How to Annihilate (And Prevent) Acne
Yes, we like Warhol. But you know what we don’t like? Zits. Image: Design With Rooster
To a lot of us, acne came and went like flip phones and that Full House reboot.
But for a rising number of North American adults, acne is the masked maniac in a slasher flick. You can decapitate it, throw it in a wood chipper, whatever you want, but nothing certifies the thing’ll die.
The fact is pimples (or “acne vulgaris” as it’s known in the medical world ) aren’t just a teen’s day ruiner anymore, nor are they the badge of a basement-dwelling “nerd.” Here’s why: That link up top takes you a 2018 study that took researchers at the Sapienza University of Rome over six years to complete. In it, they looked at 1,167 participants with varying cases of acne and what Dr. Nevena Skroza and her team found ought to raise a few eyebrows among men.
Dr. Skroza’s team’s work was done based on the fact that more adults are getting acne than ever before. But what’s curious is that while “acne in female patients was more prevalent than in male patients,” that was for a “mild” type of it (which they also found is the most common kind there is, with 92% of adult women having the condition compared to 82% adult men).
But when it came to “moderate” acne, “both male groups showed a little higher prevalence of such in comparison with the female groups.”
Did they find any factors that could cause this crap? Yes, but beyond stress and cigarette smoking, there was nil on why moderate acne hits men harder.
That same year, Cleveland Clinic published a story that says it’s a testosterone thing (or at least it is for the most part). According to dermatologist, Dr. Alok Sij, testosterone’s got a habit for pumping too much “sebum” (that natural oil we always talk about that your skin makes to fight dryness). Sebum’s a good thing, but too much of it blocks “hair follicle growth.” Once that happens, bacteria mounts and bam, you’ve got a big, beautiful zit. And whether or not hormones make us more prone to the “moderate” kind is anyone’s guess.
Either way, there’s no reason to suffer through a breakout if you can help it. Life’s got enough bullshit with which you’ll deal. So, should it make an unceremonious appearance one day, here’s how you’ll send acne back to hell.
With special thanks Dr. Anatoli Freiman, Medical Director at the Toronto Dermatology Centre.
Know Your Anti-Acne Weaponry
You know when you’re at the drug store and have no idea what matters on those ingredients lists? Now you will. Look for the following before you go over-the-counter.
Salicylic Acid The consummate destroyer of dermal enemies, you’ll find this in many an acne product, from face washes to toners. “The reason salicylic acid works is because it penetrates pores deeply and does a good job dissolving skin debris that cause acne,” explains Dr. Freiman. The reason it gets in there so well is because it’s oil-soluble, meaning it dissolves inside the oil on your face. That’s why products with salicylic acid are perfect for men with oily skin.
Glycolic Acid “This helps to exfoliate your skin while you’re using it,” says Dr. Freiman. Some of you don’t know what that means, and that’s cool; When we “exfoliate,” we’re sloughing off all the grime caught in our pores, the likes of which is so small we can’t see it. But you know what can? Glycolic acid. This stuff—which is found in sugarcane—peels away dead skin that would’ve made matter worse by adding up. This comes in different percentages, too; anywhere from 3% to 50%. So hit up your dermatologist before you buy.
Benzol Peroxide Aside from stifling inflammation, “Benzol helps to fight ‘p acnes,’ (or propionibacterium acnes, but have fun with that), a bacteria that’s more prevalent in people than common acne,” says Dr. Freiman. In fact, according to the American Society for Microbiology, p. acnes is “the most abundant bacterium on human skin, particularly in sebaceous areas.” This means your face, which is way more porous than the rest of your skin.
Vitamin A There’s a 2015 study from the Bezmialem Vakif University School of Medicine in Istanbul that connects Vitamin A to good skin. During the study, 96 acne-resistant patients and 50 control group patients were analyzed at the university’s hospital between January 2015 and December 2015 and by the study’s end, Vitamin A levels were “significantly lower in the patient group than in the control group” and that “…foods rich in vitamin A may be recommended to these patients.”
“Vitamin A is actually a mainstay of prescription acne therapy,” says Dr. Freiman. “It's often used in acne creams & also in oral form as something we call ‘isotretinoin’ (Accutane).” Mind you, this drug’s just like most others — side effects could be a thing; According to the health section of British Columbia’s official government website, they range from the serious (though rare) in depression to the more common, yet harmless in dry eyes, the latter of which could suck for contact lens wearers. Just so you guys know.
Yes, What You Eat Matters
The medical community used to look past food as cause of acne, but that’s changed of late as more research to the contrary’s starting to pile.
“We used to say diet doesn't really play a role in this sort of thing,” says Dr. Freiman. “But now we've realized there is some correlation between what you eat and acne production. We've seen in studies that milk and chocolate, as well as greasy food can produce it.” And like we mentioned before, “hormones play a part too.” “But really, it's a multifactorial thing when we look at it case by case,” says Dr. Freiman. “We certainly don't tell people to stop drinking milk, but we are telling them there's more evidence for this. It’s best to take the “trial and error in moderation” approach.
Don’t Touch It
“We always tell patients not to pick their acne, or pop it, nor matter how hard it is to resist,” reminds Dr. Freiman. “It's very common, especially with teens.”
There’s one reason you shouldn’t touch a pimple and one reason only — scarring. “Scarring can happen a lot easier than one would think if you pop it,” says Dr. Freiman. “Best to leave them completely alone, or the pigmentation in that area could actually change and that gets hard to fix later on.”
It’s In Your Head
Not that it’ll shock you, but “stress also makes acne quite worse,” according to Dr. Freiman. How, right? What happens is a chain reaction of events: When you freak out, your pituitary gland — a pea-sized ball at the base of your brain — stimulates testosterone production, which, in turn, pumps more sebum to your skin. More sebum means oilier skin, and oilier skin begets acne. That’s why New Jersey’s Dr. Warren Heymann — the dermatologist who penned that piece in the hyperlink — is pushing for other dermatologists to place more focus on a person’s psyche and its state of being.
Here’s what fellow American dermatologist, Dr. Rick Fried, had to say:
“…Clinicians should be compelled and empowered to briefly inquire about how their patients are coping with their life stresses. This need not open a Pandora’s box of a litany of problems for ‘us’ to solve. Rather, it can afford us with an opportunity to succinctly offer effective stress management techniques such as the Pythagorean Self-Awareness Intervention or other proven techniques such as Jon Kabat-Zinn’s mindfulness meditation.”
We say it’s about time.
And Don’t Skimp On Good Sunscreen
Those of you who aren’t new to acne might hate sunscreen, and we wouldn’t blame you. A lot of sunscreen is thick in texture, and why the hell would you want that near your pores? But there’s an easy way around this — “When people buy a sunscreen, they should pick a non-comedogenic one,” emphasizes Dr. Freiman. “Comedogenic” means anything that’s good at blocking pores. “The comedogenic ones plug them up,” says Dr. Freiman. “So look for broad spectrum sunscreens that have “oil-free” or “lightweight” in their labels.
Toss the Butts
In 2017, the Department of Dermatology at the Oxford Medical College Hospital and Research Centre in Bangalore, India studied the skin of 126 acne-prone guys between 15 and 45-years-old. In total, 28.57% of “cases” and 15.87% of “controls” were smokers. In the end, the researchers found that the “risk of acne was 2.12 times more in smokers than in non- smokers.”
Yes, that’s just one study, but it’s one among many you’ll yield with a few keyboard clicks, and that ought to be more than enough for you smokers to drop the shit.
Acne won’t stick around if you just take a few basic measures, but that doesn’t discount the fact that some of you guys get it bad. We get that.
If you’ve given over-the-counter approach a solid go and it's getting worse, don’t be a tough guy about it (especially since we all know it’s pissing you off).
“Certain people just have a predisposition to acne,” says Dr. Freiman. “There’s nothing wrong with that, but just know that when it’s severe — when it gets to that level — it’s best to see a professional. Otherwise you could risk permanent scarring if it’s left untreated.”
That, and go easy on the fried chicken.