It haunts so many of us throughout different stages in our lives and is something that can have a huge effect on our self-esteem! From early teen years right through to 50+ years old, acne can hit when we least expect it!
As with most skin concerns, there can be a number of reasons our skins might ‘flare up’, and it is simply a case of understanding the possible causes through thorough consultation and skin analysis that we can determine the best plan of action to tackle it head on for you as an individual – there is no blanket solution for everyone.
So let’s take a look at the most common triggers for acne flare ups in our skins. I’m sorry to say that the 3 main causes are things that all of us have within our bodies and will encounter at some time (or many times) throughout our lives.
Hormones and Sebum (Oil) Production
Testosterone is the lead androgen (sex hormone) in the production of sebum, which is our skins natural oil. Any hormonal disruption or alteration to body balance can influence development of acne.
Did you know that testosterone reacts with the enzyme ‘5-alpha reductase’ and converts in the skin to become ‘dihydrotestosterone’. This highly active version of the androgen hormone triggers sebocyte proliferation and subsequently increases oil production.
The main lipids that human sebum contains are triglycerides, wax esters, squalene, cholesterol esters, cholesterol and free fatty acids.
Experimental and clinical data seem to indicate that it’s not only just the volume of oil but more the type of oil that’s secreted that contributes to the clinical signs of acne.
Women experience shifts in hormone levels as we age. The consequence is that androgenic hormones (sex hormones Testosterone, Oestrogen and Progesterone) are not always readily suppressed, and the skin can become more sensitive to these androgens. The jaw area is typically sensitive and is a key area for male pattern hair growth and acne development.
Oestrogen and progesterone are the primary female hormones that control menstrual cycles and regulate pregnancy. Both of these hormones can have an effect on acne as well – albeit less than androgens – by their periodic monthly fluctuations.
Use of oral contraceptives or homone replacement therapy (HRT) will alter the natural hormone balance and can be possible contributors to breakout activity and increased oiliness.
The immediate increase in luteinizing hormone following ovulation incites and acceleration in sebaceous gland activity. The higher sebum secretion then stimulates or exacerbates acne breakouts usually 2-7 days prior to menstruation.
**Top Tip – Use acne products appropriate for your skin in the week before your period to help minimise breakouts **
Metabolism and Diet
Whilst it has long been accepted that a healthy diet contributes to a healthy skin, there are still a lot of myths and controversies about specific foods. Research has been able to prove that where diet influences the hormonal balance in the body, the consequences can be seen as direct changes in skin condition.
High energy cardiovascular exercise means increased blood supply and metabolism. This results in increased sebum and cell production. Sometimes this can cause increased inflammation as the skin gets hot. Sweating can also cause dirt, debris and skin cells to stick to the skin, so thorough cleansing before and straight after exercise in essential!
Changes to Thyroid Function
Thyroid hormones are responsible for driving metabolism and therefore exert an effect on sebum secretion. Hyperactive thyroid conditions will result in increased sebum production, and you can often experience oilier skin with a potential for congestion and breakouts.
Iodine supplements have been known to increase oil flow because of their ability to influence Thyroxin production.
High Glycaemic Load Foods
Increased insulin and IGF-1 stimulates the synthesis of androgens and results in growth of sebocytes and thus increases sebum production. High insulin levels also trigger hyperkeratosis (red, dotty, ‘chicken skin’ as some call it, commonly found on the tops of our arms), which combined with increased oil production results in congestion and breakouts.
Increased blood sugar levels also makes the skin more sensitive to androgens.
I say this to all of my customers, but hydration is always key!! We often underestimate how much difference it can make to our skins just being well hydrated. This is because by maximising our water content, we can avoid our skins over compensating with the production of oils therefore resulting in dehydration and breakouts.
The dreaded word that haunts us all! Chronic stress is the primary aggravating factor leading to adult acne! Acute stress and temporary stress can cause a breakout from time to time, however, chronic stress increases hormone levels, leading to an increase in oil production and persistent low grade acne.
Research suggests that stress-induced release of neuroactive substances within the epidermis can activate inflammatory processes in the skin. A side effect of Substance P, one neuropeptide released is the stimulation of sebocyte activity – meaning more oil production. Skin dehydration as a result of increased cortisol then results in skin cells building up – rough, flaky, clogged skin follicles, because the skin cannot desquimate (shed) properly.
** Did you know that psychological stress can actually
slow wound healing by up to 40%!! **
When acne occurs, it is accompanied by an inflammatory response that injures the skin. This injured area of skin then undergoes wound repair in which the body produces scar tissue (collagen) to heal the wound.
Although the body replaces injured tissue with the same type of tissue (collagen), scar tissue lays down collagen in a different and inferior manner compared to a normal tissue collagen. This different arrangement of collagen in the body’s healing process is the key feature of scar formation.
There are 2 common types of acne scars, defined by tissue response to inflammation:
- Scars triggered by increased tissue development (i.e. keloids)
- Scars caused by loss of tissue (i.e. ice-pick)
Post Inflammatory Hyperpigmentation, (which I will be doing a blog about in the coming weeks so keep your eyes peeled for that), refers to the red or dark marks that are left behind after a breakout heals. Melanin is produced to regulate the inflammation and promote healing. Dependant on Fitzpatrick Skin Type (a universal scale used to determine skin colour and tone) these pigmentation scars can last for months or even years before the marks fade.
Now that we have a better understanding of the why’s and the how’s of acne in our skins, let’s take a look at some of the headline ingredients that are proven to aid the prevention and healing of breakout activity in our skins.
From the Vitamin B family, this ingredient is a firm favourite of mine and is suitable for the majority of skins.
- Regulates sebaceous gland secretions by inhibiting 5-alpha reductase enzyme activity.
- Inhibits interleukin production, resulting in anti-inflammatory properties in the skin.
- Scavenges free radicals
From the Asprin family, salicylic acid is a popular ingredient with many product brands. Like a corkscrew, it works into the follicles and clears them out.
- It has a keratolytic action which reduces congestion
- Lipophilic nature makes it ideal for oily or acne conditions
- Exhibits anti-inflammatory properties
- Kills bacteria
Now this is a goodie – Retinol comes in various forms and has a vast array of benefits for our skin concerns from acne to ageing and more.
- It regulates and reduces sebum production
- Normalises hyperkeratosis
- Smoothes and refines skin and pores
- Speeds skin healing and renewal
There are various prescriptive medications available to help with acne, however always seek the advice of your GP or a Dermatologist before using any of the following:
- Oral contraception
- Azelaic acid
Side effects of medications can also be a contributing factor to breakouts in our skins, along with other issues such as redness, dehydration, flaky and sensitised skin.
The best way to help maintain skin health is to incorporate an essential skincare regime such as:
- Double cleanse
- Exfoliation for non-retinoid users and only if skin can tolerate
- Targeted boosters or serums to heal and/or hydrate
- Protect with moisturiser and daily SPF
Let’s solve the problem!
So what are the best treatment options to help clear congestion, heal and soothe the skin, and prevent future breakouts?
This is a mechanical exfoliation of the stratum corneum (the top layers of your skin). This will enhance product penetration and improve the appearance of the skin. Since microdermabrasion is a superficial treatment targeting the upper layers of the skin, it is ideal to use on any superficial skin concern. There are two types of microdermabrasion:
- Traditional: which focuses on crystal or mechanical only exfoliation on dry skin. This is the form of microdermabrasion that I use here at Bella Beauty Skin Centre. The abrasion tips I use are ‘CRYSTAL-FREE’, silicone carbite tips. This is fantastic for the skin as it avoids the damage, or ‘scratches’ that can be inflicted on the skin with other methods such as diamond microdermabrasion.
- Hydrodermabrasion: which combines traditional diamond-tip style with products on the skin during the procedure.
LED Light Therapy
Red and blue LED lights are currently the only two light colours that are clinically proven to have benefits for our skins. LED light therapy is something that I often incorporate into the skin treatments I offer here at Bella Beauty Skin Centre! It’s really relaxing and gives some amazing results!
The use of Blue LED is great for the treatment of acne and it can be used after extractions as an anti-inflammatory and anti-bacterial agent.
- Increases skin hydration.
- Photosensitises porphyrins to create oxygen, which kills the P. Acne bacteria, which is what causes breakouts.
- Slows sebaceous activity (oil production).
So there we have it! I hope you have found this in-depth acne blog interesting and will help in understanding your skin and why it may be tormenting you with stubborn breakouts when you least expect them.
If you have any questions or would like to know about any other aspects of your skin please don’t hesitate to get in touch via my Contact page link here – http://www.bella-beauty.co.uk/contact/
I’ll be back soon with my next blog, and as always if you would like some info on any particular skin concerns you have then do drop me a message of head over to my Online Booking page to get your free Skin Analysis – http://www.bella-beauty.co.uk/online-booking/
Owner and founder of Bella Beauty Skin Centre