How many times have you heard people say that eating junk food gives you spots? And how many times have you wondered whether or not this is true?
In the case of pizza, it might just be what you choose to put on top of it that can lead to breakouts. Cheese, like all dairy products, can cause breakouts in some people, because it has a high content of androgens (precursors to male hormones) and it also affects the insulin levels in your body. Both of these can increase the amount of oil that your skin produces, and when the glands in the skin make too much oil, this can clog the pores and cause breakouts.
As well as cheese, the pizza dough contains gluten, and some people can’t tolerate this. If you’re sensitive to gluten, the skin might break out in response.
The Effects on Blood Sugar
The glycaemic index gives foods a score out of 100 based on the effects they have on your blood sugar. The higher the score, the more of an effect it has on your blood sugar. If the food scores 55 or less out of 100, the food is classed as low GI, and if the food has a score of 70 or more, the food is classed as high GI. A pizza with tomato and cheese on it scores about 80, which means it is rated as high. This means that it raises your blood sugar level and your chances of developing acne along with it. The more sugar there is in the blood stream, the more oil the glands in the skin produce, and this can clog the pores.
Acne is a very common and fairly treatable skin condition, though treatment may need to be used for months or years to keep it at bay.
What Is Acne?
Acne is a condition whereby excess oil from the skin’s glands gets trapped in the hair follicles and this causes breakout and inflammation. Acne tends to occur most commonly in puberty, and it affects more boys than girls, because the skin’s oil production is closely related to the production of androgens (male hormones), which spike in puberty. Acne can occur at any time of life where there are fluctuations in hormone levels.
It most commonly appears on the face, back, neck, and chest where there are more oil glands, and it can range from mild acne to very severe acne which can cause scarring.
What Causes Acne?
Small glands in the skin make oil that keeps the skin hydrated. The oil is released through the skin’s pores, and at times of hormonal fluctuation, or in certain weather conditions, your skin might produce too much oil, which clings to dead skin cells and other debris, and clogs the pores.
This often presents as blackheads, whiteheads, and small pimples, which occur when the pores get clogged up with dead skin and excess oils. The black colouring of blackheads is just pigmentation, not dirt. If oil gets trapped in the pores, pimples will form. Mild acne may not get any worse than this.
This presents as larger spots and inflammation, caused by the skin producing excess oil which leads to the multiplication of a bacteria called Propionibacterium acnes. This bacteria normally live on the skin without any problems, but if it grows in large numbers, it can cause the immune system to react and inflammation occurs. The skin can become red and spots filled with pus can develop. The spots will heal eventually but the skin can become discolored or even scarred if the spots aren’t treated adequately.
What Worsens Acne?
- Certain types of contraceptive pill like the progesterone only pill
- HormonaI fluctuations prior to menstruation
- Makeup that’s not oil free
- Picking and squeezing spots
- Sweating heavily or humid conditions
- Tight clothing
- Medicines such as phenytoin for epilepsy and steroid creams
- Anabolic steroids
- Diets that are high in sugar and milk (though this is not conclusively proven)
Myths About Acne
Acne isn’t caused by having ‘dirty’ skin. Washing too frequently can actually make acne worse
Acne Is Not Caused by Stress
There is no one definitive cause of acne. It’s a combination of hormonal causes, overproduction of oil and an overgrowth of bacteria.
There’s no evidence that exposing your skin to the sun can clear up acne
Skin Care for Acne Prone Skin
Don’t wash your skin too often. Twice per day is fine for most people. Use a mild cleanser and lukewarm water. Water that is too hot or too cold can irritate the skin. Don’t use harsh scrubs or astringents as this can worsen inflammation.
Antiseptic products might help to reduce the appearance of acne and cleanse the pores.
Blackheads can’t be removed by scrubbing or cleaning the skin.
Topical acne treatments can dry the skin out. If this happens, use a fragrance-free water-based moisturizer. Water-based products should not clog the pores.
Treatments for Acne
Acne treatments are designed to reduce spots as much as possible and prevent scarring. The treatment that your doctor or pharmacist advises will depend on the severity and type of can you have. Treatments are either applied to the skin topically or taken orally in the form of tablets. If your acne is very mild, you might just choose not to treat it, but if you have inflammation and redness, you should treat it as soon as you can to prevent scarring. No treatment can completely cure acne and it often goes away on its own.
Topical Treatments for Acne
These come in the form of gels, lotions, or creams, and they work in different ways. Always read the leaflet that comes with each treatment, and make sure you understand how to use it, and what the precautions are. Topical treatments should be applied to the affected area of skin and not to each individual spot.
Benzoyl peroxide is a commonly us
ed topical treatment. It does 3 things to combat acne; it kills the bacteria that causes it, reduces inflammation in the skin and helps to clear the pores. It is effective at clearing spots that are inflamed and blackheads and whiteheads.
Benzoyl peroxide is available from pharmacies and you don’t need a prescription. You’ll find that it comes in different brand names and strength, and there’s a 2.5%, 4%, 5% and 10% formulation.
Things to note about Benzoyl peroxide:
- It works best if you wash the skin 20-30 minutes before you use it
- It can bleach hair, bed linen, or clothes
- It often causes mild skin irritation. If your skin becomes irritated, stop using it until the inflammation goes away. Try using a lower strength formula, or reducing the amount of time that you leave the product on your skin before you wash it off.
To prevent skin irritation, try:
- Using the 2.5% formulation before increasing the strength if needed
- Use a water-based formulation rather than an alcohol-based one
- When you first start using it, apply it to the skin once per day, then gradually increase the amount of time you leave it on the skin. Once your skin gets used to it, apply it twice per day.
These are good at clearing the pores. You might see these labeled as adapalene, tretinoin and isotretinoin. They also reduce inflammation, so they are good for reducing acne in the early stages to clear pores and treat blackheads, whiteheads, and inflamed spots. You need a prescription to get these treatments.
Things to note about retinoids:
- When you use retinoids for the first time, you might experience some skin redness or peeling, though this does tend to reduce over time
- Your acne can worsen before it gets better
- Your skin can become more sensitive to sunlight. Try applying the product at night and wash it off in the morning. Always wear a sun protection cream if you are going out in the sun.
- Side effects of using retinoids include burning, irritation, and dryness, so maybe use a lower-strength product, and apply it less frequently at first.
- You can’t use retinoids if you are pregnant or trying to get pregnant, as there is a risk of harm to unborn babies. Discuss alternatives with your doctor.
There are various antibiotics that work to kill bacteria and reduce inflammation. They don’t really unblock pores, so they tend to treat the acne, but you might find that blackheads and whiteheads remain. You need a prescription for antibiotics. They can cause some side effects, but generally less than the topical treatments. They are usually used alongside topical treatments rather than on their own. Remember that overuse of antibiotics can make bacteria resistant to them, so they aren’t as effective.
Azelaic acid is an alternative to retinoids, and it works by clearing blocked pores. It clears blackheads and whiteheads, and it reduces acne, but it’s not generally as effective as antibiotics or benzoyl peroxide. It does cause less irritation though, so you might need to weigh up the pros and cons.
Some treatments contain a mixture of different ingredients, like benzoyl peroxide and an antibiotic, which tend to work better than just one ingredient alone.
Tablets for Treating Acne
These work by killing the bacteria that contribute to the cause of acne and they also reduce inflammation and clear inflamed spots. They don’t really help to clear the pores, so you may still notice blackheads and whiteheads, so you might want to combine the antibiotics with a topical treatment that clears the pores. If you have a lot of whiteheads and blackheads, taking an antibiotic and using benzoyl peroxide might be the key to improving your skin. Always read the leaflet that comes with antibiotics as they aren’t all the same. Side-effects and warnings may vary. The most commonly used antibiotics used to treat acne are tetracyclines, which include oxytetracycline, tetracycline, doxycycline and lymecycline. These types of antibiotics can’t be taken by children under the age of 12, and you can’t use them if you are pregnant or intending to become pregnant either. Food and milk affect the absorption of tetracyclines, so take them on an empty stomach, in between meals. Doxycycline and lymecycline can be taken with food, however.
Other antibiotics that are sometimes used to treat acne include erythromycin and trimethoprim. These are usually prescribed if tetracyclines are unsuitable for some reason.
You may be advised to take one of these if one of the above has not worked well or is unsuitable.
The Contraceptive Pill
The combined contraceptive pill may help if acne is thought to be related to hormonal fluctuations, such as acne that has developed or worsened since puberty or that flares up around the time of the menstrual period. It is the estrogen in the pill that is believed to be helpful. A pill called co-cyprindiol is very effective in cases where acne is caused by a sensitivity to androgenic (male) hormones. It’s also useful in reducing excessive facial hair which can occur alongside the acne. Co-cyprindiol contains a combination of an estrogen plus cyproterone, which works to reduce the amount of androgens being produced.
These really reduce the amount of oil that is made by the sebaceous glands. It’s very effective and usually even clears up severe acne. This is usually a last resort treatment however because it can have serious side effects and can only be used under the supervision of a specialist.
How Long Do You Need to Use an Acne Treatment For?
Whatever acne treatment you use, it is usual for it to take up to 4 weeks before you see any visible improvement. Most people respond well to treatment by the 6-week point, though it can take up to 4 months or longer to be generally free of spots. Most treatments only fail because people don’t give them long enough to work and give up using them. You should persevere with a treatment for at least 6 weeks before deciding that it doesn’t work for you. Use it exactly as prescribed and if there is no improvement after 6 weeks, speak to your doctor about a more powerful treatment. Although treatments will usually clear most spots, they won’t guarantee you perfect skin. You’re still likely to have some spots.
Can Acne Return After Treatment?
Once the spots have cleared, acne can often flare up again if you stop treatment completely. That’s why many people carry on with treatment for 4-5 years to keep the acne at bay. Acne is most prevalent in the teenage years and in the early 20’s, but a small number of people have it into their 30’s.
Maintenance treatment is often carried out with benzoyl peroxide or a topical retinoid. Both of these can be used for as long as you need to use them. The maintenance dose that is used is often lower than the does need to treat acne. Applying the treatment once to the skin every other day is often enough to keep the spots from returning.
Topical antibiotics or antibiotic tablets are not often used as a maintenance treatment once the spots have cleared up. This is mainly because long-term use of antibiotics can lead to the bacteria becoming resistant to the antibiotics and they will be much less effective. You can only use azelaic acid for 6 months at a time, and it is not advised to take it long term. If you have been using antibiotics to treat acne, your doctor or specialist may advise you to change to a treatment like benzoyl peroxide or a topical retinoid for long-term maintenance treatment.
Do You Ever Need to Be Treated in Hospital for Acne?
If your acne is severe and doesn’t respond to treatment, you may be referred to a hospital to see a specialist. This might happen if all treatments have failed and you need to use isotretinoin. You might also need to go to the hospital if you have extensive acne scarring. Treatments you might receive in a hospital for this include laser resurfacing of the skin, breaking down scar tissue down with a needle, which is known as subcision, or injection of a collagen filler to fill up the scar.
Natural Treatment Options for Acne
If you have tried every acne treatment going and your skin still looks no better, why not give some natural treatment options a try. There are a few products that you might just have in your bathroom and kitchen that might just restore your skin’s health.
Manuka honey comes from New Zealand and it is extracted from the manuka bush. Manuka honey has long been hailed as an acne remedy, and existing scientific studies claim that the honey has significant antibacterial and wound-healing properties.
In one study, it was found that clinics and hospitals are increasingly using dressings coated in the honey to aid wound healing. However, they stated that it was not clear exactly how they worked. The researchers then looked at the antioxidant and healing effects of 3 different types of honey and found that manuka honey was the most effective.
However, there are no conclusive studies that back up the effectiveness of manuka honey to prevent infection or heal tissues.
Tea Tree Oil
Tea tree oil is an essential oil which is extracted from the leaves of the tea tree which is native to Australia. It has long been used as a natural alternative treatment for acne. In a study in the 1990’s researchers studied 124 acne patients. Some were treated with a 5% tea tree oil in a water-based gel and the rest were treated with 5% benzoyl peroxide, a conventional over the counter acne treatment. The study found that although the oil did not work as quickly as benzoyl peroxide, it did lead to similar improvements after 3 months, and users reported far fewer side effects from the oil.
Topical treatment with tea tree oil is generally safe for most people, although it can trigger a reaction in some people.