- Hi, everyone, I'm Michelle Rodrigues,
dermatologist at crime dermatology, great to be back.
Today, we're gonna be talking about all things acne.
So what is acne?
I think it's really important for us to go back to basics
and kind of think about the normal anatomy,
and structure, and function of the skin.
Each little pore that we have on our skin,
is actually an opening to a hair follicle
attached to this hair follicle,
is a little oil gland called the sebaceous gland,
and the sebaceous gland makes oil called sebum.
And what normally happens is this oil
travels up the hair follicle onto the skin,
and lubricates the skin surface.
So that's normally what happens,
but unfortunately with acne, what happens is that,
there is an increased amount of sebum oil,
but oil gland, or sebaceous gland itself,
gets a little bit bigger.
It creates inflammation under the skin.
And then we get an overgrowth of a bacteria called,
Cutibacterium acne, and this is normal,
but it can increase in amount, in certain situations
and start to cause problems.
In addition to that,
there is a clogging of the hair follicle with oil,
and with skin cells called hyperkeratinization.
So all of these things together result in blackheads,
white heads, pimples, cysts,
and really bad lumps under the skin,
so that's normally what happens.
There are many factors that contribute to acne.
Number one, genetics.
So unfortunately, if mom, or dad, or brothers,
or sisters have acne, you're gonna be at increased risk
of developing acne.
Two, is hormones, and we all know that teenagers get acne
from time to time.
And in fact, 85% of teenagers do get it.
However, there are other times in life
when acne can surface for the first time,
pregnancy, during menopause,
and often there are cyclical changes of hormones,
even during the normal cycle.
Third is medications.
So there are some medications and particularly ones
that treat anxiety, or mood changes,
that can cause pimples to arise,
or can make pimples worse,
in someone who already has the pimples themselves.
And then there's a really important,
and really interesting emerging area of science,
in relation to diet, and gut health.
Research that has been done fairly recently,
has shown that if you have a diet
that's really high in sugar,
really high in carbohydrates,
or where you have excessive amounts of dairy,
it can actually increase, or exacerbate acne.
So important to think about all of those factors.
(upbeat music)
Let's talk about hormonal acne first.
So hormonal acne usually occurs on the lower face,
the jawline, and sometimes on the neck,
30% of patients in their thirties will have acne.
It's not rare, and if you've got it,
you're certainly not alone.
In terms of treatments, it's really important to think about
not only your general skincare,
making sure you have non-pore clogging cleansers,
moisturisers, thinking about lotions and gels,
making sure you're taking off your makeup,
effectively at the end of the day,
but it's also important to think about,
potentially treatments that can help,
regulate those hormones.
So we can actually use things like,
the oral contraceptive pill,
and we can use other tablets called anti-androgens,
to try to even out the hormones over time
to stop those pimples from forming.
Fungal acne is an interesting one.
So the medical term for this is Malassezia folliculitis,
or Pityrosporum folliculitis.
But basically it's a fancy name to say
that there's an overgrowth of a yeast,
called Malassezia on the skin,
and this can occur with increased heat,
increased in humidity in the weather.
If you sweat a lot,
you're probably more likely to get this kind of acne.
We tend to see it generally on the forehead,
the chest and the back,
and all of the spots look really uniform an identical.
So things like antifungal creams, lotions,
and even antifungal tablets are needed to be able
to clear this.
But also it's important to think about maintenance therapy,
if you're at risk of this,
or if you're someone who sweats a lot,
or gets hot and humid, you're working out often,
and you're getting that kind of folliculitis,
as a result of the activity that you do,
then you're gonna need to think about,
ongoing maintenance therapy as well.
Pomade acne is not a really commonly known type of acne.
It's more common in patients that have skin of colour,
and Pomade is a type of water based greasy substance,
that's used to style hair, that can actually leak down,
and creep down onto the skin, clogs their hair follicles,
clogs the pores, and causes acne to arise.
So it's commonly seen on the forehead, and temples,
more common in patients that have Afro-textured hair,
because they're more likely to use these kinds of products.
It's important to make sure that you avoid these ingredients
if possible, but if not that you're not applying it
directly to the skin,
try and acquire about three centimetres
behind your hair line,
make sure you're washing your hair regularly
to get this stuff off.
Also making sure that you wash your face on a regular basis
to make sure that it doesn't start
to creep down on the face.
And it's really important to stop touching your hair,
and then skin, hair, and then skin.
Cause it can often transfer the grease from your hair,
directly to your skin.
And finally maskne, or mask acne.
It's been around for centuries,
in people who've had to wear masks,
or reclusive facial gear, as a result of their work.
So we often would see it in healthcare workers,
frontline workers, we're now seeing it,
in the general population.
We actually see it in the ozone, not that kind of ozone,
just ozone around the mouth.
There's an increase in humidity within the air in that area.
There's an increase in moisture because as we talk,
we create moisture and both of these two things,
changes the pH of the skin.
And it also changes the local skin microbiome,
and constant mechanical stress to the skin.
So the areas around the mask,
that are touching the skin on a regular basis,
are constantly causing friction,
and acne can develop in those areas.
So I guess the big question is,
well, what can we do to prevent it?
You want to try and wear a mask,
that's not continually re-used.
So if it's a disposable one,
make sure you're wearing it once, throwing it away.
If you are using cloth masks, or reusable masks,
it's important to make sure that you're washing them,
on a daily basis, so that the dirt,
and grime doesn't build up on the inside.
It's really important to make sure that you're not wearing
occlusive makeup underneath your mask,
because this can definitely clog pores,
and make the situation a whole lot worse.
Also a good idea to try some vitamin B3, or niacinamide,
which acts as an anti-inflammatory,
and doesn't cause irritation,
even if there's increased humidity in that local zone.
(upbeat music)
- Glycolic acid is an alpha hydroxy acid.
It's derived naturally from sugar cane,
and it can be seen in a multitude of skin care ingredients,
things like creams, gels, and cleanses.
It's a really, really good ingredient,
that penetrates really deeply into the skin.
So not only can it exfoliate the skin,
reduce blackheads, white heads, and inflammation,
but it can also stimulate collagen.
So a really nice ingredient for congested skin.
Salicylic acid is the other ingredient that I quite like.
This is a beta-hydroxy acid,
and it's naturally derived from Willow bark.
But what's really great about salicylic acid,
is it really penetrates the oil gland,
very, very effectively.
So it can be used as an exfoliant,
it can be used to decrease the inflammation,
around the oil gland,
and generally improves overall blackheads,
white heads, and acne.
Another ingredient that I love is vitamin B3,
or niacinamide, it's an anti-inflammatory, antioxidant,
wonderful ingredient for all skin types.
And what it does is actually decreases inflammation
within the skin, so decreases the pimply red spots,
lumps and bumps whilst allowing your skin,
to receive other actives,
and not get too irritated from those.
And what I mean is say, retinoids, and retinoids is another
very, very nice ingredient for congested skin.
You can get over the counter retinols,
which are okay if you've got very mild acne,
but if you've got more moderate acne,
then you're probably gonna need to think about
prescription grade, Vitamin E derive medicines.
It actually increases cell turnover,
it works at a DNA level to try to reduce acne.
It reduces inflammation, exfoliates the skin.
It stimulates collagen, it's a powerhouse ingredient.
There's also benzoyl peroxide,
which is a really nice ingredient,
when paired with other skin ingredients,
say like retinoids, for example.
What it does is increases the penetration and effectiveness
of these ingredients and helps to reduce blackheads,
whiteheads and inflammation caused by acne.
So I think it's really important
that if you're using over the counter products,
like, cleansers, and moisturisers,
that are really light.
Cleansers that contain things like glycolic, acid,
salicylic acid, and so forth.
And you've tried some over the counter stuff,
that's specifically designed for acne prone skin,
and you're not getting anywhere.
It's important to think about consulting,
your local doctor or dermatologist.
(upbeat music)
So do make sure that you take your makeup off,
efficiently and effectively at the end of every day,
do make sure you are treating your acne early,
and appropriately to avoid complications.
Please don't pop your pimples.
This is definitely going to cause more trouble than good.
You'll end up with more scarring.
I know tea tree is often used for spot treatment of acne,
and it's great at doing that.
However, it can cause a very common irritant,
and allergic contact dermatitis.
Do make sure you see your doctor,
or dermatologist early, if your acne is not responding
to those little measures that you're using at home.
Also important that if you've got blackheads,
and white heads,
that you are trying to utilise exfoliating ingredients,
rather than trying to push them out yourself,
because often what happens is you push it,
and the inflammation goes backwards rather than out.
And you can create more trouble than good.
Thanks so much for watching guys,
this acne topic is hugely important,
particularly with maskne right now.
So if you have any comments, questions, or queries,
just pop them in the comments below.
If you'd like to see more videos from me, please click here.
Otherwise I'll catch you next time.