All You Need to Know About Acne

The bottom line: Anybody can get acne

Research estimates that acne is the eighth most common disease globally. With new medical advancements, acne treatment is becoming more sophisticated. Trust a dermatologist or, at times, an endocrinologist to give you a precise diagnosis of whether your acne is a symptom of any underlying condition and to safely and effectively treat it.

Frequently Asked Questions

1. What is acne?

Acne is a common skin condition caused by blocked pores, leading to spots, blemishes, or deeper inflammation on the face and body.

2. What causes acne?

It usually develops due to excess oil production, hormonal changes, bacteria, or a build-up of dead skin cells.

3. Does diet affect acne?

Certain foods may trigger breakouts for some people, but the impact of diet differs from person to person.

Acne is often seen as a teenage rite of passage, a sign of growing up and stepping into adulthood. But it can be incredibly pesky, especially when it sticks around. “I didn’t experience nearly as much acne in my teenage years as I did in my twenties,” says Erica M, a creative consultant who has had a long relationship with breakouts. “I made several mistakes and spent a lot of money self-diagnosing my acne by buying serums or ampoules, only to end up exacerbating the issue. Eventually, I visited a dermatologist who made me do some blood work and prescribed a no-nonsense skincare routine along with oral medication that helped clear out most of my acne. If only I had the wisdom to visit my doctor sooner than get swayed by social media.”

If this sounds familiar, you’re not alone. More and more brands and beauty influencers are convincing people that a 9-step regimen is the secret to ‘flawless’, ‘glass’ skin. Unreasonable beauty standards continue to pressure people to look a certain way. While parts of the internet now celebrate Photoshop-free and makeup-free beauty, it’s still important to consume online content with caution, especially when it concerns your health. And, yes, your skin is very often a reflection of your health.

What is acne?

Acne is a common skin condition that occurs when pores become blocked with oil, dead skin cells, or bacteria. It can present in many forms, from small clogged bumps to deeper, inflamed lesions, and may be influenced by hormones, genetics, lifestyle, or underlying medical conditions.

Not all acne is the same. It is often a result of pre-existing health conditions, such as PCOS, or other causes, including hormonal imbalances, lifestyle changes, stress levels, and more.

Types of acne

Acne can be classified based on how it forms within the pores and how much inflammation is involved. Understanding these categories helps explain why some breakouts are mild while others are more persistent.

• Non-inflammatory acne
  Caused by clogged pores that aren’t infected. This includes early-stage blockages where oil and dead skin build up without triggering redness or swelling.

• Inflammatory acne
  Occurs when bacteria enter blocked pores, leading to irritation beneath the skin’s surface. This category ranges from mild inflammation to deeper, more painful lesions.

• Hormonal acne
  Driven by fluctuations in hormones that increase oil production, often appearing around the jawline and chin and worsening at certain times of the month.

• Acne mechanica
  Triggered by friction, pressure or heat on the skin, commonly caused by sports equipment, tight clothing or repeated rubbing.

• Acne cosmetica
  Linked to the use of certain skincare or cosmetic products that block pores or disrupt the skin’s balance.

Pimples VS Acne: Are they the same?

While both the terms are often used interchangeably,there’s a key difference between the meaning of acne and pimples.

Acne, or acne vulgaris, is a skin condition that occurs when your pores become clogged. This clogging is caused by a combination of factors, including excess oil production, dead skin cells, bacteria, etc. According to Dr Sanjeev Gulati, M.D, Dermatology & Venereology, acne is an overall skin condition characterised by inflammation, clogged pores, and the formation of pimples. It is the umbrella term encompassing the entire issue.

On the other hand, pimples are one of the symptoms of acne. They are the visible bumps and blemishes that appear on your skin. So, every pimple is a sign of acne, but not everyone with a pimple has acne. A single pimple might occur occasionally due to other factors like hormonal changes or clogged pores without signifying an underlying acne condition.

What causes acne?

Acne is caused by a combination of various factors. Some of them include:

1. Sebaceous glands:

These tiny glands attached to the hair follicles produce sebum, an oily substance that hydrates your skin. However, hormonal changes or individual susceptibility can lead to excess sebum production, causing blockage.

2. Dead skin cells:

Usually, these cells shed naturally. But sometimes, they can clump together and stick within the pore, forming a plug.

3. Cutibacterium acnes (C. acnes):

This bacteria naturally lives on your skin. When pores are clogged, C. acnes can multiply rapidly, leading to inflammation and blemishes.

Dr Gulati explains that “Acne isn't contagious, so you can't "catch" it from someone else's skin. Instead, it's usually due to factors like hormones, genetics, what you eat, medications, and how you care for your skin. Also, things like wearing tight clothes or helmets, using harsh skincare products, or feeling stressed can all play a role.” He also says that sharing makeup, or makeup applicators and brushes, can transfer acne-causing bacteria, dead skin cells and oil to the other person’s skin.

4. Inflammation:

Emerging research suggests that inflammation plays a key role in the development of acne. When inflammation is combined with C. acnes, excess sebum, and dead skin cells, it sets the stage for acne to thrive.

Another factor that causes acne is stress. When you're stressed, your skin feels it, too. Dr Gulati says, “When stress hits, it disrupts our skin's endocrine signals, throwing everything off balance and causing increased inflammation and sebum production, which leads to breakouts.”

Where on my body will I have acne, and how common is it

Acne most commonly appears on the face, especially the forehead, nose, and chin, but it can also affect the chest, back, shoulders, and upper arms, where oil glands are more active. It develops when hair follicles become clogged with oil, dead skin cells, or bacteria, resulting in pimples, blackheads, or cysts. While acne is often associated with teenagers, it can affect people of all ages, with adults sometimes experiencing breakouts due to hormonal changes, stress, or other lifestyle factors. Its severity and location can vary from person to person.

Symptoms of acne

Acne is a common skin condition that occurs when hair follicles become clogged with oil, dead skin cells, or bacteria. It can vary in severity and often appears on the face, chest, back, and shoulders.

Common symptoms include:

• Whiteheads and blackheads: Small, clogged pores that appear as tiny bumps on the skin.
• Pimples (pustules): Red, inflamed spots with a visible white or yellow centre filled with pus.
• Papules: Tender, small red bumps without a pus head.
• Nodules: Large, painful, solid lumps beneath the skin’s surface.
• Cysts: Deep, pus-filled lumps that are often painful and can lead to scarring.
• Redness and inflammation: Surrounding the affected areas, causing discomfort or tenderness.
• Scarring or dark spots: Marks that may remain after severe acne heals, known as post-inflammatory hyperpigmentation.

Common triggers and foods to avoid

Acne can be influenced by various lifestyle factors, hormones, and dietary choices.

Common triggers and foods to avoid:

• High-glycaemic foods: Sugary snacks, white bread, and processed cereals can spike insulin levels, which may worsen acne.
• Dairy products: Milk, cheese, and other dairy items have been linked to increased acne in some individuals, possibly due to hormones present in milk.
• Fried and greasy foods: Excessive consumption of fast food or oily snacks may aggravate inflammation and breakouts.
• Chocolate: Particularly milk chocolate, as it may trigger hormonal responses linked to acne in some people.
• Refined carbohydrates: Foods like pastries, white rice, and pasta can contribute to insulin spikes, potentially exacerbating acne.
• Stress and lack of sleep: While not foods, stress and poor sleep can increase hormonal fluctuations that trigger acne.

Self-treating and popping pimples: A big no-no

Erica M shares, “I was a regular pimple-popper. I could not help myself; it was too tempting until I started to observe that I was getting a lot of scars. My dermatologist had to conduct a few sessions of anti-scar procedures to fade them. Now, when I get a pimple, I know to leave it alone.”

Dr Gulati advises against popping pimples or treating acne on your own. Self-treating acne may lead to scarring and hyperpigmentation or worsen the condition by spreading the infection to neighbouring tissue. Moreover, with the rise in information around active ingredients in skincare, it’s easier than ever to shop online for the next trending active. However, you may risk harming your skin barrier if used without caution. Not using adequate sunscreen may lead to hyperpigmentation.