Acne or pimples are a universally unwelcome skin condition, usually prevalent on the face, and sometimes, on your chest and back. They occur when hair follicles in areas with large numbers of oil glands get clogged with dead skin cells and oil or sebum. Although this is a condition most commonly observed in teens due to increased activity of hormones, adults too, experience it. For some, the condition can be acute or chronic.

It is generally of two types.
Non-inflammatory: These are generally clogged pores (also called comedo) and manifest as blackheads and whiteheads. They are called open or closed depending upon the dilation of the follicle. 
Inflammatory: When the blocked hair follicle gets infected by bacteria, the inflammation gives rise to pus-filled bumps called pimples. 

What are the causes?

When sebum or oil produced by sebaceous glands in the skin block hair follicles, it leads to acne. Certain contributing factors include:

Hormonal changes

Testosterone — produced in larger quantities in boys than girls during puberty — leads to excess production of sebum, which clogs hair follicles. In adults, hormonal changes during premenstrual days, early pregnancy, or due to polycystic ovarian disease can cause overactivity of sebaceous glands and lead to the development of acne.

Family history

Studies have indicated that in about 50%-80% cases, genetics is the primary cause of acne. 

Medications

Steroids or certain drugs administered for the  treatment of fits, can trigger acne. 

Cosmetics

Skincare and make-up products that are not oil-free or left on the face for long periods of time, can cause acne. 

Lifestyle

Refined foods and habits such as smoking might trigger or worsen acne.

What are the treatment options?

Although acne does not have a great impact on physical health, it can severely affect mental health. The persistent presence of pimples, scarring, and pigmentation can lead to low self-esteem, anxiety and graver mental health issues. Statistically, about 90% of the global population is affected by acne at some point in their lives, of which around 92% suffer from anxiety and depression, and 14% even consider self-harm.

Some simple self-care activities can be helpful are: 

• Wash your face with mild soap and clean water at least twice a day to keep your skin oil-free
• Shampoo your hair regularly 
• Use make-up that is water based and non-comedogenic (does not block pores)
• Never pick on pimples as that will spread the infection 
• Avoid touching your face often
• Do not wear hats or tight headbands
• Stay hydrated to prevent excess oil secretion
• Apply a warm compress
• Use acne sticker, a band-aid that removes bacteria, dirt, and sebum 
• Always use a sunscreen
• Eat a healthy diet and try to avoid refined sugars
• Reduce stress

Medication

While some ointments and oral or topical antibiotics might help with acne, all medication should be used only under the supervision of a doctor. Also, look out for side-effects such as peeling of skin and liver damage. 

In severe cases, doctors may recommend certain procedures:

Photodynamic therapy: Use of lasers to kill bacteria and reduce oil secretion
Dermabrasion or chemical peel: Removal of the top layer of the skin
Cortisone injections: Cortisone is a naturally occurring steroid hormone in the body. Cortisone injections help in reducing inflammation of large cystic acne.

Acne is a fairly common skin condition that affects most people at some point in their lives. However, we should not let it get the better of us and remember that we are more than our skin. Instead, the focus should be on eating healthy, working out regularly, and staying hydrated — all lifestyle choices that go a long way to keep you healthy and glowing. 

References
1. Acne. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047 (accessed Mar 8, 2021).
2. Acne. NHS. https://www.nhs.uk/conditions/acne/causes/ (accessed Mar 8, 2021).
3. Burke D. What Causes Acne? Healthline. https://www.healthline.com/health/skin/acne (accessed Mar 8, 2021).
4. Important Statistics To Help You Better Understand Acne. Colorado Springs Dermatology Clinic. https://coloradospringsdermatologyclinic.com/info/important-statistics-to-help-you-better-understand-acne/ (accessed Mar 8, 2021).
5. Jonette E. Keri. Acne Vulgaris. MSD Manual. https://www.msdmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/acne-vulgaris (accessed Mar 8, 2021).