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ACNE


What is acne? Acne or pimples can present as whiteheads or blackheads (close and open comedones) or inflamed papules, nosules or cysts. (1)

The severity of acne is often categorized as:

  • Mild which is mostly whiteheads and blackheads, with a few papules and pustules;
  • Moderate which is more widespread whiteheads and blackheads, with many papules and pustules;
  • Severe which has lots of large, painful papules, pustules, nodules or cysts and you may also have some scarring! (2)

So, how is acne formed? There are three main factors for acne formation. Let’s see the factors as belows:

  1. The skin cells are not shredded properly which cause plugging of pores.
  2. Androgen hormones which are present in both males and females regulate oil production in the skin. During adolescence, increased androgens or increased response to androgen can cause increased oil or sebum production.
  3. Overgrowth of Propionibacterium acnes bacteria within hair follicles.
  4. All the above factors will eventually cause inflammation and swelling of the hair follicles, result in acne formation. (1)

Do you know what factors that may worsen acne?

  • Milk and foods with high glycemic index such as white rice, glutinous rice, white bread, cornflakes, fried noodles, boiled potato, watermelon and the tarik may worsen acne.
  • Stress may also worsen acne. In some studies, exam stress worsens their acne.
  • Smoking may worsen acne too when smoker has lower level Vitamin E and cause higher level of oxidized sebum.

Acne Do’s

  1. Wash your face twice a day with water and gentle, oil-free cleanser.
  2. If you wear make-up, preferably use oil-free and water-based products and remove them before sleep.
  3. Apply acne medication to manage blemishes. Make sure you understand how to apply them correctly to get maximum benefit.
  4. Use a water-based moisturizer to keep skin soft, smooth and hydrated if necessary.
  5. Shampoo regularly and keep your hair off your face if you have long hair.
  6. Replace cosmetic sponges and old brushes regularly to reduce bacteria.
  7. Drink plenty of water, eat balanced diet and exercise regularly.
  8. Stop smoking
  9. Seek the advice from doctor if your skin condition doesn’t improve.
Oily Skin: Treatment and Prevention

Acne Don’t

  1. Do not ignore your acne as it may cause permanent scarring
  2. Do not squeeze or pick your acne as this can deepen the inflammation and cause scarring.
  3. Do not use harsh scrubs and cleansers that may irritate or dry your skin.
  4. Do not expose your skin to extreme temperature or sunlight.
  5. Do not use greasy oil-based cosmetics that can clog pores and trigger breakouts.

Treatment for Acne

Mild Acne
You may use commercial products. Otherwise, one topical agent can be considered.

Moderate Acne
A combination of 2 topical agents or if more severe, an oral antibiotic (prescription-only) to be prescribed by a doctor.

Severe Acne
In presence of nodulocystic acne or acne not responding to treatment, referral to a dermatologist is required. (1)

Reference

  • Patient Information Leaflet Acne Vulgaris. Malaysia: Ministry of Health, Dermatological Society of Malaysia, Academy of Medicine Malaysia; June 2012.
  • NHS. Acne [Internet]. United Kingdom; 2019 [updated 2022 July 12; cited 2022 Aug11]. Available from: https://www.nhs.uk/conditions/acne/diagnosis/