What Causes Acne?
No one factor causes acne. Acne happens when oil (sebaceous) glands come to life around puberty stimulated by male hormones from the adrenal glands of both boys and girls. Oil is a natural substance which lubricates and protects the skin, and under certain circumstances, cells that are close to the surface block the openings of sebaceous glands and cause a buildup of oil underneath. This oil stimulates bacteria, (which live in everyone's skin and generally cause no problems), to multiply and cause surrounding tissues to become inflamed….
If the inflammation is right near the surface, you get a pustule; if it's deeper, a papule (pimple); deeper still and it's a cyst. If the oil breaks though to the surface, the result is a "whitehead." If the oil becomes oxidized (that is, acted on by oxygen in the air), the oil changes from white to black, and the result is a "blackhead."
Some factors that don’t usually cause acne, at least by themselves are:
• Heredity: With the exception of very severe acne, most people do not have the problem exactly as their parents did. Almost everyone has some acne at some point in their life.
• Food: All over the world, parents tell teens to avoid pizza, chocolate, greasy and fried foods, and junk food. While these foods may not be good for overall health, they don't cause acne or make it worse.
• Dirt: Some individuals have more "oily" skin than others (as mentioned above, "Blackheads" are oxidized oil, not dirt). Sweat does not cause acne, therefore, it is not necessary to shower instantly after exercise for fear that sweat will clog pores. On the other hand, excessive washing can dry and irritate the skin.
• Stress: Some people get so upset by their pimples that they pick at them and make them last longer. Stress, however, does not play much of a direct role in causing acne.
• Hormones: Some women break out cyclically, but most women (and men) don't. Some oral contraceptive pills may help relieve acne, but unless a woman has abnormal menstrual periods and excessive hair growth, it’s unlikely that hormones play much of a role in causing acne.
• Cosmetics: Most cosmetic and skin care products are not pore-clogging (“comedogenic.”) Of the many available brands, those which are listed as “water-based” or “oil-free” are generally a better choice.
In occasional patients, contributing factors may be:
• Pressure: In some patients, pressure from helmets, chinstraps, collars, and the like can aggravate acne.
• Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone or the steroids bodybuilders or athletes take.) Most cases of acne, however, are not drug-related.
• Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne.

Treatment options
Skin care:
A good skin regime is the 1st step in the acne treatment. A cleanser containing alpha-hydroxy acids or beta-hydroxy acids, such as those found in ASAP, Aspect and CosMedix skin care products, can help remove the oil and dead skin cells from the surface of the skin to prevent the physical blockage of pores and acne. Beta-hydroxy acids (including salicylic acid) have the advantage of having anti-inflammatory properties and are more oil soluble making them penetrate oily skin better than alpha-hydroxy acids. For those with sensitive skin types, a gentle cleanser can be used and then active products like alpha-hydroxy acids or retinoids can be placed on the skin after as tolerated.
Topical retinoids, derivatives of Vitamin A, are also used in the treatment of acne. They are one of the most effective topical agents in the treatment of acne. Topical Vit A works by increasing the natural turnover rate of the skin, reducing the dead skin cells at the surface of the skin resulting in less blockage. This property also means that skin texture and fine wrinkles also improve. Some retinoids also help to reduce the amount of bacteria causing acne in the skin.

Microdermabrasion:
Microdermabrasion helps remove the dead skin cells from the surface of the skin and reduce pore blockage and acne. It is especially effective for blackheads (comedones ). It also helps with the penetration of skin care products.

Chemical peels
More effective than microdermabrasion usually, are chemical peels. Chemical peels exfoliate by using substances such as alpha-hydroxy acids (fruit acids) or beta-hydroxy acids. Beta-hydroxy acid peels, also known as salicylic acid peels, are a good option for those with acne as it helps reduce inflammation associated with the acne.

Make-up/foundation:
Make-up is also implicated in the cause of acne. Clients with active acne usually apply make up to try to cover up and in turn this causes more acne, leading to the use of more make-up .Foundations, even those claiming to be oil-free can physically block pores and cause acne. Mineral make-up does not block pores, and instead sits on top of the skin. At Jeunesse, we recommend Jane Iredale Skin Care Make-Up as they have anti-oxidants and anti-inflammatory properties as well as a SPF factor.

Photodynamic therapy
There have been advances in the treatment of acne that do not involve drugs with significant side effects, and can be highly effective. Photodynamic therapy is such a treatment that targets sebaceous gland activity. Being a localised treatment, it only has localised side effects, ie on the treated skin. There has been some studies showing that it may be as effective as Roaccutane in some cases. Photodynamic therapy works by placing a substance on the skin, which is attracted specifically to the sebaceous glands, and then activating the substance with a light source or laser. This specifically disrupts the function of the sebaceous glands and reduces their activity and the acne they cause. The results can last up to a year and some people require no further treatments for acne after their initial treatments.

Pharmacological Preparations:
Antibiotics either topical or oral & hormone treatments are alos used. Antibiotics work by reducing the acne-causing bacteria (including Propionobacterium acnes) at the surface of the skin. Antibiotics are most suited to inflamed acne lesions. They do unfortunately also affect the rest of the body as well.
Hormonal treatments work by helping to switch off the androgenic hormones, or the hormones that increase oil/sebum production and cause acne.

Why should I choose Jeunesse Appearance Medicine Clinic as my provider of acne treatments?
Our doctors specialise in skin treatments and will be able to give you the proper advice on the right treatment for you. Many of the treatments (both topical and oral) are prescription only and can only be prescribed by doctors. Our doctors also have a special interest in acne, and they are up-to-date with the latest treatments.

The first step is simply contacting us for your initial consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.

Ask our doctors a question about acne