What can you do – About impure and acne-prone skin?

Around 70-80% of people suffer from different forms of impure skin and acne-prone skin. In some forms of mild to moderate acne, people do not seek out medication to manage their symptoms. However, it is advisable to consult a dermatologist, even for early or mild symptoms, as medicinal intervention can help to prevent further aggravation and consequences such as scarring.

Non-medicinal treatments, such as: cleansers, toners, scrubs, moisturisers and concealers are sold by pharmacists, over the counter, with no need for a prescription. These cleanse, clear and care for impure and acne-prone skin. There are also a number of lifestyle changes sufferers can make to control outbreaks and minimise symptoms.

Before deciding which non-medicinal treatment to use, it’s important to identify the symptoms that are causing concern. Treatments for impure and acne-prone skin and mild to moderate acne tend to address one or more of the four issues attributed to the condition.

They work by:

• reducing sebum production thereby controlling seborrhea.
• speeding up skin cell shedding, and therefore helping to deal with hyperkeratosis.
• fighting bacterial infection caused by microbial colonisation.
• and may even reduce inflammation and, in turn, calm down spots, papules and pustules.

It is also important to differentiate between impure and acne-prone skin and hypersensitive skin reaction with pimples or rosacea. The papules and pustules that appear in the hypersensitive disorder Rosacea, for example, are similar in appearance to acne but there are no blocked pores, the skin is more likely to be dry than greasy and Rosacea spots don't leave scars.

Read more about Rosacea and Couperose-prone skin.

Impure and acne-prone skin is a very common skin condition that usually begins during puberty when both boys and girls experience major hormone changes. Hormone substances, called androgens, stimulate sebaceous glands to produce more sebum than is necessary (seborrhea). This seborrhea may itself interfere also with the normal skin shedding.

When skin produces an excess amount of sebum and does not shed dead skin cells sufficiently, the two can build up in the hair follicle and form together as a soft plug. This plug may cause the follicle wall to bulge and produce a whitehead or, the plug may be open to the surface and may darken, causing a blackhead.

Pimples (also known as papules or pustules) are raised red areas of skin with a white centre that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside sebaceous glands produce lumps beneath the surface of the skin called cysts.

Impure skin is most commonly found on the face, shoulders, chest and back as these are the areas that produce the most sebum.

Hormones. Although most common in teenagers, there are increasing numbers of adults with impure and acne-prone skin, particularly women who experience hormonal changes during pregnancy, menstruation or as a result of a hormone-related condition such as polycystic ovary syndrome.

Bacteria. Acne-prone skin tends to be quite oily as a result of the excessive sebum secretion. This makes it more prone to bacterial overgrowth of the usually harmless bacteria that live on the skin. These cause irritation and inflammation to the enlarged sebaceous glands.

Genetics. There is some evidence that genetic predisposition plays a large part in the development of acne. If both parents suffered from acne during their adolescence, then the likelihood is great that their children will also develop acne. In the same vein, the children of adult acne sufferers are more likely to develop adult acne themselves.

As well as the facts, there is a lot of fiction surrounding the causes of acne-prone skin. These unfounded myths unfairly blame the sufferer for their condition. For example, people with acne-prone skin are often told that they are unhygienic or do not wash their skin often enough. The truth is that over-washing is actually more damaging to acne-prone skin than under-washing as skin can become more irritated by excessive rubbing. Sufferers are also accused of having a poor diet.

While a healthy diet is always preferable, there is little evidence to show that greasy foods or chocolate exacerbate symptoms.

Read more about medicinal acne therapies

While the main causes of acne-prone skin tend to be hormonal or genetic, there are some further factors that have been shown to aggravate the symptoms. For example:

• a diet rich in certain carbohydrates
• excessive drinking of milk and other dairy products 
• cigarette smoking
• heavy or comedogenic skin care products and make-up which is known to block pores

Whilst it is always a good idea to seek advice from a dermatologist, even for mild and early symptoms (to prevent the condition worsening), there are certain rules that make sense to be followed:

• Use lukewarm water rather than over-hot or over-cold.
• Use non-comedogenic make-up.
• Only use non-comedogenic skin care.
• Use sun protection tailored to the needs of oily and acne-prone skin.
• Leave pimples alone – touching or squeezing them will only make things worse.

Read more about medicinal acne therapies.

Moderate to severe acne may need medical intervention from a doctor or dermatologist but mild comedonal acne can often be treated without medication.

Pharmacists can offer a range of dermo cosmetic care products. These may include:

• Topical antibacterials, such as Decandiol, which can kill bacteria
• Licochalocone A, an effective anti-inflammatory
• Carnitine, which decreases sebum secretion
• Lactic acid, as a keratolytic agent

These can be used on any affected area, whether it’s the face, shoulders, chest or back. They can also be used as adjunctive care to standard medication treatment to counteract side effects such as skin dryness or sun sensitivity.

Given its additional risk of sun-induced acne-marks and its increased sebum production, it is important to include special sun protection in daily skincare routines. For example, Eucerin Sun Gel-Creme Oil Control Dry Touch SPF 50+/30 provides broadband UVA/UVB protection, biological cell protection and Oil Control Technology with sebum regulating L-Carnitine and a combination of three lipid-absorbing pigments for a long lasting dry-matt finish.

As well as the creams and gels used to treat the symptoms of acne-prone skin, there are also products available that can help mask the physical effects. For example, non-comedogenic make-up can be used to cover up facial blemishes, although it is important to remove it with a gentle cleanser at the end of the day. Men can also use camouflage make-up to tone down redness and give complexions an even tone. Concealers can be used topically on small, affected areas.

Contrary to myth, neither toothpaste nor Aspirin masks are effective in drying up spots. There is no medication evidence to prove either help in any way. In fact, toothpaste contains substances that can irritate and damage your skin.

In addition it is a good idea to eat healthily, stay away from places where skin is exposed to smoke or dirt and, given the psychological effects of impure skin, pursue interests that help improve self-esteem and self-confidence.

A daily cleanse, clear and care routine can take several weeks to take effect so be patient and persevere.