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Seven ways ... to manage acne

The Guardian logo The Guardian 15/04/2018 David Cox
© Provided by Shutterstock Don’t pick your spots

Squeezing or picking can lead to permanent pigmentation marks or scarring. Acne is the result of dead skin cells, bacteria and natural oils blocking up hair follicles in your skin, but you can’t drain them on your own. Some adults experience cystic acne, inflamed lesions that form deep beneath the skin tissue due to infection. This requires medication.

Use sensitive products

If you are prone to acne, using too much makeup and cosmetic products will block your pores and make matters worse. Try to use products that are described as water-based, oil-free, and non-comedogenic – meaning it doesn’t cause blackheads by blocking pores. If you have facial acne, avoid overwashing your face. Washing more than twice a day can dry out your skin, stimulating it to produce more oil to compensate.

Discuss birth-control options

The main cause of acne is believed to be hormone fluctuations, which makes adult women more prone to breakouts than men. Switching contraceptives, however, can sometimes help, as there are several birth control pills that are approved for treating acne.

Stick to low-glycemic foods

The relationship between food and acne is complex, with foods long-suspected of causing acne – chocolate, fried food and nuts – not found to have an effect in large studies. Research has shown that excess insulin from foods with a high glycemic index, such as pasta and bread, may increase the levels of oil-triggering hormones in women, contributing to acne. Low-glycemic foods such as whole grains are digested slower and cause less of an insulin spike.

Acne problem. © Getty/iStockphoto Acne problem. Retinoids

Prescription creams containing topical retinoids are among the most effective acne treatments, although you may not see immediate results for several weeks. The skin converts retinol to retinoic acid which helps unplug the blocked follicles. They also stimulate collagen, and can be used in combination with other spot treatments. Those containing ingredients such as salicylic acid, which gently exfoliates to unclog the pores, and benzoyl peroxide, which kills acne bacteria, are especially effective. But be careful, as overuse of retinoids and benzoyl peroxide can irritate your skin.

Antibiotics

For severe acne, your doctor may also prescribe you a short course of oral antibiotics, such as tetracycline, to kill excess skin bacteria and reduce inflammation. Research has suggested taking antibiotics along with benzoyl peroxide to reduce the risk of antibiotic resistance.

Hormonal treatments

If your acne is thought to be directly related to changes in hormones rather than infection, you may be prescribed a medication such as spironolactone. This helps to block hormones from triggering the oil glands. But while spironolactone is one of the most reliable hormonal treatments for acne, it could be advisable to consider alternatives if you are thinking of starting a family, as it remains unclear whether spironolactone is safe to use during pregnancy.

Related: How To Get Rid Of Cystic Acne, According To Top Derms (Provided by Refinery29)

a person posing for the camera: Think back to middle school when year after year, person after person would tell us that we’d grow out of our acne. We get it: The adults in our lives wanted to be encouraging. So they threw out a glimmer of hope — an “it gets better” kind of thing that has us bamboozled all these years later. Because after countless cycles of hormonal acne, we’re here to say that it does not, in fact, always get better: A 2011 study showed that nearly half of women aged 20-29 has clinical acne. One of the most notorious types? The cystic variety, which can be brought on by monthly hormonal cycles — and can be way more intense to deal with than your average pimple.“Cysts are like balloons under the skin that are filled with oil, but have no place to go. As your oil glands make more oil, cysts become enlarged, the wall cracks, and inflammation develops,” explains Joshua Zeichner, MD, a New York-based dermatologist and Director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital. Unlike more surface-based acne, he explains, cystic spots can’t be picked: “They have no connection to the surface of the skin so any attempt to pick them will cause more harm than good.”Extractions are also out when it comes to cystic acne. S. Manjula Jegasothy, MD, a Miami-based dermatologist with a celebrity-rich clientele, notes that these suckers can start deep in the skin, at one-to-two millimetres beneath its surface. “They’re extremely difficult, if not impossible, to extract or ‘pop,’ even by a skin-care specialist or dermatologist,” she says. In short, these spots are deep-rooted and tough to fight, which is why our pros suggest booking an appointment with a derm as a first line of defence. Prescribed treatments like oral antibiotics, some types of birth control pills, Aldactone, (a pituitary hormonal oral medicine), and isotretinoin (what used to be known as Accutane) top Dr. Jegasothy’s list of prescribed treatments.Though Accutane has proven controversial for some, Marina Peredo, MD, a New York-based dermatologist and associate clinical professor of Dermatology at Mount Sinai Hospital, also likes the medication to treat cystic acne. “For most patients, it's a cure and will prevent deep scar formation if started early in a course of a disease,” she says, noting that a proactive approach is key. “It is very important to start Accutane is soon as possible with severe cystic acne because prolonging the start of the treatment can cause deep scars, which are very hard to treat even with the most aggressive laser treatments later.”Dermatologists also use cortisone shots as a magic wand to instantly deflate cystic bumps, though Dr. Jegasothy notes that this methodology is falling out of favour. “They are known to occasionally cause indentations which may persist up to three months after the spot has gone,” she warns. Instead of using steroid injections, she turns to combinations of oral antibiotics (typically used for two to four months), light chemical peels (to help control oil and reduce clogged pores), topical medications, probiotic cleansers (which can help balance skin), and lasers.Bottom line? If you want to get serious about cystic acne treatment, there’s no getting around time-consuming derm visits and prescribed meds. But here’s the upside: We can take action from our own bathrooms to help minimise cystic acne from forming and help control those mighty bumps in between doctor’s visits (or until we meet the deductible on our health insurance, anyway). Ahead, get pro advice on how to best tackle deep-rooted acne at home.Read These Stories Next:The Easy Way To Know Which Acid Is Right For Your Skin Type Sunscreens That Won't Make You Break Out, Because That's Not Cool This Is How Much My Cystic Acne Costs Me A Year How To Get Rid Of Cystic Acne, According To Top Derms
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