What is acne?

Acne is one of the worst and most common skin problems in the world.

Although acne is generally associated with teenagers and puberty, the fact is that you can get spots at any age. What can you do about them?

Excessive sebum production

Spots are the result of several factors within skin. Over-proliferation of a specific bacteria, Propionibacterium, (also known as Cutibacterium) within the pores triggers inflammation. The bacteria “feeds” on sebum, causing further inflammation and backing up the pore lining. The accumulation of dead skin cells on the skin’s surface and inside the pore prevents the sebum from being secreted freely from the skin, causing clogged pores, while the inflammation leads to acne spots.

Forms of acne

Acne can occur on various body parts, including the face, neck, chest, back, shoulders and arms. Although most people associate acne with typical teenagers’ spots, it comes in various forms:

• Comedones. With this type of acne, you mainly see comedones. Comedones are the non-infected version (or the initial stages) of spots. Closed comedones on the skin’s surface are small, white spots under the skin, also called whiteheads. If they are open, oxygen oxidises the blockage in the pore opening, resulting in black colouration: this is then called a blackhead. In other words, the dark spot is not dirt under the skin’s surface.
• Papule. These are red spots (without a white head of pus) that indicate inflammation.
• Pimples. Larger than papules; red, sensitive spots with a white head of pus. These indicate a more advanced, deeper infection.
• Nodules. One of the most painful forms of acne; large, solid papules under the skin. They arise when there is too much pressure on the wall of the pore and the infection breaks through into the second layer of skin around the pore.
• Cysts. Painful, pus-filled cavities that form under the skin’s surface and entail a greater risk of scarring than other types of acne due to their depth. Read more about cystic acne.

Step-by-step treatment of an acne-prone skin

Step 1: Use a mild cleanser. It is essential to wash your face twice a day with a mild, water-soluble cleanser to prevent redness, help the skin heal and reduce sebum production. Always avoid using bars of soap or aggressive cleansers as they dry out the skin too much. The ingredients in a bar of soap or an aggressive cleanser can also block the pores. Avoid coarse scrubs as well, since the resulting irritation can make the problem worse. You cannot scrub away spots and blackheads!

Step 2: Use an exfoliant with salicylic acid (BHA) to remove dead skin cells and stimulate healthy cell rejuvenation, both on the surface of the skin and in the pores. BHA also helps with redness and inflammation and tackles the bacteria that cause spots.

Step 3: Fight the bacteria (P. acnes) that cause spots with benzoyl peroxide. Solutions are available in the concentrations of 2.5 to 10 percent and you can buy them over the counter at the pharmacy or chemist. It is best to start with a lower concentration. A product containing 2.5 percent benzoyl peroxide irritates the skin less than a solution with 5 or 10% and may be just as effective. If your skin doesn’t tolerate benzoyl peroxide, then the Clear Daily Skin Clearing Treatment with azelaic acid + BHA is a perfect alternative.

Step 4: Protect your skin from sun damage. The skin cannot heal spots if it is also fighting sun damage. A good sunscreen with a SPF of at least 30 will help spots to heal more quickly and protect the skin from further damage.

Step 5: Absorb excessive sebum by using a sebum-absorbing clay face mask regularly. Do not use products that are too emollient as they can block the pores even more.

It is essential that your skincare products do not contain irritating substances such as camphor or alcohol. They are very common in sebum-absorbing products for spots. They only make the problem worse or cause a dry, flaky and red skin.

If you do not see a significant improvement after consistently following these steps for at least four weeks, you might decide to talk to your doctor about a medical treatment for spots. The options are topical products containing retinol (vitamin A) or an antibiotic with benzoyl peroxide.

Recommended cleansers for spots:

• Paula's Choice Clear Pore Normalizing Cleanser

Recommended exfoliants with BHA:

• Paula's Choice Clear Regular Strength 2% BHA
• Paula’s Choice Clear Extra Strength 2% BHA

Recommended product with sun protection for spots:

• Paula’s Choice Clear Daily Hydrating Fluid SPF 30+

Related articles

• Four important tips for a more balanced skin
• Cystic acne: what is it and what can you do about it?
• Fight spots and wrinkles at the same time: it’s possible!
• What can teenagers do about spots
• Red spots and acne scars: how to get rid of them?