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Acne Uncensored

by Raychel Agramon, RN, MPM, June 23, 2020

Acne Uncensored

Different Kinds of Acne and How to attack them

Acne comes in several shapes and sizes. They can range from barely noticeable whiteheads to the more severe nodules and cysts. Because of their different features, treatments and interventions may vary according to type and severity.

Types of Acne

There are 6 kinds of acne. While they mostly affect women, certain types occur more so in men. They include: 

  • Blackheads
  • These are small bumps that appear black or yellowish. This is due to the air-oxidized sebum that blocks the pores. 

  • Whiteheads
  • These are similar to blackheads, though they tend to be firmer. The contents tend to remain even after the pore is squeezed. In his interview, Dr. Joshua Zeichner explained that whiteheads occur because "Skin cells stick together inside your pores, blocking the opening.” 

  • Papules
  • These are small, red marks that may be sore, if not tender. According to Dr. Zeichner, this inflammatory acne is due to the “Growth of the bacteria P. acnes on the skin (that) promotes inflammation, causing acne bumps to become red and tender.” 

  • Pustules
  • These are similar to papules, though they have a defining white center. This type of inflammatory acne occurs due to the build-up of abscess or pus in the lesion.

  • Nodular 
  • This severe condition is characterized by big, hard pimples. These are usually located beneath the surface, and as such can be painful to the touch.

  • Cystic Acne
  • This severe type of acne is known for its large size and pus-filled lump. As such, cystic acne is often likened to the image of a boil. Should the cyst erupt, the infection can spread and cause more pimples. 

    Cystic acne brings about permanent marks. Complications include ice pick scarring, wider pores, and indentations on the skin. 

    Cystic acne commonly occurs in men. It also takes place in women, where the lower half of the face is usually affected. 

    Symptoms usually manifest during the teen years, to the early 20s. It runs in the family, so you are more likely to develop cystic acne if your parents have them as well. 

    Doctors are unsure of what causes this skin condition. Most blame the hormones, specifically androgen. According to research, it can bring several skin changes that can trigger cystic acne. 

    Apart from hormones, cystic acne may be caused by pregnancy, menstrual changes, and Polycystic Ovary Syndrome. The use of certain medications and skin products can trigger this problem as well. Tight clothing, sweating, and high humidity are also known to contribute to cystic acne. 






    Acne Severity

    Acne severity is graded according to three categories. You have mild acne if you mostly have whiteheads and blackheads, and just a few pustules and papules. 

    Acne is considered moderate if there are more pustules and papules that occur with blackheads and whiteheads. 

    A severe case of acne is characterized by big, painful papules and pustules. Nodules and cysts that cause scars may be apparent as well.

    Medications for Acne 

    As mentioned, treatment will depend on the type or severity of your acne. If you have mild acne – just a few whiteheads, blackheads, and spots, you may be prescribed with gels or creams that contain benzoyl peroxide. This works as an antiseptic, and as such can help fight the germs that cause acne. 

    If you have moderate or severe acne, you will require more intensive treatment. According to the National Health Services, your dermatologist may prescribe you with any (or a combination) of the following:

    • Topical Retinoids 

    This medication aims to exfoliate the skin. As a result, it can help remove the dead skin cells that may plug the pores. 

    The most commonly prescribed topical retinoids are Tretinoin and Adapalene. You need to apply your gel or cream to the affected areas, leaving them on for as much as 20 minutes. Results may be visible after 6 weeks of use.

    Topical retinoids are not given to pregnant women, as these medications can lead to birth defects in babies.

    • Oral or Topical Antibiotics

    Antibiotics help fight the bacteria that infect the pores. Topical antibiotics need to be applied for 6 to 8 weeks in total. After this period, usage should be stopped to prevent resistance to these medications. 

    Oral antibiotics, on the other hand, need to be taken for 4 to 6 months. It takes 6 weeks for results to be noticeable. Tetracyclines are commonly given. But since they can cause harm to an unborn baby, pregnant women are prescribed with Erythromycin instead. 

    • Azelaic Acid

    This treatment is usually prescribed in patients who find the side effects of benzoyl peroxide and topical retinoids worrisome. It can help exfoliate the skin and kill the microbes that cause acne.  

    • Combined Oral Contraceptive Pills (OCP)

    OCPs are given to women suffering from hormonal acne. This can occur during the menstrual cycle, or with Polycystic Ovarian Syndrome. This metabolic disorder causes pimples, infertility, body hair growth, and obesity, to name a few. 

    Alternative Therapies for Acne 

    The above-mentioned medications, while effective, usually have unpleasant side effects. As such, more and more people are looking for natural alternatives for acne treatment. Such is especially the case for cystic acne, which is a severe, scarring condition.

    In his interview with Allure, Dr. Joshua Zeichner recommends killing the bacteria that infect the cysts. While benzoyl peroxide is often used for this, it can have burning or stinging effects on the skin. If you dislike these after-effects, then you can try more natural alternatives. Probiotics or Grape Seed Extract supplements have antibacterial properties that may help fight acne-causing germs.  

    Swelling is another thing you need to address with cystic acne. As such, Dr. Zeichner advises 'icing' the affected areas in 10-minute intervals, three times an hour. "Ice-cold temperatures help constrict blood vessels, so wrap an ice cube in a paper towel and hold it against the bump to reduce redness and bring down the swelling a bit," he explained. 

    Apart from ice therapy, natural anti-inflammatory supplements may help mellow the swelling as well. According to the book “Remapping your Mind," herbs such as Burdock Root, Curcumin, and Bromelain may help combat skin inflammation. 

    Wrapping Up

    There are 6 types of acne, namely blackheads, whiteheads, pustules, papules, nodules, and cysts. Treatment depends on the severity of the breakout. For more severe conditions such as cystic acne, several medications may be prescribed.

    Due to the unpleasant side effects of certain acne medications, more people are gearing towards natural alternatives. After all, certain supplements can help fight the infection and swelling that commonly occur with cystic acne.