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Your Skin on Stress: Acne, Hair Loss, and More

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Stress can present itself through skin conditions like acne, inflammation, and more. How can you tell it’s from stress?

Your skin is your body’s largest organ. External issues can be a telltale sign that not all is well underneath.

While bottled serums and sheet masks possess a certain level of aesthetic and soothing allure, a solid skin care routine may not be enough to provide calm for your body’s complex systems.

The increased jump in cortisol can jumble up the messages your nerves decide to send, causing anything from an outbreak of hives to fine lines.

While this correlation between stress and skin has been known since ancient times, formal studies revealing the deeper connection only date back to the last two decades.

And yes, your diet or skin care products can cause skin concerns, but it’s also important to consider stress as a potential culprit — especially if a rash appears out of nowhere or persists long after you’ve tested for everything.

We’ve outlined eight proven ways that mental, physical, and hormonal stress changes your skin. But more importantly, we also tell you what you can do about it.

Even before looking internally, there’s one beaming factor that can physically stress out your skin and weaken its defenses: ultraviolet (UV) radiation. A carcinogenic (cancer-causing) component of sun exposure, it can have a negative effect on the skin.

Whether in the form of natural sunlight or more artificial means such as tanning beds, ultraviolet rays signal blood cells to rush to the exposed area in an attempt to repair it. This manifests as sunburns.

Overexposure to ultraviolet radiation may lead to darkened blemishes, moles, and even skin cancer. The best way to combat UV rays and sun stress is by applying sunscreen every morning.

On top of sunscreens, you can also oppose sun damage from the inside out. Research has linked certain nutrients to the ability to boost your skin’s natural sun protection.

Limonene, a chemical derived from citrus peels, has been studied for use in cancer prevention medicines. Eating citrus peel might also provide sun protection.

Fruits high in antioxidants and vitamin C (like strawberries and pomegranates) have the ability to protect your cells from the free radical damage caused by sun exposure.

It’s important to remember that eating these foods does not replace wearing sunscreen. You should still wear sunscreen in addition to considering eating foods high in limonene, vitamin C, and other antioxidants.

Hives, psoriasis, eczema, dermatitis, and rosacea are often a result of inflammation, but studies also show that when your brain is on overdrive, it can actually compromise your skin’s protective abilities.

In other words, stress makes it harder for your skin to regulate and stay balanced. It’s no wonder you might have an extra breakout during a sleepless week or after an intense argument.

Inflammation can also cause acne. But remember, some skin conditions like rosacea can look like acne, too. It’s important to note the difference before treating the conditions, including whether your irritation is a result of stress, allergies, or a harmful product.

Fighting stress inflammation begins with eliminating the cause. Finding out the exact reason behind your stress might be difficult or impossible, but there are still ways to tame the fires with food, exercise, or therapy.

Whether it’s the impending dread of finals week or spontaneous heartbreak, we’ve all likely suffered at the hands of a stubborn pimple (or two).

Stress is highly associated with acne, especially for women. It can mix up our skin’s nerve signals, causing imbalanced hormones and chemicals that increase oil production.

While it’s nearly impossible to remove stress from the equation entirely, there are ways to overcome it. Keep 5- and 10-minute stress-relief tricks handy, and try longer stress-management techniques, like exercise, to increase your body’s abilities to adapt.

And most acne reacts to topical treatments, too. The secret ingredient in our most beloved anti-acne products is often a beta-hydroxy acid known as salicylic acid.

This oil-soluble chemical penetrates pores extremely well for unclogging and cleaning, but this doesn’t mean that it’s exempt from its own set of cons. Too much or too strong salicylic acid can dry out and even irritate your skin.

So with careful application in mind, nightly spot treatments are helpful for targeting troubled areas without harming the skin in the surrounding areas.

There’s no one way to experience stress. Have you ever unconsciously pulled your hair, bitten your fingernails, or picked at both? That could be the stress hormone, cortisol, triggering your body’s fight-or-flight response.

Before you assume it’s stress, though, you might want to check in with a dermatologist and doctor to rule out other potential issues. For example, scaly or waxy skin could be eczema. Or hair loss or peeling nails could be due to insufficient nutrition from skipping meals.

In the time being, avoid extremely hot showers to prevent further damaging your skin and scalp. Bring more consistency to your day by aiming to exercise regularly and eating a nutrient-dense diet of fruits and vegetables.

The skin might get thinner in cases of abnormally high cortisol levels. Cortisol results in the breakdown of dermal proteins, which can cause the skin to appear almost paper-thin, as well as bruising and tearing easily.

However, this symptom is most noticeably associated with Cushing syndrome. Also known as hypercortisolism, this hormonal disease includes additional symptoms such as glucose intolerance, muscle weakness, and a weakened immune system (you may experience increased infections).

If you think that you may have Cushing syndrome, make an appointment with a healthcare professional. In most cases, medication can be prescribed for the management of cortisol levels.

In the face of severe stress, your epidermis can quickly become weakened, increasing your risk for infections and environmental pathogens. This also slows down your skin’s natural ability to heal wounds, scars, and acne.

To repair your skin barrier, you can use products with glycerin and hyaluronic acid.

The same remedies you use to combat sun exposure apply here, too. Consume antioxidant-rich food for a similar effect and strengthened internal healing.

In addition to keeping skin hydrated internally (through water consumption), focus on using products based on zinc, sal (Shorea robusta), and flaxseed oil. These ingredients are shown to your keep your skin moisturized and provide a packed healing punch for wound healing.

If you’ve ever been on the receiving end of a comment regarding the undeniable dark circles around your eyes, then you know just how much sleep deprivation reveals itself physically. And yep, that’s stress, too.

Our bodies keep adrenaline running on a constant cycle while in fight-or-flight mode, including late at night.

If you’re already trying meditation and yoga for sleep, ramp up your bedtime routine by using essential oil diffusers, turning on white noise machines, and avoiding screens in the 2-hour time span before sleep.

For sleep disorders such as insomnia and sleep apnea, CBD oil and melatonin pills may act as more reliable remedies.

From the furrow of a brow to a frown, psychological stress inevitably finds a way to make permanent evidence of our emotions.

So what’s one to do about it? You can try face yoga. Arguably safer than Botox, face yoga can lead to similar results, although the commitment to doing this every day might a hard to do.

By targeting the facial muscles we subconsciously use every day, through pointed massage techniques in high-tension areas such as our foreheads, brows, and jawline, these exercises can counteract developing wrinkles and leave skin flexible and resilient.

For additional assistance, applying facial pressure with a chilled jade roller activates the lymphatic system, which can also reduce puffiness and the appearance of stress damage on the skin.

Stress does not manifest the same in every person, but every person ultimately experiences stress to some extent. Instead of comparing stress levels with others to gauge whether your stress is “all that bad,” choose to care for yourself when you need it.

While we can’t control the myriad ways stress rears its head, we can control how we choose to react to it. Remembering to care for ourselves and for our skin is one of the small ways we can slowly but surely reduce stress.

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Skin Barrier Function and How to Repair and Care for It

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Your skin barrier protects your body from free radicals. Harsh environments are often the cause of damage. Keep it protected using oils, ceramides, and more.

Beauty boutique and drugstore shelves are packed with products that aim to protect and rejuvenate your skin. Some of them exfoliate, some plump, and others moisturize.

All these products share the fact that they act on your body’s outermost layer, which is called the skin barrier.

But what exactly is your skin barrier, what’s its purpose, and what can cause damage?

In this article, we’ll help answer those questions and also explore the steps you can take to protect and restore this vital defensive layer.

Your skin is made up of layers, each of which performs important functions in protecting your body.

The outermost layer, called the stratum corneum, is often described as a brick wall. It consists of tough skin cells called corneocytes that are bound together by mortar-like lipids. This is your skin barrier.

Inside the skin cells, or “bricks,” you’ll find keratin and natural moisturizers. The lipid layer contains:

  • cholesterol
  • fatty acids
  • ceramides

This fantastically thin brick wall is literally keeping you alive. Without it, various harmful environmental toxins and pathogens could penetrate your skin and cause adverse effects inside your body.

Additionally, without your skin barrier, the water inside your body would escape and evaporate, leaving you completely dehydrated.

Your skin barrier is essential for your overall health and needs to be protected to help your body function properly.

Daily, your skin defends against a barrage of threats, many of which come from outside your body, and a few come from within.

Some of the external and internal factors that can affect your skin barrier include:

The role of the acid mantle

Your skin barrier is slightly acidic. This acidity (the acid mantle) helps create a kind of buffer against the growth of harmful bacteria, viruses, and fungi that could damage your skin and lead to infections and other skin conditions.

It’s especially important to protect the acid mantle around wounds since the skin’s acidity is necessary for many of the biological interactions that occur during the healing process.

Sometimes, a health condition like diabetes or incontinence can change your skin’s acidity, weakening this buffer. For people with these conditions, experts recommend slightly more acidic skin care products.

When your skin barrier is not functioning properly, you may be more prone to developing the following skin symptoms and conditions:

Given the importance of maintaining your skin barrier and acid mantle, what can you do to keep them both healthy and functional? Let’s look at five strategies that can help.

Simplify your skin care routine

If you’re performing a complicated daily skin regimen involving a basketful of products, you may be inadvertently weakening your skin barrier. Consider talking with a dermatologist or another skin care professional about which products are essential and most effective.

If you’re exfoliating, notice how your skin reacts to the method you use. According to the American Academy of Dermatology, those with sensitive skin and darker skin tones may want to use a soft cloth and a mild chemical exfoliant.

Some types of scrubs and brushes may temporarily damage your skin barrier.

Pay attention to pH

Your skin’s delicate acid mantle hovers around a pH of 4.7. But the pH of some skin products can range from 3.7 to 8.2.

Researchers recommend cleansing with a product that has a pH between 4.0 and 5.0.

Keeping your skin’s pH at a healthy level may help protect you from skin conditions like dermatitis, ichthyosis, acne, and Candida albicans infections. Although not all products list their pH, some do.

Try a plant oil to replenish your skin barrier

Research from 2018 suggests that certain plant oils may help repair the skin barrier and also prevent your skin barrier from losing moisture. Many of these oils have antibacterial, anti-inflammatory, and antioxidant effects, too.

Some of the most effective plant oils to consider using on your skin include:

There are many ways you can use plant oils on your skin.

You can apply creams and lotions that contain one or more of these oils as an ingredient. Or you can pour a small amount of the oil into the palm of your hand and then massage it gently into your skin until it’s absorbed.

Look for formulations that include ceramides

Ceramides are waxy lipids found in especially high concentrations in the stratum corneum. They are crucial for making sure your skin barrier functions properly.

Research from 2019 shows that products containing pseudo-ceramides may help improve the dryness, itchiness, and scaling caused by a poorly functioning barrier. Ceramide-rich moisturizers may also strengthen the structural integrity of your skin barrier.

Ceramide moisturizers may be especially helpful if you have acne. In acne-prone skin, the barrier is often impaired, and acne treatments can leave skin dry and reddened. Products containing ceramides may also help protect darker skin. According to a 2014 review of studies, darker skin tones were shown to contain lower ceramide levels.

Try moisturizers containing hyaluronic acid, petrolatum, or glycerin

Dry skin is a common problem, and moisturizers are the often-recommended solution.

An occlusive moisturizer aids the skin barrier by reducing the amount of water loss from your skin. These products leave a thin film on your skin that helps prevent moisture loss.

One of the most frequently recommended occlusive moisturizers is petrolatum, which experts say can block as much as 99% of water loss from your skin.

Like occlusive moisturizers, humectants can also improve barrier function. Humectants work by drawing water — either from the environment or from inside your body — and binding it into the skin barrier. Researchers recommend products that contain hyaluronic acid, glycerin, honey, and urea.

How to use

Gently apply moisturizer to your skin immediately after you get out of the shower, when your skin is moist.

Not all skin care ingredients work for everyone. That’s why you may want to try a few different products to determine which one works best for keeping your skin healthy, protected, and well moisturized.

The outermost layer of your skin, known as your skin barrier, defends your body against environmental threats while simultaneously protecting your body’s critical water balance.

Symptoms such as dryness, itching, and inflammation can alert you to a disturbance in this important barrier.

You can help repair your skin’s barrier by:

  • simplifying your skin care regimen
  • using products with a suitable pH
  • using a moisturizer that contains ceramides or a humectant like hyaluronic acid

Moisturizers with petrolatum can also help your skin barrier seal in moisture.

Your skin barrier is your body’s frontline defense against everything the environment can throw at you. Keeping it healthy is much more than a cosmetic concern.

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‘Apple’ Body Shape: Does It Matter for Health?

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Bodies come in different shapes and sizes, making us all unique.

Though there is immense pressure from society to look a certain way, it’s important to prioritize your health over beauty ideals — and to keep in mind that “health” looks different for everyone.

For some time, people have described body shapes by comparing them to fruit, particularly pears and apples. People who have “pear-shaped” bodies are often thought to be healthier than those with “apple-shaped” bodies.

But is this true?

This article dives into the apple and pear body shapes, the research behind them, and whether they truly mean anything for your health.

People have used fruit terms to describe body shapes for many years because this is an easy way to describe body types without using more scientific, formal terms.

The “apple” body shape is known in the scientific community as “android,” meaning that most of the fat is stored in the midsection and less fat is stored in the hips, buttocks, and thighs.

People with android body types tend to have a larger waist-to-hip ratio, meaning their waist is larger or close to equivalent in circumference to their hips.

In contrast, the “pear” body shape is known as “gynoid,” which means more fat is stored in the hips, buttocks, and thighs than in the midsection.

People with gynoid body types often have a smaller waist-to-hip ratio, which means their hips are usually wider than their waist.

Though there are more formal terms to describe body shapes, the average person can better imagine an apple or a pear than an android or gynoid body type.

First things first: The way a person’s body looks does not automatically tell you whether they are healthy.

That said, certain body shapes may be at an increased risk of negative health outcomes, according to numerous research studies.

One 2020 review of 72 studies found that people with greater fat distribution in the stomach area (an apple shape) had a significantly higher risk of death from all causes than those with pear-shaped bodies.

In one 2019 study involving 2,683 postmenopausal women, those who had an apple body type — more fat in the midsection and less fat in the legs — were three times more likely to have heart disease than those with a pear body type.

Interestingly, having a pear body type had a protective effect against heart disease, reducing risk by up to 40%.

Another study found that apple-shaped bodies were significantly associated with an increased risk of heart disease and type 2 diabetes, regardless of body mass index (BMI). (Remember: The BMI has limitations as a predictor of health, especially for People of Color.)

Also, a small study including 49 males found that despite having the same BMI, body weight, and body fat percentage, men with more android fat had lower endothelial function, which leads to poorer blood flow in the body.

They also had higher insulin resistance, blood lipid levels, and heart rates, suggesting worsened heart and metabolic health.

Finally, a 2021 review of 31 studies found that excess weight around the midsection is significantly associated with greater risk of heart disease.

The review found that for every 10-cm (3.9-inch) increase in waist circumference, there was a 3% and 4% increased risk of heart disease for women and men, respectively.

Other negative health outcomes — such as kidney disease, lung and colorectal cancers, and even cognitive decline — are linked with central obesity (the presence of excess fat in the midsection).

Ultimately, most research suggests that fat distribution — not necessarily body weight or BMI — can affect health outcomes.

Though using fruit metaphors to describe body types may be convenient, it’s not ideal.

Using objects to describe a person’s body type creates the opportunity for others to make general assumptions about someone’s health and body.

For instance, people with higher body weight and body fat tend to experience weight bias in healthcare settings, meaning that healthcare professionals may focus only on their weight, regardless of their reason for seeking medical care.

This can cause people to lose trust in healthcare professionals and can delay diagnosis, treatment, and care.

Making assumptions about people’s health based on their body type can also be a disservice to those with pear-shaped bodies, as the healthcare professionals they interact with may not screen for health conditions based on their body type.

Further, using such terms can worsen a person’s body image by suggesting that they do not have the “ideal” body type. The binary nature of these terms also fails to recognize that there are other body types besides pear- and apple-shaped ones.

What’s more, positioning one body type as superior to another can lead to judgment and stigma against people with other body types. No one needs to modify their body to resemble another’s, and research suggests that body shape isn’t a choice, anyway.

Genetics can play a role in your body shape. Some people have longer torsos and shorter legs, while others may have shorter torsos and longer legs or be somewhere in between. Your height and limb length can play a huge role in the way your body looks.

Hormones can also play a role. For example, hormonal differences between men and women can lead to differences in fat storage. Men often store more fat in their stomach area, while women tend to store more fat in their hips, legs, and buttocks.

As women’s estrogen levels decline with age, their bodies tend to store more fat in the stomach region and less in the lower body.

While research has linked apple or android body types to greater risk of chronic disease, this is not always the case. Someone with more fat in the stomach area can be in terrific health, while someone who has a different body type may not be.

Finally, the available research is mostly based on observational data, which means it can’t confirm cause-and-effect relationships. Thus, while apple body types are associated with increased health risks, it’s not certain that the apple body shape is the cause of those risks.

There are many ways that you can better understand your body composition and health risk, such as:

  • Waist circumference: A larger waist circumference (greater than 35 inches or 85 cm in women; greater than 40 inches or 101.6 cm in men) indicates greater body fat in the abdominal area and greater risk of chronic disease.
  • Waist-to-hip ratio: This ratio compares the difference in waist and hip circumference, which can help indicate fat distribution. A ratio of greater than 0.80 in women and greater than 0.95 in men suggests greater fat stores in the stomach area. Those with a higher waist-to-hip ratio are at greater risk of chronic disease.
  • Body fat percentage: This can tell you how much fat is stored in your body. While this may be generally helpful, not all tests tell you where the fat is stored.
  • Lab tests: Blood work can tell you and healthcare professionals how your health is, regardless of your body type.

While these measurements and tests can be helpful, healthcare professionals shouldn’t rely on a single test to make a judgment about someone’s health. Instead, they should do follow-up tests if they have any concerns.

Also, it’s important to look at health from all angles, including diet, physical activity, sleep habits, stress, genetics, and mental well-being.

People often use the terms “pear” and “apple” to describe how bodies look and how fat is distributed. Historically, these terms have been used as indicators of a person’s health.

Numerous research studies have found that greater fat distribution around the midsection — an “apple” or “android” body type — may be linked with a higher risk of chronic disease and poor health outcomes.

However, because many of these studies are observational, the results do not clearly indicate how big of a role body type truly plays in health.

Additionally, it’s problematic to use a person’s appearance to make generalizations about their health, since bodies come in all shapes and sizes. Such generalizations also promote weight bias, which can lead to delayed care and treatment.

Instead, it’s important for you and any healthcare professionals you work with to look at your health holistically by considering all aspects of health, including lifestyle, genetics, and age-related factors.

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The Definitive Guide to Acne: Everything You Need to Know for Healthy, Happy Skin

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Acne is sometimes thought of as an issue for tweens and teens.

While it often happens in adolescence, it doesn’t necessarily stop once you’ve blown the candles out on your 20th birthday.

Reid Maclellan, MD, a member of the adjunct faculty at Harvard Medical School, says the idea that breakouts clear up with age is one of many myths about acne.

Other misconceptions, like the myth that having acne means your skin is dirty, can also interfere with proper treatment.

Complicating matters, there are several types of acne that require different approaches, and individuals respond differently to treatments.

“Acne is not a one-size-fits-all treatment,” says Maclellan, who is also the director of Proactive Dermatology Group and founder and CEO of Cortina. “Each individual person is unique and different, so what may work for one individual with a certain type of acne may not work for another.”

Whether you’re a teen trying to manage frustrating breakouts or an adult experiencing hormonal or cystic acne, you have options available to you.

Here’s what Maclellan and two other dermatologists have to say about how to treat acne based on your specific situation.

The most common types of acne are:

Aaron Secrest, an academic/research dermatologist at the University of Utah, says these types are broken into two groups:

Both types of acne are caused by:

Acne subtypes

There are also several subtypes of acne, including:

  • adult hormonal acne (occurs due to hormonal fluctuations)
  • acne excoriée (occurs when someone with acne compulsively picks their skin, leading to scarring)
  • acne mechanical (occurs due to friction or pressure against the skin)
  • acne conglobata (occurs when nodules, abscesses, and cysts link below the skin, causing redness and swelling)
  • acne as a side effect of medications

Adult hormonal acne

Adult hormonal acne occurs when sex hormones rise and fall. This can cause excess sebum production, changes to circulation and pH balance, and inflammation.

Acne excoriée

Acne excoriée, also known as excoriation or skin picking disorder, occurs when acne is picked at. It’s most commonly found among adolescents with anxiety disorders or obsessive-compulsive disorder (OCD).

Acne mechanica

This type of acne occurs when the skin is squeezed, rubbed, or exposed to pressure. It often occurs in professionals who wear masks or helmets, like football players or medical staff.

It typically shows up on the:

  • face
  • arms
  • legs
  • torso
  • buttocks

Acne conglobata

Acne conglobata is rare but severe and most often seen in teenage males, according to 2018 research. It happens due to sebum and bacterial buildup and can lead to large, red, painful bumps on the skin.

Acne as a medication side effect

Acne may be a side effect of several types of medication, according to older 2013 research. These include:

One common thread between all acne types and subtypes is the recommendation from dermatologists not to pop the pimple. Maclellan warns it can lead to scarring.

Fungal acne

Fungal acne technically isn’t acne. It’s actually caused by yeast.

“Fungal acne is a very rare condition that I have seen less than five times in the past decade, despite its popularity on social media,” Secrest says. “It is caused by a yeast, Malassezia furfur, and can occur after chronic use of oral and topical antibiotics to treat inflammatory acne.”

Erin Schoor, MD, a dermatologist with NYU Langone, says fungal acne is most common in people with oily skin.

Though pharmacies are full of products that promise to unclog pores, over-the-counter (OTC) remedies are not always the best route.

“When the acne becomes inflamed or OTC medications are not working, prescription medications are recommended,” Schoor says. “Antibiotics can be more helpful for deeper inflammation, which can lead to scarring.”

Prescription products and medications are most often needed for inflammatory acne.

Topical treatments

Mild to moderate inflammatory acne typically requires a prescription-strength topical treatment, Schoor says.

According to 2016 research, these products typically contain ingredients like:

Retinoids are a derivative of vitamin A that typically — but not always — requires a prescription. A 2017 report supported their use in acne therapy.

Maclellan says benzoyl peroxide is also typically more effective than salicylic acid. Still, he noted some people find it causes dryness, flaking, and irritation. In this case, he might prescribe a product with salicylic acid instead.

A 2020 study suggested azelaic acid was less effective than benzoyl peroxide.

A 2021 review indicated niacinamide could aid in treating several skin conditions, including acne.

A 2016 study on acne treatment mentioned that sulfur has become less popular because of its smell. The same study indicated that topical corticosteroids could be used for very inflammatory acne but noted they should only be used for a short duration.

A 2018 case study suggested that oral dapsone may help treat nodulocystic acne if isotretinoin (Accutane) doesn’t work.

Oral medication

Oral antibiotics may be prescribed to treat inflammatory acne. The most common include:

  • macrolides, like erythromycin, clindamycin, azithromycin, and roxithromycin
  • fluoroquinolones, like levofloxacin
  • tetracyclines, like doxycycline, minocycline, and lymecycline
  • co-trimoxazole

Schoor says spironolactone, a water pill normally used for blood pressure, may also help with hormonal acne treatment but should be avoided during pregnancy.

Schoor notes that oral antibiotics are not a long-term solution and are usually combined with other, often topical treatments for the most effectiveness.

“Oral antibiotics are limited to a 3-month treatment for fear of antibiotic resistance and side effects,” she says.

Isotretinoin can also come in pill form and may help with moderate to severe acne, but it’s also not a long-term treatment.

“This pill is usually given for 4 to 6 months and is weight-based,” Schoor says. “It can cause birth defects if a pregnant person takes isotretinoin and is associated with other potential side effects, so it is monitored closely.”

Maclellan says hormonal birth control may aid in treating hormonal acne.

Injections

Schoor says cortisone can be injected into a deeper nodule or cyst for a more rapid resolution.

Research from 2016 suggested that these injections, particularly using the corticosteroid triamcinolone acetonide, may reduce the appearance of keloid scars and their post-surgical reappearance.

Still, researchers indicated that this treatment isn’t without risk, including side effects like pain and skin atrophy, characterized by a loss of skin elasticity.

A 2020 study indicated that using glucocorticoids could also induce skin atrophy.

Laser and light-based therapies

According to Schoor, individuals hoping to avoid medication sometimes opt for laser therapy. She says it’s most effective for scar treatment. Research from 2016 suggested laser and light-based therapies were effective.

There are several sources to choose from, including:

  • fluorescent lamps
  • full-spectrum lights
  • green light
  • violet light
  • blue metal halide lamps
  • xenon flash lamps
  • laser

The American Academy of Dermatology (AAD) says people often see results, but they vary and can take time, typically about 12 weeks.

However, lasers and light treatment can rarely clear acne completely and are typically not recommended as a lone treatment.

Photodynamic therapy (or PDT) is a similar option that uses lower-powered light sources to nix P. acnes.

It’s most effective when combined with topical treatments, like aminolevulinic acid (ALA).

A 2013 study of 75 patients suggested it can help treat acne conglobata.

Other physical treatments

The AAD indicates acne scar removal surgery and fillers can aid in treating a few depressed acne scars.

Per 2016 research, other treatments may include:

  • comedone extraction to remove scarring, usually combined with isotretinoin
  • cryoslush therapy, or brushing a combination of solid carbon dioxide and acetone on the infected skin area
  • cryotherapy, usually with liquid nitrogen, to destroy diseased skin tissue, improve cosmetic appearance, and aid in the treatment of acne conglobata

There are a lot of options when it comes to acne treatments, and it can be overwhelming. It’s important to speak with a dermatologist if you can to get personalized recommendations for you. You can even do so via telemedicine or with an app.

Acne that is mild, comedonal, and without scarring can sometimes be treated with OTC and natural remedies.

Over-the-counter ingredients

Experts and research suggest these are the best ingredients to try if you’re trying to treat and reduce the appearance of acne:

Benzoyl peroxide

Benzoyl peroxide can often be found in gels and lotions. OTC benzoyl peroxide is available in concentrations ranging from 2.5% to 10%, according to a 2021 review.

Schoor says OTC products with benzoyl peroxide can help unclog pores and reduce comedones.

Maclellan also says it’s effective. However, like its prescription counterpart, it can cause skin irritation.

Salicylic acid

Like benzoyl peroxide, Schoor says OTC products with salicylic acid aid in unclogging pores and treating comedones. Maclellan says it’s typically less harsh than benzoyl peroxide.

An older 2012 review suggested that salicylic acid can be found in products at concentrations of 0.05% to 5%. Researchers noted that it may help the appearance of acne, but results from OTC concentrations may be modest.

Nicotinamide

Nicotinamide is available in products over the counter and as a supplement.

A small 2017 review of 10 studies called for more research, however, two studies of oral nicotinamide supplementation suggested it led to a significant reduction in acne.

Peptides

A 2021 review listed antimicrobial peptides as a promising treatment for acne. This ingredient reduces bacteria, a trigger for acne, though more research is needed to confirm its effectiveness.

Azelaic acid

Azelaic acid, found in cleansers and creams, is a naturally-occurring ingredient with antibacterial and anti-inflammatory properties.

A 2021 review suggested it could help with acne treatment and post-inflammatory discoloration.

Azelaic acid may cause more hyperpigmentation in individuals with darker skin. Mild stinging is also a noted side effect.

Glycolic acid

Schoor says glycolic acid is good for exfoliation, which can help with cell turnover.

A 2020 study indicated that even at concentrations as low as 0.2%, glycolic acid could be an effective OTC treatment for acne.

Vitamin A

Retinols and retinoids are both vitamin A derivatives, but retinoids typically require a prescription.

Differin gel is the only retinoid that’s currently available OTC.

Schoor says it’s very effective in treating acne, and that OTC retinols are often effective at treating mild forms of acne as well.

Natural and DIY options

There’s not much evidence to support the efficacy of natural and DIY remedies for acne. Still, some herbs and home remedies can be used.

A few ingredients that have come up in research include:

Green tea

A 2019 study indicated that green tea extract has anti-inflammatory properties.

The main polyphenol in green tea, known as epigallocatechin-3-gallate (EGCG), may have sebo-suppressive effects. It inhibits the growth of P. acnes and has anti-inflammatory benefits, according to a 2016 review.

Still, other studies of green tea’s efficacy in reducing acne showed no improvement, the 2016 review noted.

Tea tree oil

A 2021 review suggested that tea tree essential oil may be as effective as topical benzoyl peroxide or salicylic acid for mild to moderate acne, but researchers noted the evidence was low quality.

Basil oil

A 2021 review indicated basil essential oil might reduce acne lesions.

A 2016 review also suggested that Ocimum gratissimum, a form of basil oil, reduced lesions faster than 10% benzoyl peroxide lotion. Another study mentioned by the authors indicated that Ocimum sanctum and Ocimum basilicum, two other forms of basil oil, may have antimicrobial activity against P. acnes.

While research suggests there are health benefits, the FDA doesn’t monitor or regulate the purity or quality of essential oils. It’s important to talk with a healthcare professional before you begin using essential oils and be sure to research the quality of a brand’s products. Always do a patch test before trying a new essential oil.

Copaiba Oil

A 2016 review indicated that this ingredient might help heal pre-existing pustules and prevent future pustule outbreaks if used for 21 days. Another study mentioned by the authors noted its anti-inflammatory effects.

Minerals

A 2021 review indicated that research suggests that seaweed-based therapies may help treat acne lesions.

A 2016 review suggested clay minerals like talc, often used in masks, may help acne treatment, particularly blackheads and spots.

Treating acne goes beyond visits to a dermatologist’s office. Tweaking aspects of your lifestyle and routine may aid in the reduction of the condition.

Skin care routine

Maclellan says the most important lifestyle tweak someone with acne can make is implementing a daily skin care routine that reduces their type of acne.

“When I say daily skin regimen, I mean a multi-step approach,” Maclellan says.

Though ingredients may vary based on the type of acne and individual, Maclellan says the six basic building blocks are consistent.

“There’s a myth that your face is dirty if you have acne,” Maclellan says, adding that it prompts some people to scrub their face. This action actually harms the skin barrier, which Maclellan says can exacerbate acne.

Washing twice per day with a gentle cleanser is a better solution, he says.

He recommends looking for a cleanser with benzoyl peroxide. Patch test it on a small area of skin for a few days. If you notice irritation, Maclellan suggests opting for a cleanser with salicylic acid.

Exfoliating with an alpha or beta hydroxide acid, such as salicylic or glycolic acid, can nix the dead skin cells that worsen acne.

Maclellan says a retinol or retinoid cream not only typically helps with any type of acne, but it has benefits for skin starting to show signs of aging as well.

Retinoid creams can make your skin even more susceptible to sunburns. Wearing a sunscreen of at least SPF 30 and reapplying every 2 hours if you’re in the sun is critical.

Maclellan suggests using a mineral-based sunscreen, as chemical sunscreens can irritate acne-prone skin.

Diet

Some research suggests diet may contribute to acne.

Research from 2016 suggested a link between high sugar foods and acne. The researchers also indicated a weak association between acne and dairy consumption.

The AAD notes that low glycemic foods may reduce pimples and that some evidence suggests cow’s milk — but not yogurt and cheese — may affect acne.

A 2021 study indicated that participants with acne had higher fast food intake but lower dairy intake than non-acne participants. Consumption of vegetables and water did not have a significant effect.

Mental health care

Though there have been several studies that suggest acne can trigger stress, there’s limited research about the reverse.

A 2017 review suggests that the idea that stress can trigger or worsen acne is underestimated. Researchers called for a holistic approach to treatment that includes working with mental health professionals.

Therapy can be an important part of acne treatment. This includes modalities like cognitive behavioral therapy (CBT) for anxiety and OCD, as well as more generalized therapy for support with self-esteem and confidence.

Maclellan notes acne can occur anywhere there are sebaceous glands. He says the areas with the most oil glands and most prevalence of acne are:

  • the face
  • shoulders
  • upper back
  • chest

The face is the primary spot where acne occurs, but certain types of acne are more likely to appear on specific body parts.

The appearance of each type of acne will be more or less the same wherever it appears on the body, as will the treatment.

Acne on the lower face and jawline

Hormonal acne usually appears on the lower face and jawline. It presents as deep cysts and nodules.

Treatments can include:

  • retinoids
  • oral antibiotics
  • topical use of benzoyl peroxide
  • topical use of azelaic acid
  • topical use of Winlevi (clascoterone)
  • spironolactone for females

Hormonal treatments, such as birth control, are also commonly prescribed, Secrest says.

Acne on the back and body

Secrest says tight-fitting clothes and backpacks can trigger acne mechanica on the back and body. Avoiding these items can help reduce this issue. Otherwise, standard treatments apply.

Try washing with a gentle cleanser containing acne-fighting ingredients like benzoyl peroxide, retinoid cream, and topical antibiotics.

The back is also a common spot for acne conglobata to appear, according to 2018 research.

Acne on the buttocks

Severe acne conglobata can also appear on the buttocks, particularly in adolescent males.

Potential treatment options include:

  • antibiotics
  • glucocorticoids
  • surgical incisions
  • retinoids
  • excision, the use of a scalpel to remove tissue above the fat layer.

The AAD notes that acne can affect a person emotionally as well as physically, including triggering anxiety, depression, and feeling alone.

But people should feel comfortable living their day-to-day lives, and Maclellan says there are ways to do so without worsening acne.

At the gym

A 2021 study did not indicate a link between exercise and acne. Still, Maclellan says some behaviors at the gym can trigger acne by spreading bacteria and clogging pores.

Taking some extra steps at the gym can help prevent post-workout breakouts, including:

  • removing make-up before a workout
  • wearing clean workout clothes
  • applying sunscreen before heading out, and reapplying every 2 hours if you’re taking an outdoor fitness class
  • toweling off and reapplying sunscreen to dry skin after sweating and before heading home
  • wiping down equipment before use
  • showering and using a gentle cleanse after working out

Maclellan says it’s best only to get the skin wet twice per day. Scheduling your workout in the morning or evening can help ensure you aren’t washing the skin and breaking down the barrier too often, he says.

In the sun

Maclellan says people with oily, acne-prone skin may be hesitant to wear sunscreen, as their skin already feels greasy. However, it’s essential.

Broad-spectrum, mineral-based sunscreens of SPF 30 or higher are the least irritating for people with acne, he says.

Maclellan says people with oily, acne-prone skin may be hesitant to wear sunscreen, as their skin already feels greasy. However, it’s essential.

Remember, retinoids can up the risk of sunburn. Some individuals taking retinoids may need to avoid the sun, particularly during peak hours of 10 a.m. to 4 p.m.

At the pool

A dip in an indoor or outdoor pool shouldn’t affect acne too much, particularly if you follow a few best practices, Maclellan says. These include:

  • Wear broad-spectrum, water-resistant sunscreen and reapply to dry skin after getting out of the water.
  • Check the water resistance of the sunscreen on the bottle, and be sure to reapply to dry skin as needed.
  • Moisturize, as pool chemicals may dry out the skin.

Maclellan adds that it’s acceptable to rinse off in the shower after going in the pool but avoid overwashing or scrubbing the skin.

Secrest breaks down acne development and treatment by age into three general groups: Tweens, teens, and 20+. Here’s what to know about dealing with acne throughout your life.

Ages 10 to 12

Secrest says this is the age people typically notice blackheads or whiteheads. He most frequently sees it in the T-Zone (forehead and middle of the face). He suggests opting for a retinoid.

Adapalene is available over the counter. Tretinoin, or Retin-A, can be prescribed by a dermatologist.

Instructing tweens to avoid picking at acne can help them avoid scarring later.

Ages 13 to 19

As people hit their teenage years, Secrest says acne becomes a combination of comedonal and inflammatory acne and requires a combination of treatments.

He suggests Adapalene for comedones and larger pores.

For inflammatory acne, Secrest recommends using an antibacterial wash, preferably with benzoyl peroxide, on the face, shoulders, chest, and back.

“The benzoyl peroxide needs time to soak into the skin, so I recommend to patients to rinse their faces in the shower, apply the benzoyl peroxide, and then leave it on for at least 5 to 10 minutes before rinsing it off,” Secrest says.

Ages 20+

Secrest says he treats just as many adults as teens and tweens these days, and the triggers can vary. If the usual rounds of topical washes aren’t working, it’s best to see a dermatologist for prescription topical or oral medication.

Adult hormonal acne has deeper cysts and nodules that often appear on the lower face and around the jawline, Secrest says. The breakout can last for weeks.

“Because these are deep acne spots, they rarely respond to topical over-the-counter acne products, so a visit to a dermatologist is necessary to prescribe a medication to counter the hormonal imbalance,” he says.

Acne from supplements

Secrest says testosterone treatments are a common cause of medication-induced acne.

“Very few [people] I have seen are willing to give up their testosterone supplements, so they need strong oral acne medications to combat this medication’s side effects,” he says.

Have more questions about acne? We’ve got you covered.

What’s the best acne treatment?

The best acne treatment is the one that works best for your skin and acne type. No one treatment works for everyone.

Mild acne, particularly blackheads and whiteheads, can often be treated with OTC topical products, such as cleansers or creams with benzoyl peroxide.

Inflammatory acne typically needs prescription-strength medications and creams, such as retinol and oral antibiotics. Sometimes, surgery, lasering, or another physical procedure is required to reduce the appearance of scarring.

Acne isn’t just triggered by physiology. Mental health can also be at play.

Some conditions, like anxiety and OCD, may prompt compulsive picking and cause scarring. Stress may also play a role in breakouts. Medications like selective serotonin reuptake inhibitors (SSRIs), talk therapy, and other de-stressing activities like exercise can aid in the treatment of these issues.

How do I get rid of acne in 5 minutes?

It’s not possible to nix acne in 5e minutes, but you can reduce its appearance.

Secrest says that anecdotally, Visine may reduce redness. Concealers can also cover up pimples.

Icing the pimple can minimize pain and swelling, according to the AAD.

How do I get rid of acne overnight?

Maclellan says using a cleanser with an acne-fighting product like benzoyl peroxide or salicylic acid can help reduce acne quickly, though you may not be able to get rid of it overnight.

You may be able to find spot treatments, such as creams, with a higher concentration of benzoyl peroxide at a drugstore.

Still, he cautions about overdoing it — especially if your cleanser already has the ingredient. It’s irritating and can worsen skin damage.

Scrubbing hard will also damage skin, so avoid it.

What is the ultimate cure for acne?

There’s no cure for acne, Schoor and Maclellan say: only treatments.

A skin care regimen that includes twice-daily use of a cleanser and moisturizer with ingredients proven to treat acne, such as benzoyl peroxide, is your best bet.

SPF is also a must to prevent further skin damage. Some forms of acne require prescription-strength products, oral antibiotics, and physical treatments like lasering.

Speak with a dermatologist if OTC remedies aren’t working for you.

How can I drastically reduce acne?

First, figure out what type of acne you have and the severity. That will determine whether you need prescription-strength or OTC treatments. A dermatologist can help you figure that out.

At home, use a cleanser with an ingredient like benzoyl peroxide, glycolic acid, or nicotinamide twice per day.

Apply sunscreen daily and reapply every 2 hours if you’re in the sun. Try to refrain from scrubbing the face or popping pimples, as that will only cause more skin damage. Take any medications as prescribed.

Consider lifestyle changes, such as mental health treatment for stress or compulsive pimple picking, and dietary changes at the discretion of a medical professional.

Acne treatments may have unwanted side effects, particularly under certain conditions. Secrest warns benzoyl peroxide may dry out skin, so using a moisturizer is necessary.

Forget the myth that drying out the skin will solve acne, Maclellan urges. “Dry skin will try to produce more oil,” he says.

Schoor adds that doxycycline, a common antibiotic used for acne, can cause sun sensitivity and worsen reflux. Retinoids can also exacerbate sun sensitivity.

Sun protection is essential all the time, especially during acne treatment.

Individuals who are pregnant or trying to become pregnant will need to speak with their providers, Schoor says. Retinoids should be avoided during pregnancy.

Acne can occur at any age, and treatment isn’t one-size-fits-all. The best course for you will depend on the type of acne you have, the severity, and how your body reacts to specific treatments.

Though there’s no cure for acne, multiple therapies are available. These range from OTC and prescription topical products to antibiotics and physical treatments like surgery or lasering.

A skin care regimen that includes washing with a cleanser twice per day and using SPF is a way to reduce acne and prevent reoccurrence and further skin damage.


Beth Ann Mayer is a New York-based freelance writer and content strategist who specializes in health and parenting writing. Her work has been published in Parents, Shape, and Inside Lacrosse. She is a co-founder of digital content agency Lemonseed Creative and is a graduate of Syracuse University. You can connect with her on LinkedIn.

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