SHARES
Have you ever tried so hard to cover the pimples on your face with concealers or foundation? Has it ever bothered you so much that you stop yourself from attending your best friend’s birthday party because you are just so worried about what people would think of your face? If your answer is yes to the questions or if you know someone who would nod their head away when you pop these questions, you my friend drop whatever you are doing and take a few minutes to read our focus this time, acne and the psychosocial stress caused by acne, and whether can acne be treated. Let’s first learn a little about pathophysiology of acne!
What is Acne?
Acne is an inflammatory condition of the pilosebaceous unit. Pilosebaceous unit is a skin structure that consists of hair, hair follicle, arrector pili muscles and sebaceous gland. The condition is more common but not limited to the adolescent age group (more severe in males) with the onset peaking in puberty. In males, the condition resolves in their twenties whilst women tend to suffer persistent acne which could go on till their forties. Acne can be characterized by certain changes in our skin as described below:
- Increased sebum production resulting from androgenic effect on pilosebaceous gland. Androgenic effect is the changes in hormone levels following puberty especially testosterone hormone.
- Blocking of the sebaceous duct due to hyperproliferation of keratinocytes. Keratinocytes are epidermal cells that form keratins in our skin
- Overgrowth of Propionibacterium acnes (P.acne) bacteria
- Inflammation and scarring
Image source: http://www.theacnelab.com/treatment/what-is-acne.asp
The image above shows the changes that occur in the skin during acne formation
Do you know that presence of small pimple (papules) alone on the face does not confirm the diagnosis of acne? Diagnosis of acne is confirmed by presence of comedones (open-blackheads or closed-whiteheads), papules and pustules. If someone is presented without comedones but only pustules, acne is unlikely.
Comedonal Acne
Acne Vulgaris
Nodulocystic acne
Image source: DermNet NZ http://www.dermnetnz.org/acne/acne.html
What causes Acne?
Acne is usually caused by a combination of factors such as:
- Genetics/heredity
- Androgenic hormones & sebum production
- Colonization of bacteria
- Stress
- Blocked hair follicles
Psychosocial Stress Due to Acne
Approximately 85% adolescents aged between 12 and 25 develop acne. Even though acne is a self-limiting condition that can be treated and resolved completely in most cases, the psychosocial stress caused by acne can be serious. This is because, adolescence is a crucial period of personality development and physical appearance plays a significant part in the process. Acne, regardless of its severity, can largely impact on self-esteem and body image of people who are affected by the skin condition. Large proportion of people with acne tend to be embarrassed with their skin and usually try to use thick layer of make-up or long hair to cover their faces. Acne affecting the trunk of the body on the other hand, might hinder them from joining sports that need them to disrobe in public changing rooms such as swimming, football or rugby. This shows how acne can significantly interfere in one’s daily activities.
The fear and inferiority complex that stem due to acne might lead to social withdrawal or isolation among teenagers especially. Presence of acne depreciates the self-confidence and hence causes trouble in forming new relationships mainly due to negative appraisal by the society. In severe circumstances, social phobia can develop and can aggravate depression. Social isolation in turn affects one’s performance in work and education. Some people might restrict career choices by opting to not go for jobs that require much social interaction or careers that depend on personal appearance. This can impinge on work satisfaction and work quality to a large extent.
Continuous depression and disturbed body image due to the psychosocial stress lead to a perception that one is suffering from severe acne even when the severity is very low. This condition is known as dysmorphophobic acne. People who suffer from dysmorphophobic acne might need psychiatric assistance on top of acne treatment. If acne is messing with your self-confidence and interfering with your social interaction, never hesitate to discuss this matter with your doctor.
Remember, acne is a condition prone to full recovery and anyone is susceptible to this skin condition. Would you believe if we tell you that, many of the ‘ever flawlessly’ perceived celebrities like Emma Stone, Justin Bieber, Britney Spears, Brad Pitt and our current Oscar fame, Leonardo di Caprio have all suffered from acne at a certain point of their lives! So, don’t fret and stress too much because you can flaunt your flawless skin too one day.
Can Acne Be Treated?
Yes we can. Now that we have talked about flaunting flawless skin, we can hear you asking what can be done to manage acne. So here are some of the self-contained managements for acne:
- Wash the affected area twice daily with mild cleanser and water/with an antiseptic wash
- Apply acne products to the area affected by acne, not just on the spots
- Do not scratch/pick the spots
- Use oil-free moisturizers
- Avoid oil-based cosmetics/sunscreen
- Smoking increases sebum retention and increases scale within the follicles, forming comedones. So, stop smoking helps reducing acne problem (and improves overall health too)
- Consume more vegetables and fruits (again, why not because it is good for health!)
- Avoid excessively humid conditions
- Consult your doctor if you are experiencing stress due to your acne problem
Mild acnes mostly can be treated using over-the-counter topical products; however it is always a good idea to visit a dermatologist if you are experiencing moderately severe to severe acne for appropriate treatments.
Our writer could personally relate to this topic while writing the article because they have also been affected by acne at some point of their life. So, we realize that it is very important for people to understand that acne is a self-limiting condition that can be treated and it is common to be stressed about it. The most important point though, never hesitate to seek help when you are depressed because you deserve a stress-free life! If you have experienced acne or have an insight on the topic please share with us in our discussion forum.
Fun Fact: Did you know that June is Acne Awareness Month??
References
by Thanusha Ganesan
Final year pharmacy student. Highly curious and immensely enthusiastic. I strongly believe that to be happy is to indulge in the spirit of giving. View all articles by Thanusha Ganesan.
