In 2015, acne was estimated to affect 633 million people globally, making it the 8th most common disease worldwide. Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world. Lower rates are reported in some rural societies. Children and adults may also be affected before and after puberty. Although acne becomes less common in adulthood, it persists in nearly half of affected people into their twenties and thirties and a smaller group continue to have difficulties into their forties.
Hormonal treatments for acne such as combined birth control pills and antiandrogens may be considered a first-line therapy for acne under a number of circumstances, including when contraception is desired, when known or suspected hyperandrogenism is present, when acne occurs in adulthood, when acne flares premenstrually, and when symptoms of significant sebum production (seborrhea) are co-present. Hormone therapy is effective for acne even in women with normal androgen levels.
The Daily Skin Clearing Treatment is an all-over 2.5 percent benzoyl peroxide cream that also touts calming bisabolol and allantoin to alleviate the dryness and irritation that can crop up mid-treatment. Anyone frustrated with oil-slick skin will also love this part of the regimen — it creates a satin mattifying effect, instantly transforming shininess into a glow.
Many skin conditions can mimic acne vulgaris, and these are collectively known as acneiform eruptions. Such conditions include angiofibromas, epidermal cysts, flat warts, folliculitis, keratosis pilaris, milia, perioral dermatitis, and rosacea, among others. Age is one factor which may help distinguish between these disorders. Skin disorders such as perioral dermatitis and keratosis pilaris can appear similar to acne but tend to occur more frequently in childhood, whereas rosacea tends to occur more frequently in older adults. Facial redness triggered by heat or the consumption of alcohol or spicy food is suggestive of rosacea. The presence of comedones helps health professionals differentiate acne from skin disorders that are similar in appearance. Chloracne, due to exposure to certain chemicals, may look very similar to acne vulgaris.
Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne. During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease. This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.
Combination therapy—using medications of different classes together, each with a different mechanism of action—has been demonstrated to be a more efficacious approach to acne treatment than monotherapy. The use of topical benzoyl peroxide and antibiotics together has been shown to be more effective than antibiotics alone. Similarly, using a topical retinoid with an antibiotic clears acne lesions faster than the use of antibiotics alone. Frequently used combinations include the following: antibiotic and benzoyl peroxide, antibiotic and topical retinoid, or topical retinoid and benzoyl peroxide. The pairing of benzoyl peroxide with a retinoid is preferred over the combination of a topical antibiotic with a retinoid since both regimens are effective but benzoyl peroxide does not lead to antibiotic resistance.
Benzoyl peroxide is an antibacterial ingredient, and it’s very effective at killing the P. acnes bacteria that causes breakouts. But benzoyl isn’t without its downsides. The leave-on creams and cleansing treatments can dry out sensitive skin types and bleach clothing if you aren’t careful. Board-certified dermatologist Eric Meinhardt, M.D., previously told SELF that it's best to stick to formulations that have no more than 2 percent of benzoyl peroxide listed on the active ingredients chart; stronger concentrations are harder on your skin without being any tougher on bacteria.
Your pimples need TLC, too. The study on acne vulgaris found that, in an attempt to dry out acne lesions, patients often use too many products or apply excessive amounts to problem areas, resulting in further irritation and over drying of the skin. Vigorous scrubbing and using harsh exfoliants can make acne worse by rupturing whiteheads and blackheads, turning them into painful red ones. And remember: no matter how satisfying it is, picking and popping your zits will also increase inflammation and opportunity for infection.
Retinoids are medications which reduce inflammation, normalize the follicle cell life cycle, and reduce sebum production. They are structurally related to vitamin A. Studies show they are underprescribed by primary care doctors and dermatologists. The retinoids appear to influence the cell life cycle in the follicle lining. This helps prevent the accumulation of skin cells within the hair follicle that can create a blockage. They are a first-line acne treatment, especially for people with dark-colored skin, and are known to lead to faster improvement of postinflammatory hyperpigmentation.
Tea tree oil, also known as melaleuca, is one of my favorite and most recommended remedies for acne because it has amazing microbial properties that help fight the bacteria causes acne. A study published in the Australasian Journal of Dermatology revealed that tea tree oil provides positive results for mild acne with no serious adverse effects. The study asked participants to apply tea tree oil to the affected area of the face twice a day for three months with assessments conducted at four, eight and 12 weeks of use. The acne was reduced, making tea tree oil a great choice for how to get rid of pimples. (14)
Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.