Everything You Wanted To Know About Acne From A Dermatologist

Acne – it’s more than just a reminder of our awkward teenage years. It’s an all-too common skincare condition that can vary from small annoyance to full-blown nightmare.

Thankfully, we had the chance to listen to Dr Nazirin Ariffin, a consultant dermatologist at Pantai Hospital Kuala Lumpur who also runs her own skin clinic in Midvalley, share her experience with treating acne.

What exactly is acne?

Acne is what happens when sebaceous glands on the body or face get clogged and infected, leading to pimples. It’s the most common skin condition in the world, especially among teenagers and young adults who tend to have more active sebaceous glands, and in oily-skinned folks.

While healthy sebaceous glands normally produce sebum to protect and care for the skin, they can get clogged by dirt, dead skin cells or other heavy substances like the wrong skincare or makeup. You see, a particular strain of bacteria called Propionibacterium acnes (P. acnes) also lives below your skin in follicles and pores, where it feeds happily on sebum and other skin cell debris.

Photo: Dr Nazirin Ariffin

This is usually fine, but when a gland is clogged, sebum has no way out and accumulates below the skin. This excess sebum causes the P. acnes bacteria to go wild– they gleefully chomp away at the feast, leaving a trail of waste and digestive enzymes in their wake. Their mess can irritate your follicles and cause inflammation – painful red swelling.

Imagine a quiet fine dining restaurant filled with couples on dates versus a horde of hungry uninhibited diners at an all-you-can-eat buffet. At closing time, the buffet is probably going to be littered with plates, leftovers, food stains… you get the metaphor.

All this damage also weakens your skin, leaving it susceptible to infection by more harmful bacteria. If the sebum clog gets infected by bacteria, this causes swelling and pus. That’s what we call a “whitehead”, because the pus shows up as an opaque, white liquid. A “blackhead” forms when the sebum clog is exposed to air, causing it to oxidise and turn black. When sebum accumulates without forming an inflamed head, you get a bump below your skin which is called a “closed comedone”. In severe cases, acne can manifest as large painful cysts.

Each of these blemishes can be treated in their own way.


So why doesn’t everyone get acne?

If we all produce sebum and play home to P. acnes, why do some people develop acne while others don’t? It comes down to a number of factors

  • Genetics: If your parents had acne, you’re more likely to develop it. Acne is more likely to affect someone with oily skin, which is also genetically determined.
  • Hormones: Androgens or “male hormones” such as testosterone increases sebum production. This happens during puberty and even in stages of the menstrual cycle for women – hence those pesky pre-period breakouts.
  • Medications: Certain medications like corticosteroids, lithium, and androgen treatments can worsen acne.
  • Physical contact: If your skin frequently comes into contact with grease, this can cause blockages.
  • Stress: Stress weakens your body’s natural defenses against infection and worsens acne.


How do you treat acne?

Broadly, acne treatments target two things: comedogenesis (pore blockage) and inflammation. Comedogenesis can be treated with regular use of hydroxy acids, commonly called chemical exfoliants. These include good old AHAs, BHAs like salicylic acid, and PHAs (polyhydroxy acids, gluconolactone).

If your acne doesn’t respond to drugstore treatments, it may require attention from a dermatologist. Your dermatologist will assess your case as being either mild, moderate, or severe, as effective treatments depend on severity.

In milder cases, topical ointments such as benzoyl peroxide, retinoids, or azelaic or salicylic acid are sufficient to bring acne under control. Your dermatologist may also prescribe an oral antibiotic to treat mild or moderate cases.

For severe cystic acne, dermatologists will prescribe isotretinoin, an oral retinoid that can decrease sebum production. Isotretinoin is most commonly known as Accutane and can only be obtained after diagnosis with a prescription.

What about natural options?

Like synthetic chemicals, naturally-derived compounds can also have antiseptic and anti-inflammatory properties. Honey, some essential oils, and even some elements like sulphur and silver are antibacterial. Besides that, willow tree bark is a source of naturally-occurring salicylic acid, which can dissolve excess sebum and debris in pores to clear blockages.

Resveratrol, a compound found in red wine, and tea tree oil are such examples that are both antiseptic and anti-inflammatory.

Tea tree oil, in particular, has been used as an anti-acne measure for years. According to a study by the Medical Journal of Australia, tea tree oil was nearly as effective as benzoyl peroxide (a bleach-derivative that suffocates acne-causing bacteria) in treating acne, and with far less irritating side effects.

Because of this, tea tree oil is found in a whole lot of skincare products targeted at addressing acne concerns. It’s touted as a multifunctional, miracle ingredient thanks to its antiseptic action, able to treat everything from acne to wounds and insect bites and more.

If you’d like to try a tea tree regime for yourself, the 100% natural Australian skincare range from Meditree is now available online and in all leading pharmacies!

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Featuring a completely natural and organic ingredient list with Australian tea tree and willow bark extract, Meditree’s offerings promise to treat acne, oily, or combination skin. For more information, head over to Meditree.