’. Wrong! Laser therapy is incredible, if done correctly by a professional. There are lasers which are able to treat acne by destroying the acne bacteria and by damaging the sebaceous glands, causing them to produce less oil.

Chemical peels – When I say the word ‘chemical’ your face turns white and you want to run away, because people have been led to believe that chemical peels are dangerous and will burn your face off. Ok look, I’m not going to lie, chemical peels can be intense and your face can burn off if you go to the wrong place. So, the moral of the story is to go to a reputable clinic, not some random back garden beauty salon. Chemical peels are amazing because there are so many different types to play with and they can target numerous concerns. They involve the application of relatively high concentrations of various types of acids to the skin in order to remove the top layers. Various strengths of chemical peels are available and usually range from mild to deep.

Alpha hydroxy acids (AHAs) – AHA’s disrupt comedone formation and the activity of acne bacteria in the skin. They also help to resurface the skin by removing the dead skin cells.

Well that was a mouthful, but at least now you know what Acne Vulgaris actually is, even though we are only scratching the surface here.