A guide to acne

Almost 85% of Australians experience acne but what is the best way to treat it?

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Almost 85% of Australians experience acne — that is a staggering number of people affected by the skin condition. So, what causes acne? What does 'vulgaris' actually mean? And, what are the best ways to get rid of it?

The good news is that you've come to the right place. Here, we'll be exploring everything from the common types of acne to how it forms and the best way to approach the treatment of acne.

We're setting out to explain everything you need to know about acne and also bust some common acne myths along the way.

What does acne vulgaris mean?

Acne vulgaris is the medical name for 'common acne' [1]. It has acquired the name because almost 90% of adolescents develop acne, and it is commonly seen in adults (particularly women) too [2].

So, if you see or hear the name acne vulgaris, it's simply the official name for acne breakouts.

What causes acne?

There are a few things that can cause acne, but the biggest cause is hormones. Increases in some hormones can cause a surge in our body’s production of sebum, which can create hormonal acne.

The relationship between hormones and acne explains why many teenagers develop hormonal acne as they start puberty, and it also explains why acne is so common for people on hormone therapy, people taking prescribed steroids, women going through menopause, and women with polycystic ovary syndrome [8].

Some women may also notice an increase in acne during certain stages of their menstrual cycle, and this too is related to hormones [9]. Post-pill acne can also be a common experience when people stop using the contraceptive pill.

Aside from hormones, there are a number of things that play a role in the development of acne. These include:

  • Cosmetics products, including sunscreens, moisturisers and foundations, can include ingredients that combine with the oil on your skin and in turn, can clog your pores and cause acne. This is known as acne cosmetica and it usually pops up on your forehead, temples, jawline and around the mouth.
  • Wearing items that apply pressure or rubbing to the skin can result in acne mechanica. This is often exacerbated with heat and friction and is common in the formation of body acne — commonly found in places like the breasts, shoulders, bum and arms — thanks to the frequent rubbing of clothing on the skin.
  • Stress, smoking (and vaping!) and certain medications have also been shown to play a role in acne [12].

There have been some studies done that have revealed tenuous links between diet and acne, but we believe more research needs to be done in this area before any conclusions can be drawn from it. Although, there are some foods that can encourage clear skin including those high in omega-3 fatty acids (like salmon and sardines) as well as foods high in dietary fibre like fruits, vegetables, cereals and oats.

What are the different types of acne?

There are a number of different types of breakouts and despite various names like pimples and acne being used interchangeably, these refer to particular forms.

For example, pimples are individual acne lesions and while everyone gets them once in a while, when there are a lot of pimples on the face or body, this is considered acne.

There are a few different kinds of pimples [3]:

Comedones

Comedones are small bumps on the skin that generally form around the forehead and chin. Both blackheads and whiteheads are comedones — blackheads are open comedones, while whiteheads are closed comedones.

Papules

Papules often appear as small red bumps on the skin and are usually sensitive to the touch. These inflamed lesions can form in clusters and are caused by pores or hair follicles that are clogged with dead skin cells and bacteria.

Pustules

These larger red bumps contain pus and present with a white or yellow head. These pimples can come in different sizes and are usually a combination of oil, dead skin cells and bacteria that are trapped under the skin.

Nodules

Considered to be a more severe form of acne, nodules are large, often painful blemishes that appear as hard lumps under the skin's surface.

Because these blemishes don't contain pus, they are often referred to as 'blind pimples' and they develop when bacteria becomes trapped under the skin.

Pseudocysts

Cystic acne is considered to be one of the most severe and painful forms. Much like nodules, cysts develop under the surface of the skin, but these tend to contain pus. Cysts can often make themselves known during your period thanks to hormonal changes.

Papules, pustules, nodules, and pseudocysts are considered inflammatory acne because of the redness and swelling that accompanies them.

What’s considered ‘severe’ acne?

Acne is graded from mild to severe. The severity of acne depends on 2 things: the number of lesions you have, and the type of lesions.

The following information, from DermNet New Zealand, explains it well [1]:

Mild acne

  • Less than 20 comedones (blackheads or whiteheads)
  • Less than 15 inflammatory acne lesions
  • Less than 30 lesions overall

Moderate acne

  • 20-100 comedones
  • 15-50 inflammatory lesions
  • Between 30-125 lesions overall

Severe acne

  • More than 5 pseudocysts
  • More than 100 comedones
  • More than 50 inflammatory lesions
  • More than 125 lesions overall

If you see a doctor or dermatologist for help, the severity of your acne will be taken into account when deciding on the best possible treatment for it.

Why do some people get severe acne and some don’t?

We all have that one friend who never gets acne, and it can be frustrating to think that they’ve found some secret to good skin that we don’t know about. But unfortunately, we don’t yet know why some people get severe acne, some only get a mild case, and some get none at all.

One research paper has suggested that there are different strains of the p. acnes bacteria that could play a role in how severe an individual’s case of acne is, but even though this idea is interesting, it needs more research before we can know for sure whether it makes a difference [10].

In the meantime, it’s important to know that your likelihood of getting acne isn’t something you can control initially. No matter how severe your acne may be, it’s not your fault that you have it.

However, with a doctor’s advice (and a few clinically proven skincare ingredients) you can work towards giving your skin the best opportunity to combat this annoyingly common condition.

How do pimples form?

Pimples form when skin oils and bacteria get caught inside our hair follicles. Our follicles are usually pretty good at self-cleaning thanks to something called the sebaceous gland, which exists in each follicle and produces an oily substance called sebum.

Sebum carries out any impurities or foreign matter and expels it through the pore, at the top of the hair follicle [4].

This process occurs over and over again in our bodies every day, and it usually happens without any problems — but sometimes the follicle gets clogged. The sebaceous gland continues producing sebum, which builds up inside the follicle and creates a breeding ground for a skin bacteria called propionibacterium acnes [5].

As this bacteria multiplies, the body’s immune system is triggered and the skin around the area becomes inflamed as the body tries to heal the new pimple [6]. White blood cells can sometimes be used by the body to help heal the pimple, and these are later expelled as pus [7].

Is acne unhygienic?

Acne is definitely not unhygienic. While skin bacteria does play a role in acne, this bacteria is found on everyone’s faces and is natural to our bodies.

Having acne is not a sign that someone needs to bathe or shower more, or that they are ‘dirty’ or unclean in any way. In fact, showering or washing your face too much can cause acne to get worse, rather than better [11].

Acne is also not contagious, either.

Are there acne treatments available?

The good news is that there are a number of ways to treat acne and even the most severe acne can be treated and managed. From topical treatments to antibiotics, there is something for everyone.

We believe it’s important to seek treatment for acne once you believe it’s becoming a problem. If you’ve tried some over-the-counter acne treatments and they’re not working, or if acne is affecting how you feel about yourself, it might be time to speak to a Software doctor. Our Australian doctors can an effective treatment that’s proven to work.

The best ingredients to fight acne

When it comes to treating acne, there are a handful of skincare ingredients that are genuine superheroes. If you're on the hunt for a new way to treat acne, make sure that some of these ingredients are included in your formula.

Salicylic acid

Salicylic acid is a beta-hydroxy acid (or BHA) that has anti-inflammatory benefits, helps regulate oil production and gently exfoliates the skin. When it comes to acne, salicylic acid should be one of your go-t0 ingredients because it has the ability to sink deep into the skin and dissolve dead skin cells and trapped oils within the pores.

Clearing out the pores means you're less likely to develop acne. Plus, this BHA has also been shown to reduce the production of oil on the skin, helping to further reduce the likelihood of breakouts.

Software's Salicylic Acid Foaming Wash helps to target acne, exfoliate skin and repair the skin barrier with this superstar ingredient. This wash unclogs debris and oil in the pores, clears away acne-causing bacteria and in turn, helps reduce the formation of blackheads and whiteheads.

Plus, our unique blend of low-irritant ingredients means you can use the Salicylic Acid Foaming Wash 2-3 times per week on your face as well as your chest and back (and even your legs and neck) to treat pesky body breakouts.

Prescription retinoids

A derivative of vitamin A, retinoids are often prescribed as the first-line treatment to help manage mild to moderate acne.

Prescription retinoids work by stimulating the growth of new skin cells and increasing the rate at which old skin cells are shed. At the same time, retinoids also help reduce keratinization, which is the production of excess skin cells.

These actions help to reduce the formation of comedones while also improving skin roughness to reveal a smoother skin texture. Retinoids also have anti-inflammatory properties, helping to reduce redness and swelling associated with papules and pustules.

Benzoyl peroxide

Benzoyl peroxide helps treat acne by reducing the bacteria on the surface of the skin thanks to its antimicrobial properties [13]. It can be found in over-the-counter and prescription treatments in the forms of lotions, creams, gels and foams.

Azelaic acid

Last, but definitely not least, is azelaic acid. This ingredient is effective during all stages of acne, helping to reduce active breakouts, clearing up redness and scarring and keeping acne bacteria at bay.

In fact, azelaic acid kills the bacteria that reproduce in sebum. It seeks out the 2 forms of acne-causing bacteria (propionibacterium acnes and staphylococcus epidermidis), attacks them and inhibits their reproduction. This ingredient also helps to prevent clogged pores and reduces inflammation associated with acne.

Will acne go away on its own?

Acne can go away on its own but this process can take years, so actively seeking out acne treatments is worth it.

A really successful acne treatment won’t just target the pimples themselves, it will also improve the quality of your skin in general and make it so that pimples are highly unlikely to return.

If your acne has an underlying cause — for example, a hormonal imbalance — a doctor may be able to diagnose and manage that as part of your acne treatment.

It’s important to know that leaving more severe cases of acne to heal on their own can cause scarring, which can damage the condition of your skin. Acne scars can be treated, but as with acne itself, the sooner you access treatment, the better.

What’s the best treatment for me?

The best acne treatment for you is the one that works! For some, this may be with products that address acne at every stage. Software's Acne Kit is a 4-step system that works to reduce acne inflammation, balance oil production in the sebaceous glands, control emerging breakouts and repair the skin barrier.

Within the kit, you'll find Software's Acne Supplement, which targets breakouts from within and is designed to be taken throughout the lifecycle of a pimple (yes, supplements for acne are a thing!), as well as the AHA/BHA Pimple Patches, which speed up the healing process by delivering AHAs and BHAs into the deeper layers of the skin.

Pimple patches are also handy as they cover the breakout so you can't pick at it — no matter how much you might want to. And, in case you were wondering, no, you shouldn't pop a pimple. Leave them be and pop a patch on instead.

For others, a doctor-prescribed skin treatment may be necessary to say goodbye to breakouts. There are several things a doctor will take into account when prescribing you an acne treatment: which skincare products you have used before, any allergies you may have, any other skin conditions you would like to treat, and the sensitivity of your skin.

Because of this, there’s no single acne treatment that works for everyone: a good acne treatment will be tailor-made just for you and your skin. That's why Software's prescription acne treatment is personalised to your skin goals.

Using medical-grade ingredients like topical retinoids, niacinamide and azelaic acid, Software's formulas are created by our Australian doctors to target acne by strengthening the skin barrier, fighting acne-causing bacteria, preventing clogged pores and reducing redness and swelling.

Simply take our text-based consult and share your skin goals and an Australian doctor will customise a formula just for you. From here, your skincare treatment will be compounded and shipped straight to your door.

What does a successful acne treatment do?

A successful acne treatment may take weeks or even months to start visibly working, but once it does, it should reduce the number of visible acne lesions on your skin, along with any swelling, inflammation, and redness that comes with them.

After most acne lesions have healed, you might begin treatments that help restore your skin’s health and appearance and reduce any scars that are left over from having acne.

No treatment will work overnight, and treating acne does require time, patience, and the faith that it will work. But it’s important to know that it is possible: acne can be treated, and acne-free skin is achievable.


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