Jano, Pehchano Aur Sudharo: Here’s your Expert Guide on Dealing with Acne

Remember standing in front of the mirror, frustrated with those pesky pimples popping up on the face? You might think it was just the teenage years spent trying to hide acne, praying for smooth, clear skin in adulthood. News flash; acne may crop up during one’s later years too. So this time, as it’s Acne Awareness Month, let’s get rid of them for good. 

Local Samosa talked to Dr. Dinyar Workingboxwalla, Celebrity Aesthetician and Co-founder of Beauty by BiE, and Dr. Smriti Naswa Singh, Consultant Dermatologist & Cosmetic Dermatologist at Fortis Hospital in Mulund. Here are their expert tips, tricks, and more to get rid of acne the right way.

What Exactly is Acne?

Like you, we were also curious about which bumps are pimples and what causes acne. Dr. Workingboxwalla said, “Acne is a common skin condition where your pores get clogged. Imagine tiny tunnels in your skin - hair follicles. These follicles have oil glands that keep your skin lubricated. But sometimes, dead skin cells and excess oil team up to form a plug, blocking the follicle. This blockage creates the perfect environment for bacteria to grow, leading to those pesky pimples, whiteheads, and blackheads.”

“Acne or pimples occur when pores get blocked by dead skin cells, oil released by the sebaceous glands, and bacteria. This leads to red bumps caused by the inflammation of the walls of the ducts of the sebaceous glands, which are present on your face, chest, back, and arms,” shared Dr. Singh.

Yes, we are as grossed out as you are. But we must soldier on to know what causes acne. Dr. Singh mentioned, “Acne happens due to puberty as a normal adolescence phenomenon. It can happen in some hormonal imbalance conditions like polycystic ovaries or adult acne post 30 years; due to some drugs like progesterone pills, steroids, anti TB treatment.” And yes, acne can happen on the body due to dandruff. Who knew!

Dr. Workingboxwalla shared a list to uncomplicate the causes of acne.

• Hormonal Fluctuations: Hormones, particularly androgens, can increase sebum production, making the skin more prone to breakouts. This is often seen during puberty, menstruation, or periods of high stress.

• Genetics: Your family history plays a significant role. If your parents had acne, you are more likely to develop it as well.

• Diet: While the relationship between diet and acne is still being studied, high-glycemic foods and dairy products have been linked to worsening acne in some individuals.

• Skincare Products: Not all skincare products are created equal. Comedogenic ingredients can block pores, exacerbating acne. 

• Stress: High-stress levels can trigger hormonal changes and inflammation, leading to breakouts.

How to Know if it’s Actually Acne?

There are times when your skin throws you a curveball and out pops something you possibly can’t identify. Is it a heat boil? Is it a razor bump? It’s best to ask the experts and settle this once and for all.

Dr. Workingboxwalla said, “While acne is a common concern, sometimes breakouts can mimic other skin conditions.”

Here are some pointers he shared to help tell the difference:

• Appearance: Acne typically presents as a mix of whiteheads, blackheads, pimples, and possibly cysts. Whiteheads and blackheads are non-inflammatory, whereas pimples and cysts are red, swollen, and can be painful.

• Location: Commonly affected areas include the face, chest, back, and shoulders. These regions have higher concentrations of sebaceous glands, which can become clogged and inflamed.

• Consistency: Acne breakouts are recurrent and tend to follow a pattern, often flaring up during hormonal changes like puberty, menstrual cycles, or periods of high stress.

• Duration: Acne is persistent and can last for weeks, months, or even years without proper treatment. If your skin condition is fleeting or resolves quickly, it might be a different issue such as an allergic reaction or rash.

• Triggers: Note if your skin issues worsen with certain foods, stress levels, or specific skincare products. Acne is often influenced by these external factors.

• Sensitivity: Acne blemishes can be tender or inflamed, but some conditions might cause itchiness, burning, or extreme dryness.

Dr. Singh explained it very well. She said, “Grade 1 acne are white and black heads. Grade 2 acne looks like red bumps on the skin of the face like the cheeks and t-zone, neck, chest, back, shoulders and arms. Grade 3 acne are pustular acne, in which you will start seeing small pustules or bumps containing pus on your skin. If this progresses further and the inflammation goes deeper, you will notice nodular acne, which spreads deep beneath the surface of the skin and sometimes becomes a cyst or an abscess. This is called grade 4 acne.”

Remember, if you're unsure about a breakout, it's always best to consult a dermatologist for a proper diagnosis. They can rule out other possibilities and recommend the most effective treatment plan.

Teenage Acne, PCOS Acne, Pregnancy Acne

If you get a pimple right before you get your period and have always wondered about this phenomenon, then Dr. Singh has the answer for you. “Premenstrual flare-ups occur on the upper part of the face and usually settle on their own if the person has good dietary habits and no other hormonal problems.”

She said that acne during teenage years, also known as acne vulgaris, commonly appears on the cheeks, nose, chin, and forehead, which is called the T-zone. But these lesions are not painful. Then there’s acne caused by PCOS and hormonal changes. These typically occur before periods, commonly on the lower side of the face and along the jawline; they can also appear on the neck area. About acne during pregnancy, she mentioned, “It  occurs due to progesterone, especially if you have been given progesterone to sustain the pregnancy, and you might find acne on the face, chest, back, hands, and arms.”

Dr. Workingboxwalla shared a detailed explanation to help differentiate between the varied types of acne.

• Teenage Acne: Teenage acne, also known as adolescent acne, typically arises during puberty due to hormonal changes. Increased androgen levels stimulate the sebaceous glands, leading to excess oil production and subsequent clogged pores. This type of acne commonly appears on the face, chest, and back, and is characterised by whiteheads, blackheads, and inflamed pimples. It often resolves as hormone levels stabilise with age.

• PCOS Acne: Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that can cause various symptoms, including acne. PCOS acne tends to be more persistent and severe, often affecting adult women. It's driven by hormonal imbalances, particularly elevated androgens, leading to increased sebum production and acne flare-ups, typically along the jawline and chin. Treating PCOS acne often requires a multifaceted approach addressing hormonal regulation alongside skincare.

• Pregnancy Acne: Pregnancy acne occurs due to hormonal fluctuations during pregnancy, particularly increased levels of progesterone. While some women experience clearer skin during pregnancy, others may develop acne or see a worsening of existing acne. Pregnancy acne can resemble teenage acne or adult hormonal acne, often appearing on the face, chest, and back. Treatment options during pregnancy are limited due to potential risks to the developing baby, so it's essential to consult with a healthcare provider for safe skincare options. 

• Regular Acne: Regular acne, often termed as adult acne, can occur at any age and is not necessarily tied to hormonal fluctuations. It can result from a combination of factors, including genetics, stress, diet, and skincare habits. Regular acne typically manifests as a mix of whiteheads, blackheads, and inflamed pimples, commonly appearing on the face, chest, and back. Treatment may involve topical or oral medications, along with lifestyle modifications and proper skincare.

Dealing with Acne, What Works?

Dedicated skincare ingredients can target acne and help you get rid of it. Dr. Workingboxwalla shared a list of ingredients that you should include in your skincare routine for an acne-free experience.

• Salicylic Acid: This beta hydroxy acid (BHA) is highly effective for acne-prone skin. It exfoliates the skin, unclogs pores, and reduces inflammation. Look for concentrations between 0.5% to 2%.

• Benzoyl Peroxide: An antibacterial agent that kills acne-causing bacteria and reduces excess oil production. It's available in concentrations ranging from 2.5% to 10% in various formulations.

• Glycolic Acid: An alpha hydroxy acid (AHA) that exfoliates the skin, helps to remove dead skin cells, and prevents clogged pores. It also improves overall skin texture and tone.

• Niacinamide (Vitamin B3): This versatile ingredient helps to regulate sebum production, reduce inflammation, and improve the skin's barrier function. It's well-tolerated and suitable for all skin types.

• Retinoids (Retin-A): This vitamin A derivative is effective for treating acne by unclogging pores and accelerating cell turnover. It can also help with post-acne marks and texture improvement.

• Tea Tree Oil: Known for its antibacterial and anti-inflammatory properties, tea tree oil can help reduce acne lesions and inflammation. It should be used in diluted form to avoid irritation.

• Hyaluronic Acid: While not directly preventing acne, hyaluronic acid is excellent for hydrating the skin without clogging pores, which can help maintain skin balance and prevent overproduction of oil.

Dr. Singh reminded us to avoid oxybenzone and benzophenone in the sunscreen or mousse based make ups which can be comedogenic.

Body Acne; is that even Real?

Acne is not exclusive to the face. Pimples on the back, chest, thighs, bum and more are all body acne. And many suffer silently from it unaware of the causes and that there are solutions to it. 

Dr. Singh said, “Body acne occurs due to dandruff and active oil glands in the chest area, back, shoulders, and arms. It can also occur if someone is sweaty or actively participates in sports; friction between the skin and clothing can cause folliculitis, or inflammation of the hair follicles. Acne appears in places other than the face because of the presence of oil-secreting sebaceous glands on our arms, chest, back, and other areas.”

Dr. Workingboxwalla shared the underlying causes and mechanisms of body acne which are quite similar to facial acne:

• Hair Follicles and Sebaceous Glands: Just like the face, the body has numerous hair follicles and sebaceous glands that produce oil (sebum). When these glands become overactive or are influenced by hormonal changes, excess oil can mix with dead skin cells and clog pores.

• Bacteria: Propionibacterium acnes (P. acnes), a type of bacteria that lives on the skin, can multiply and contribute to inflammation when pores become clogged.

• Hormonal Changes: Hormonal fluctuations, such as those during puberty, menstruation, pregnancy, or stress, can increase sebum production, making the skin more prone to acne.

• Friction and Irritation: Tight clothing, sweat, and friction can contribute to clogged pores and inflammation, especially in areas where skin rubs against clothing or gear.

• Skincare Products: Using heavy or comedogenic (pore-clogging) body care products or not rinsing off after exercising can contribute to body acne.

Acne, Bye Bye!

Now that we all know the causes, types and features of acne, it’s time to get rid of it for good. Dr. Workingboxwalla gave us a list of some necessary products that would work on acne-prone skin.

• For cleansers, I recommend using a gentle, non-comedogenic cleanser that effectively removes excess oil and impurities without stripping the skin of its natural moisture barrier. Look for ingredients like salicylic acid or glycolic acid, which help to unclog pores and exfoliate gently.

• Next, for treatment products, try incorporating a targeted acne treatment containing ingredients like benzoyl peroxide or salicylic acid. These ingredients are effective at reducing acne-causing bacteria and preventing future breakouts. 

• Moisturising is crucial, even for acne-prone skin. Opt for a lightweight, oil-free moisturiser that provides hydration without clogging pores. Ingredients like hyaluronic acid and niacinamide are excellent choices as they hydrate and soothe the skin without causing breakouts.

• Sunscreen is non-negotiable. Choose a non-comedogenic, broad-spectrum sunscreen with SPF 30 or higher to protect your skin from UV damage without aggravating acne. Look for formulas that are labelled as "oil-free" or "non-greasy."

• Finally, consider incorporating a weekly exfoliating treatment with ingredients like alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) to help keep pores clear and prevent breakouts. This step is essential for maintaining smooth and healthy-looking skin.

Say Goodbye to Body Acne

But what about skincare products for acne that’s not on the face? Don’t worry, here’s everything you need to know about ridding yourself of back acne, according to Dr. Workingboxwalla.

• Body Wash with Salicylic Acid: Look for a body wash formulated with salicylic acid (typically around 2%). Salicylic acid helps to exfoliate the skin, unclog pores, and reduce inflammation. Use it daily in the shower to target acne on the back, chest, and shoulders.

• Benzoyl Peroxide Spot Treatment: For stubborn acne spots on the body, consider a benzoyl peroxide spot treatment. Benzoyl peroxide is effective against acne-causing bacteria and can be applied directly to the affected areas after cleansing.

• Exfoliating Body Scrub: Use a gentle exfoliating body scrub once or twice a week to help remove dead skin cells and prevent pores from becoming clogged. Look for scrubs with ingredients like glycolic acid or lactic acid.

• Oil-Free Body Moisturiser: Choose an oil-free, non-comedogenic body moisturiser to keep your skin hydrated without clogging pores. Look for ingredients like hyaluronic acid, which hydrates the skin without adding oil.

• Body Sunscreen: Don't forget to protect your skin from UV rays. Choose a non-comedogenic, oil-free sunscreen with SPF 30 or higher to prevent sun damage without aggravating acne.

Local Samosa Recommendations

Here are some skincare products that Local Samosa found in line with the expert advice;

1. Minimalist Salicylic Acid + LHA 2% Cleanser

This is a daily, gentle exfoliating, acne-fighting face cleanser. It claims to combine BHA + LHA (Salicylic Acid + Capryloyl Salicylic Acid) in 2% concentration, to provide deep cleansing, pore decongestion and sebum reduction without drying out the skin.

2. BeBodywise 2.5% Benzoyl Peroxide Facewash

This creamy-non foaming facewash promises to be non-drying, unlike other Benzoyl peroxide treatments.

3. Pilgrim Advanced Anti-Acne Kit

This includes Volcanic Lava Ash Face Wash, Skin Clarifying Serum, and Anti-Acne Serum.

4. Deconstruct Salicylic Acid Body Wash

It is a daily gentle, paraben and SLS-free, exfoliating, acne-fighting body wash. It claims to treat body acne, deep cleanse, remove dead skin cells, unclog pores and reduce sebum production without drying out, and smooth rough and bumpy skin.

5. CLARINS Exfoliating Body Scrub

This bamboo powder-infused scrub promises to 'rub away' rough, flaky surface cells and impurities, giving skin a sleek new start.

Avoid these Skincare Mistakes that Lead to Acne

While we've discussed some great ingredients and routines, let's talk about what NOT to do and keep acne at bay. Dr. Workingboxwalla has it all listed down for us.

Mistake 1: Over-Cleansing or Scrubbing: Harsh scrubbing and frequent cleansing can strip your skin's natural oils, leading to irritation and even increased oil production to compensate. 

The Fix: Cleanse your face twice daily with a gentle cleanser suitable for your skin type.

Mistake 2: Skipping Moisturiser: Even acne-prone skin needs hydration! Skipping moisturiser can make your skin dry and dehydrated, which can worsen breakouts. 

The Fix: Use a lightweight, oil-free moisturiser to keep your skin hydrated without clogging pores. 

Mistake 3: Picking at Your Pimples: It's tempting, but picking can worsen inflammation, lead to scarring, and spread bacteria. 

The Fix: Resist the urge! Use spot treatments to target blemishes and let them heal on their own.

Mistake 4: Harsh Chemical Exfoliants: Harsh scrubs or irritating ingredients can damage your skin barrier and worsen breakouts.

The Fix: Opt for gentle exfoliation with AHAs or BHAs (salicylic acid) a few times a week to remove dead skin cells without irritation.

Mistake 5: Not Using Sunscreen: Sun exposure can worsen acne and lead to hyperpigmentation after breakouts heal. 

The Fix: Apply a broad-spectrum, non-comedogenic sunscreen with SPF 30 or higher every day, even on cloudy days. BiE offers several sunscreens that suit acne-prone skin!

Remember, consistency is key! Following a gentle skincare routine with the right products and avoiding these mistakes will go a long way in keeping your skin clear and healthy.

Acne that Still won’t Go Away?

For severe or persistent acne, it's crucial to take a targeted and comprehensive approach to treatment. For severe and persistent acne, it's crucial to identify the root cause. 

Dr. Singh said, “Typically, teenagers leading an active and healthy lifestyle don't have bothersome acne. However, if acne persists and is severe, there may be an underlying hormonal imbalance. In such cases, one should consult a dermatologist to determine the cause.”

Most experts agree that consuming junk food, processed packaged foods which are low in fibre, and high in sugar, salt, or dairy products can aggravate acne. “Another factor is sleeping patterns; staying up late disrupts the circadian rhythm and thyroid function, impacting ovarian hormones. Additionally, lack of physical activity contributes to fat accumulation around the abdominal area. The abdominal fat leads to an oestrogen excess state in the body and insulin resistance causing stubborn acne. Strength training exercises working on increasing lean muscle mass should be incorporated in the exercise regime besides cardio or walking. Therefore, incorporating healthy eating habits and strength training is important to help manage acne,” clarified Dr. Singh.

Here are some recommendations by Dr. Workingboxwalla:

Consult a Dermatologist

If your acne is severe or persistent, I strongly recommend consulting with a dermatologist. They can assess your skin condition and provide personalized recommendations, including prescription treatments if necessary.

Topical Treatments

• Retinoids: These vitamin A derivatives help to unclog pores, reduce inflammation, and promote cell turnover.

• Benzoyl Peroxide: An effective antibacterial agent that can help reduce acne-causing bacteria and inflammation.

• Topical Antibiotics: These can help reduce inflammation and kill bacteria on the skin's surface.

Professional Treatments

• Chemical Peels: These can help to exfoliate the skin and unclog pores.

Skincare Routine

• Gentle Cleanser: Use a mild, non-comedogenic cleanser twice daily.

• Treatment Products: Apply prescribed or over-the-counter treatments as directed by your dermatologist.

• Oil-Free Moisturizer: Keep your skin hydrated without clogging pores.

• Sunscreen: Protect your skin with a non-comedogenic, broad-spectrum sunscreen daily.

Lifestyle Changes

• Healthy Diet: Limit dairy and high-glycemic foods that can trigger acne.

• Stress Management: Practice stress-reducing techniques, as stress can exacerbate acne.

• Hygiene Practices: Keep your skin and hair clean to prevent excess oil and bacteria buildup.