What to do with acne

What is acne and how does acne occur?

Your skin has tiny holes called pores that can get blocked by oil, bacteria, dead skin cells, and dirt. When this happens, you may develop a pimple. If your skin is repeatedly affected by this condition and you develop more red spots or red bumps, you may have acne.

There are different forms of acne:

  • Acne vulgaris, also known as the pimples because it is a common form of acne in adolescents and young adults.
  • Acne fulminans  is one of the forms of acne where you see an acute worsening of already existing acne.
  • Acne neonatorum is a form of acne that is mainly seen in young children or newborns.
  • Acne inversa, where lesions develop as subcutaneous inflammation in the skin of skin folds.
  • Acne conglobata, often caused by the male hormone, is the form of acne that persists after acne has cleared in adolescents and young adults.

Acne is one of the most common skin conditions in the Netherlands. While acne isn't a life-threatening condition, it can be painful, especially if it's severe. It can also cause emotional distress. Many young people do not develop symptoms until later in life, when they are in puberty. Facial acne can affect self-confidence and self-esteem and can cause permanent physical scars over time. There are many effective treatments for acne that both prevent acne and reduce the risk of scarring. We will discuss this further in this blog.

What are the symptoms of acne?

Acne can be found almost everywhere on your body. The red pimples and red bumps usually develop on the face, around the mouth on the back and chest or on the shoulders. In places where the growth of bacteria can run wild and where excessive sebum production plays a major role in the development of acne. If you have acne, you usually see pimples with a white or black head. Another word for blackheads comedones is used to name these pimples pustules and pimples. Blackheads form on the surface of the skin, giving them a black appearance due to oxygen in the air. Whiteheads are subcutaneous inflammations, which give them a white appearance. While blackheads are the most common lesions seen with acne, other types of acne can also occur. Inflammatory lesions are more likely to cause acne scarring. These include:

  • Papules are small, red, raised bumps caused by inflamed or infected hair follicles.
  • Pimples are small red pimples with pus at their ends.
  • Nodules are firm, often painful lumps under the surface of the skin.
  • Cysts are large lumps under your skin that contain pus and are usually painful.

What causes acne?

Acne occurs when the pores of the skin become clogged with oil, dead skin cells or bacteria. The bacteria propionibacterium acnes in particular causes the symptoms of acne. Every pore of your skin is the opening to a follicle. The follicle consists of a hair and a sebaceous gland (oil). The oil gland releases sebum (oil), which flows through the hair, out of the pore, and onto your skin. The sebum keeps your skin smooth and soft. One or more problems with this lubrication process can cause acne. It can occur when:

  • too much oil is produced by your follicles (excessive sebum production)
  • dead skin cells accumulate in your pores
  • overgrowth of bacteria accumulating in your pores

These problems contribute to the development of pimples.A pimple appears when bacteria (propionibacterium acnes) grow in a clogged pore and the oil cannot escape

What are the risk factors for developing acne?

Myths about what contributes to acne are quite common. There are many facts and myths about acne. Many people believe that there is a relationship between acne and diet. foods with a high glycemic index such as chocolate or chips are said to contribute to acne. While there is no scientific support for these claims, there are certain risk factors for developing acne. These include:

  • The influence of hormones and hormonal changes caused by puberty or pregnancy. The male hormone testosterone in particular plays a role in the development of acne.
  • Certain medical devices, such as certain contraceptive pills or corticosteroids
  • A diet rich in foods with a high glycemic index, sugars or carbohydrates, such as bread and chips
  • Having parents who had acne

The people with a skin condition like acne who are most at risk of developing it are adolescents and young adults. During this time, the body is subject to changes under the influence of hormones. These changes can cause the excess sebum production, leading to an increased risk of acne. Hormonal acne associated with puberty usually decreases or at least improves in adulthood.

How is acne diagnosed?

If you have symptoms of acne, your doctor can make a diagnosis by examining your skin. Your doctor will identify the types of lesions and their severity in order to make the best choice of acne treatments. Even then, the doctor can determine how many treatments are needed to prevent the acne symptoms from worsening.

How is acne treated?

There are a few self-care activities you can try at home to prevent breakouts and clear up your acne. Home remedies for acne include:

  • Prevent poor hygiene by cleansing the skin daily with a mild soap to remove excess oil and dirt
  • Wash your hair regularly and keep it out of your face
  • Use makeup that is water-based or labeled "non-comedogenic" (doesn't clog pores)
  • Do not squeeze or pick pimples, which spreads bacteria (propionibacterium acnes) and excess oil due to excessive sebum production
  • Not wearing hats or tight headbands
  • Don't touch your face

Natural skin oils

Castor oil, also known as castor oil has a cleansing effect and frees the skin from pores. Due to the low molecular mass in the oil, it penetrates deep into the skin and has a bactericidal effect. For this reason, castor oil is a good remedy for (mild) acne and gives dry skin and sensitive skin a fresh tint. To treat mild acne complaints, dab a little pure castor oil on the skin with a clean cotton pad before going to bed. The oil will reduce the redness and swelling of the acne spots over time. To prevent future blemishes, wash your face with warm water first. The pores will open. Massage a small amount of oil (just a few drops) into the skin. It is best to let the natural oil soak in overnight. Wash the face in the morning and rinse off the oil. Rose hip oil may help prevent acne. The vitamin A in the rosehip oil helps counteract excessive sebum production in the skin. When the skin produces less sebum, blackheads and other skin impurities such as acne are prevented. In addition to preventing acne, the oil also works particularly well in treating acne scars.Especially dark (old) acne scars fade when using rosehip oil


If the above doesn't help your acne, there are a few over-the-counter acne medications available. Most of these medications contain ingredients that can help kill bacteria (propionibacterium acnes) or reduce excess sebum production on your skin. Some of these drugs have an anti-inflammatory effect. These include:

  • Benzoyl peroxide is present in many acne creams and gels. It is used to dry out existing red pimples and red bumps and prevent new ones. Benzoyl peroxide also kills acne-causing bacteria (propionibacterium acnes)
  • Sulfur is a natural ingredient with a distinctive odor found in some lotions, cleansers and masks.
  • Resorcinol is a less common ingredient used to remove dead skin cells.
  • Salicylic acid is often used in soaps and acne. It helps prevent pores from clogging and prevents excessive sebum production.

Sometimes people with a skin condition continue to experience symptoms despite various acne treatments. If this happens, it's best to seek medical advice for acne treatments specific to your skin. Your doctor can prescribe medications that can help reduce your symptoms and prevent acne scarring. These include:

  • Topical or oral antibiotics have an anti-inflammatory effect and kill the bacteria that cause pimples. Usually, antibiotics are only used for a short time, so that your body does not build up resistance and you are susceptible to infections.
  • Prescription creams such as retinoic acid or benzoyl peroxide are often stronger than over-the-counter treatments. They work to reduce excess sebum production. Benzoyl peroxide serves as a bactericidal agent that prevents the resistance of acne-causing bacteria to antibiotics. It also has moderate comedone destroying and anti-inflammatory properties.
  • Women with hormonal acne can be treated with birth control pills or spironolactone. These drugs regulate hormones that can cause acne by decreasing oil production.
  • Isotretinoin (Accutane) is a vitamin A-based medication used to treat certain cases of severe nodular acne. It can cause serious side effects and is only used when other treatments have failed.

Your doctor may recommend procedures to treat severe acne and prevent scarring. These procedures work by removing damaged skin and reducing oil production. They contain:

  • Photodynamic therapy uses medication and a special light or laser to reduce oil production and bacteria. Other lasers can only be used to help improve acne or scars.
  • Dermabrasion removes the top layers of your skin with a rotating brush and is best for treating acne scars as opposed to acne treatment. Microdermabrasion is a milder treatment that helps remove dead skin cells.
  • A chemical peel removes the top layers of your skin. That skin peels off to reveal less damaged skin underneath. Chemical peel can improve mild acne scars.

Your doctor may recommend using cortisone injections if your acne consists of large cysts. Cortisone is a steroid produced naturally by your body. It can reduce inflammation and speed up healing. Cortisone is usually used in conjunction with other acne treatments.

What is the outlook for someone with acne?

Treatment for acne is often successful.Most people can expect their acne to clear up within six to eight weeks. However, flare-ups are common and may require additional or long-term treatment. Isotretinoin is the treatment that will produce the most permanent or long-lasting positive results. Acne scars can cause emotional stress and worsen mental health. But prompt treatment can help prevent scarring. Also, a dermatologist or medical specialist has treatment options designed to treat scars.

How can acne be prevented?

Acne is difficult to prevent. But you can take steps at home to help prevent post-treatment acne. For example:

  • Wash your face twice a day with an oil-free cleanser
  • Use an over-the-counter acne cream to remove excess oil
  • avoid makeup that contains oil
  • remove make-up and thoroughly cleanse your skin before bed
  • shower after exercise
  • avoid tight-fitting clothing
  • healthy food with a low glycemic index
  • reduce stress
  • prevent poor hygiene

To learn more about strategies to manage your acne, talk to your doctor or a healthcare professional.

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