Like most people, I, too, have had a skin problem. Among them acne. The problems arose in adolescence and accompanied me until I finished my degree. The thing that hurt me the most was a few small pimples that came out on my forehead. I went to the dermatologist and he recommended a cream with benzoyl peroxide. It is a common treatment, but my skin could not bear it. My forehead became dry and irritated. It was so unpleasant that I immediately threw in the towel. I imagined that it would end up healing itself, with age, but that is not the case, acne can accompany us for life.
Between my dire experience with that product and the little faith I had in cosmetics at that time, I spent many years without using any specific product. My problem was not serious, it was not even obvious, but it was leading me down the path of bitterness.
• What is acne?
Although there are several types, acne is a skin condition that is usually a consequence of changes in our hormonal levels, which is why it occurs especially at puberty and during the teenage years.1
Hormones called androgens are responsible for establishing communication between the sebaceous glands —the ones that generate sebum in the skin— with the follicles —the small openings in the skin through which sebum is secreted.
In essence, acne is the consequence of poor communication between the sebaceous glands and the follicles. Normally, sebum protects the skin with a waterproof layer, but hormonal changes cause the secretion to accelerate and the skin to become more oily. The outer layers of the skin become thicker and denser influenced by the same hormones. The result is that the follicles become clogged with a dense mixture of cells and sebum. Blackheads are formed, in which the mixture darkens when it comes into contact with air, or whiteheads, covered by the surface of the skin.
This is where a bacterium called P. acnes gets involved. This multiplies in poorly aerated environments such as clogged pores causing inflammation. The consequences: an increase in reddened pimples, pustules, or even severe and deep lesions called nodules and cysts.
The cells in charge of eliminating waste, macrophages, destroy damaged tissues, and stimulate the skin to repair the damage. This takes from a few days to weeks, depending on the severity of the acne.
Several studies3 have been carried out, with different age ranges and different dairy products4, which have led to the conclusion that the consumption of dairy products can trigger acne. It is still unknown which ingredients in milk are responsible and, therefore, how this happens. There is greater evidence with the consumption of skimmed milk5, which could be attributed to alpha-lactalbumin. Since this does not always happen, it does not happen to everyone and it does not prevail with all dairy products, consuming less dairy is advice that should not be taken very seriously.
2. Sweets, candies, and other high-glycemic foods
In theory, high glycemic load diets would increase insulin levels, stimulate sebum production, and contribute to acne lesions. The reality is that studies show that a low-glycemic diet improves acne6. For this reason, it is advisable to stop consuming foods with added sugar (sweets, pastries, sweets, sugary soft drinks, etc.), sweeteners such as honey or syrups, as well as bread, pasta, or cereals made with white flour.
Chocolate is possibly the food that we most associate with acne, but surprise, it is a myth. There is no scientific evidence linking chocolate consumption to acne. In fact, the antioxidants in chocolate are beneficial for the skin.
We can think that the reason for this myth lies in the type of chocolate we consume. If chocolate contains sugar, it is a food with a high glycemic index and, therefore, we could relate it to acne. 7The problem with chocolate is in the sugar, so the best option is to have chocolate without sugar.
4. Fatty foods like pizza or french fries
A common myth about acne is that dietary fat translates into more oil in the pores, but there is no direct relationship between the two.8 However, a diet rich in saturated fat can stimulate micro-inflammations in all organs of the body. , including the skin.
• Remedies against acne
If you are looking for acne remedies, run away from anyone who promises results in a few days, miracles, or homemade recipes. You will read silly things like using baking soda, toothpaste, honey, yogurt, or Sudocrem. Don’t use any of that.
Baking soda and toothpaste are both alkaline and abrasive substances that can fuel lesions and irritate your skin. Don’t use food, like honey or yogurt. The sugars they contain will serve as food for the acne bacteria. Sudocrem is interesting if you have a cut or scratch because it will promote healing, but it does not act against the cause of acne and can clog pores even more. Also, do not use any other cream that is not indicated for acne. A comedogenic cream could make the problem worse.
Another of the false remedies against acne is the sun. You’ve probably heard that sunbathing and tanning dries out pimples and heals them. It’s not like that. Tanning can mask some acne marks, but the reality is that ultraviolet radiation from the sun has recently been found to make acne worse.9 The drying effects of the sun will cause your skin to rebound and accelerate sebum production. The thickening of the outer layer of the skin will clog the pores and prevent sebum from being released properly. To avoid this, it is necessary to use specific sun protection products for skin with acne, oil-free fluids, and non-comedogenic textures.
To find the best, safe, and effective acne remedy, you should go to your doctor, your dermatologist, and ask your pharmacist. Depending on the severity of acne, your skin type, your age, and your lifestyle, he will recommend you follow one treatment or another. The most common are:
1. Topical treatments
They are creams that are applied to the skin. They usually contain benzoyl peroxide and retinoids. Benzoyl peroxide kills the bacteria responsible for acne, reduces redness, and exfoliates dead cells. The main disadvantage of this type of treatment is that it can leave the skin red, irritated, dry, and with visible superficial peeling.
Retinoids are a group of derivatives of vitamin A with exceptional results against acne. They help exfoliate surface cells that clog pores. The disadvantage is that they photosensitize the skin, so they can only be used at night or must be formulated in products with sun protection.
Other common substances in this type of cosmetics are niacinamide —with a calming effect—, piroctone, olamine, and glycosyl —to fight against bacterial proliferation—, proceed —a ceramide that prevents irritation and acne marks—, LHA, Linoleic acid, and salicylic acid —micro exfoliants and with keratolytic action.
The usual oral treatments are antibiotics and isotretinoin10. Antibiotic treatments are only prescribed in cases of severe acne and when topical treatments are insufficient. Doxycycline is the most common.
The main drawback is that these antibiotics make the skin very sensitive to sunlight. That is why it is essential to combine them with cosmetics with sun protection, light, and non-comedogenic formulas.
Isotretinoin is the most powerful acne medicine. Dries up the original source of acne (excess sebum) and stops the appearance of pimples indefinitely. This solution is the last resort. Patients should monitor their body responds to treatment with regular blood tests. Side effects include severe dryness of the skin and lips or nostrils, which could cause flaking, tightness, and even nosebleeds. It is also photosensitizing, which means that it makes the skin more vulnerable to the sun.
If you are taking isotretinoin, you will need to keep your skin hydrated with rich textured moisturizers and use a high sun protection index. Use a lip balm specifically designed for very dry lips.
At the end of chemistry, some of my classmates opted for cosmetics. They were my link with that science and the reason why I dared to ask for advice again. Here’s the bottom line: If you have an acne problem, ask for advice. Check with your doctor, your dermatologist, your pharmacist.
I tried new products adapted to my skin and my lifestyle, in my case without benzoyl peroxide, as it turned out to be too aggressive for my skin. This time he was hopeful. I had gotten rid of my prejudices thanks to understanding the science behind the study of acne and the cosmetic and pharmacological products that fight it. It took me weeks to start seeing results, but the results came. My case was a mild case, which I was able to solve in a short time and only using topical treatments. I have never had those annoying pimples on my forehead again, no marks, no irritations, or redness. I wish I had known all this a little earlier.