What is Acne?
Acne is a skin condition that causes whiteheads, blackheads, cysts, nodules, or pimples on the face, shoulders, neck, back, chest, and upper arms. Tiny holes in your skin called pores blocked by oil, dead skin cells, bacteria, and dirt result in acne. The most severe type of acne is a pimple. A pimple is a swollen, red, and painful bump on your skin.
Acne can occur at any age but is commonly found in teenagers during puberty. Around this age, the sebaceous glands, also called oil glands, are activated. These glands, present at the base of the hair follicles, produce oil and are stimulated by hormones produced by the adrenal glands in both males and females. Each hair follicle is at the base of an opening or pore. The oil secreted along with dead skills and bacteria block the pore and cause acne.
The most common skin condition in the U.S. is acne, which affects almost 50 million Americans every year, as reported by the American Academy of Dermatology.
Acne is not a life-threatening condition. It can be extremely painful, depending on how severe the condition is. Pimples can leave scars on the skin over time. Acne on your face can cause emotional distress if persistent for a long time. The earlier acne is treated, the better. Treatment can help reduce permanent scarring and reduce the amount of acne.
Signs of Acne
Signs and symptoms of acne vary depending on how severe the condition is.
- Blackheads that open on the surface of the skin
- Whiteheads that are just below the skin
- Papules - small red bump caused by inflamed hair follicles
- Pustules - small red bumps with pus at their tips
- Nodules - solid, red bumps beneath the skin surface
- Cysts that are solid, painful, pus-filled lesions below the skin
The Genetics Behind Acne
If both your parents have acne, you are at a higher risk of developing acne. Genetics determines how effectively your immune system can fight a bacteria called Propionibacterium acnes that is responsible for causing acne.
The FST Gene
The FST gene contains instructions for the production of a protein called follistatin. This protein inhibits the release of follicle-stimulating hormones.
Follistatin also inhibits a protein called TGFB2, which is involved in controlling acne. If more follistatin is produced, TGFB2 activity will be inhibited, and this, in turn, increases the development of acne and acne-causing bacteria.
rs38055 is an SNP found in the FST gene. The A allele is the risk allele and can increase your risk of developing acne.
The TGFB2 Gene
The TGFB2 gene contains instructions for the production of a protein called transforming growth factor beta-2. This protein is important in all stages of life, from early development throughout life. It is involved in various cellular mechanisms for the proper growth and development of cells.
TGFB2 is also found to be involved in the growth and healing of skin by slowing down the production of keratinocytes, a type of skin cells. This clogs the skin and promotes the growth of acne-causing bacteria](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857353/).
rs1159268 is an SNP found in the TGFB2 gene. The A allele causes a decrease in the production of TGFB2 protein, which increases the risk of acne.
Non-Genetic Factors that Influence Acne
Hormonal changes: These changes are common during puberty and pregnancy and lead to breakouts. Androgens, a hormone produced by the adrenal glands in boys and girls, trigger the sebaceous glands to secrete more oil-containing fluid called sebum. This usually happens at puberty.
Age: Acne is most common in teenagers but occurs in people of all ages.
Diet: Certain food items like chips, carbohydrate-rich foods, refined sugars are found to worsen acne. Studies are being done to find the impact of a certain diet on acne.
Grease or oil: Acne can also develop when the skin comes into contact with lotions or cream that contain a lot of oil.
Stress: Stress is not a causative agent but can worsen acne.
Skin damage: Friction or pressure on the skin can also cause acne. Tight collars, helmets, backpacks can exert more pressure on your skin.
Medication:* Drugs that contain testosterone, lithium, or corticosteroids can cause acne.
How to Manage Acne?
These can help treat mild acne at home and prevent more pimples.
- Use a mild soap to clean oil and dirt from the skin daily.
- Use oil-free makeup and remove it before going to bed. Makeup that’s water-based and labeled non-comedogenic ( not pore-clogging) can be used.
- Avoid touching your face frequently.
- Do not try to burst the pimple or poke it. This leads to scarring and more acne as it spreads the bacteria and excess oil.
- Shampoo your hair regularly, especially if you have oily hair.
- Reduce your stress to prevent worsening of acne.
- Wear loose-fitting clothing to manage acne present on the back and arms.
- Avoid sun exposure as it can lead to excess sebum secretion and sunburns.
- Avoid tanning under the sun and tanning beds.
If self-care doesn’t help with your acne, certain OTC medications can be used. These include creams and gels that contain sulfur, benzoyl peroxide, or resorcinol. Washes or soaps that contain salicylic acid are also used. There are many acne creams, washes, soaps, masks, and serums available in the market.
In severe cases of acne, where over-the-counter medications also don’t help, a doctor should be consulted. A doctor will prescribe certain medications or treatments to help manage your acne.
Medication: Oral or topical antibiotics are prescribed to reduce inflammation caused by bacteria. Certain topical creams that are stronger than OTC medication are also prescribed.
- Photodynamic therapy: Special light or laser along with medication is used to reduce oil production, kill bacteria, and improve scarring.
- Dermabrasion: Top layers of skin are removed with a rotating brush, and acne scarring is treated.
- Chemical peels: Can improve mild acne scarring and removes the damaged top layers of skin.
- Cortisone injections: Used for acne that consists of large cysts. It helps reduce inflammation and speeds the healing process.
- Acne is caused by excess oil, bacteria, dirt, and dead skin cells blocking the pores present on the skin. Pimples, whiteheads, blackheads, cysts, nodules, pustules, and papules are different types of acne found on the skin or beneath the surface.
- The severity of the condition determines how painful it can get. Acne can cause emotional distress if persistent.
- The FST and TGFB2 genes are known to increase your risk for acne. Both these genes influence oil production in the body.
- Certain factors like age, hormonal changes, stress, diest, and medication can worsen acne.
- Depending on the severity of acne, home remedies or over-the-counter medications can be used to treat it. For severe cases, a consult with a dermatologist is advised.
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