30% of adults suffer from this condition

What is acne vulgaris?

Acne vulgaris is translated from Latin as “common acne”. This inflammatory skin condition mainly affects adolescents but persists as adult acne (also called late acne or Acne tarda) in 30% of cases. In acne vulgaris there is a overproduction of sebum caused by hormonal changes, particularly androgens, as well as keratinisation disorders in the sebaceous gland ducts. This leads to inflammatory reactions.
Annoying pimples, blackheads, papules and pustules affect the face, neck, décolleté, chest and back, and less commonly the underarms and the genital and buttock areas. 

How does acne develop?

At the start of puberty more male sex hormones, androgens, are released, which together with growth factors promote sebaceous gland overactivity. Sebum should normally reach the skin surface freely via the sebaceous duct. However, androgens also promote a increased production of keratinous material in the sebaceous duct. 

This keratinous material clogs the excretory duct, sebum can no longer flow freely and so-called microcomedones form. These are not yet visible to the naked eye but serve as precursors to blackheads. 

All of this creates favourable conditions for the growth of Cutibacterium acnes. This bacterium is part of the normal skin flora, but in some cases it proliferates excessively and triggers an inflammatory reaction with the formation of pustules, papules and nodules.

What forms of acne are there?

Common acne occurs in several forms. Acne comedonica is characterised by oily skin and the formation of predominantly closed comedones on the face (especially the forehead, nose and chin) that are not yet inflamed. 

In Acne papulo-pustulosa there are more open comedones, pustules and painful papules on the face and on the chest, back, neck and upper arms; these become inflamed and promote scarring. 

In men a severe form can occur, Acne conglobata or cystic acne, where highly inflammatory nodules may later encapsulate as deep abscesses. 

Other forms of acne are also known: contact acne, cosmetic or chlorine-acne, drug-induced acne, abuse-related acne, Mallorca-acne and hidradenitis suppurativa (acne inversa). In children one differentiates between neonatal acne and infantile acne.

Which bacteria are involved in the development of acne?

The bacterium Cutibacterium acnes plays a central role in the development of acne.

This bacterium is a natural component of the skin flora but can multiply excessively when the sebaceous glands are blocked. It then promotes inflammatory processes by activating the immune system and stimulating the production of inflammatory substances.

Other microorganisms such as Staphylococcus epidermidis can be involved in rare cases – usually secondarily, when the skin is already damaged.

Clearer skin made easy: the best tips against acne

• Choose the right skincare products: they should not contain perfumes or fragrances, pore-clogging ingredients such as coconut oil, olive oil, Acetylated Lanolin Alcohol, Isopropyl Myristate, Oleth-3, nor skin-damaging alcohols such as SD Alcohol, Propyl Alcohol, Isopropanol. Prefer dermatologically tested ingredients like niacinamide, panthenol, aloe vera and formulas with a skin-like pH (approx. 5.5).
• Cleanse acne-prone areas once a day. If you do it too often, the skin's natural microbiome is disturbed, which can worsen acne.
• After washing use water-based moisturisers. Oily or greasy creams are taboo for acne as they can block pores.
• Acne is less noticeable on tanned skin. However, UV exposure (including tanning beds) promotes blackheads and active acne treatments make the skin more sensitive to UV light. Avoid excessive sun exposure and choose non-greasy sunscreens.
• Adjust your diet. Avoid foods high in short-chain carbohydrates (maltose, glucose, potatoes, cornflakes, white bread). These products cause blood sugar and insulin levels to rise quickly, and insulin stimulates sebum production. The same applies to cow's milk and dairy products, which also have insulinotropic effects and can increase sebum production. Prefer a diet rich in fruit and vegetables.
• If you are unsure which foods aggravate your acne, remove a suspected food from your diet for a while and observe changes in your skin. A food diary can help determine whether these foods affect your acne.
• Do not squeeze pimples on the face above the upper lip, at the sides of the nose or towards the eye corner! This can lead to spread of germs and blockage of certain vessels. Acne cleansing should only be performed by experienced cosmeticians.
• Avoid touching your face, otherwise you risk stronger inflammations from additional bacterial contact.
• After consulting your doctor you can have chemical or mechanical peels. The keratin-sebum material can be dissolved by special peeling agents, acne cleansers or medications such as vitamin A acid preparations.
• If you want to cover acne with makeup, choose oil-free makeup. Use non-comedogenic cosmetics and antiseptic concealers.
• With acne it is important to wash bed linen, towels and washcloths regularly and thoroughly, otherwise they become breeding grounds for bacteria and promote acne.
• Sport and exercise are important not only for the whole body. They stimulate blood circulation and thus improve oxygen supply to the skin. Ensure adequate physical activity.
• If the consequences of acne become a psychological burden, support acne treatment with psychosomatic accompaniment therapy.
• For pronounced forms of acne consult a physician to determine suitable active ingredients and care measures depending on the severity of the condition.

These tips and tricks help you achieve healthy-looking skin without annoying pimples!