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Pimples; blackheads; spots; cysts and pustules all refer to acne and acne breakouts, and differ only in their indication of the level of severity of the breakout.

All acne forms some kind of a blemish that rises above the surface of the skin, so it’s not surprising to find the word ‘acne’ comes from the word acme meaning ‘the highest point’; a reference to the little mountains that form on the skin during an acne breakout.

Acne is a condition that arises from a combination of sebaceous skin oil, blocked follicles and dead skin cells. The normal self-cleansing and moisturising process of the skin is disrupted, and bacteria proliferates in the blocked follicles causing inflammation and subsequent blemishes.

As acne develops where we have the most sebaceous glands; it’s usually found on our face, neck, chest, back, shoulders, and upper arms.

Dr. Lisa Fay at Cosmetic Doctor runs an acne clinic to help people of all ages; teenagers and adults alike, who are suffering from acne to the point that it is interfering with their lives; self-esteem and confidence.

How acne is formed

Acne is a skin condition that involves the oil glands at the base of the hair follicles in our skin.

These glands secrete sebum, or oil, that in normal amounts help to keep our skin clean and moisturised. During hormonal shifts such as puberty or peri-menopause (the years leading up to menopause in women), the sebaceous glands can start to over produce oil. When this happens, the follicles become blocked and the oil accumulates under the surface of the skin.

The dead skin cells, oil and hair clump together to form a plug in the follicle, thus creating a ripe breeding ground for bacteria. The bacteria that normally exists peacefully enough on our skin, P. acnes, thrives in the excess oil and rapidly increases. As the bacteria multiply in a clogged pore, the pore gets inflamed.

Once bacteria takes hold, the skin swells into a blemish or pimple, varying from blackheads and whiteheads to more severe papules, pustules, nodules or cysts. When inflammation reaches deep into the skin, an acne cyst forms- this can be quite severe and can cause permanent scarring.

Types of Pimples

Whiteheads – remain under the skin and the pore is closed- a ‘closed comedo’.

Blackheads – clearly visible; the pore remains open and the sebum oxidises, turning black where it’s in contact with the air. An ‘open comedo’.

Papules – visible on the surface of the skin. They are small bumps, usually pink.

Pustules – clearly visible on the surface of the skin. They are red at their base and have pus at the top.

Nodules – clearly visible on the surface of the skin. They are large, solid pimples. They are painful and are embedded deep in the skin.

Cysts – clearly visible on the surface of the skin. They are painful, and are filled with pus. Cysts can easily cause scars.

So why do some people get acne and others don’t?

It’s all about hormone levels and how your sebaceous glands respond to them. Whether you’re a teen or an adult, the root cause of acne is directly linked to hormones and a shift in their levels. Experts believe the primary cause is a rise in androgen; the ‘male’ hormone, which can happen either in puberty or as an adult.

This androgen hormone makes the oil glands grow enlarged and produce more sebum, which causes cellular walls within the pores to break down, spreading the bacteria and causing inflammation and redness.

Acne often first appears during puberty, when there is a surge of androgen hormones within the body, stimulating the sebaceous glands and making skin oily and prone to breakouts.

Women may see considerable hormonal fluctuations during menstruation, pregnancy, menopause and perimenopause. During these life phases, acne is most likely to develop or flare up.

How can I tackle Adult Acne?

The short answer is that a multi-pronged approach may be the most effective. Medical grade products such as the ZO Medical range (only available from doctors) are the only products with sufficient strength of concentration to really have an impact on problematic acne.

A combination of chemical peels and daily regime tailored to the issues of each patient can make a huge impact on acne-damaged skin, as well as treatments designed to minimise scarring and normalise skin tone and texture.

In some cases Dr. Fay may recommend an adjustment of hormone levels with an oral contraceptive pill, or if a patient has a hormonal condition such as Polycystic Ovary Syndrome (PCOS) may refer them to an endocrinologist (hormone specialist) for initial treatment before addressing the acne issue.

To book an appointment at Dr. Fay’s Acne Clinic call Cosmetic Doctor Dublin on 01 685 3100.

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