Since your skin can tell you so much about your health, it’s always a good idea to pay attention to what the location of your acne means, as well as what type of acne it is, in order to get a better idea of what’s going on inside your body. If it seems like new or worsening acne is cropping up — despite taking care of your health and your hygiene — it may be one way to tell if something greater is going on with your health.
While most acne is simply due to clogged pores, it’s possible that it might be a sign of something else. “It is important to consider your skin’s natural tendencies as new acne develops,” board-certified dermatologist Shari Hicks-Graham, MD tells Bustle. “If acne is common for you, that’s one thing, but if your acne suddenly becomes worse, consider any other changes in your health or medications and get help from your medical professional or see a dermatologist.”
Acne could be a sign of a hormonal imbalance, a side effect of medications you’re taking, or even a symptom of a yeast infection, or other systemic issues. Depending on where the acne is, it can be easier to pin down the cause. Here are nine places acne can crop up and what it may mean, according to experts.
Skin Conditions and Acne
IN THIS ARTICLE
• What Causes Acne?
• How Is Acne Treated?
• How Can Acne Be Prevented?
Most people develop acne — the most common skin condition — to some degree, but it primarily affects teenagers undergoing hormonal changes.
Acne may be mild (few, occasional pimples), moderate (inflammatory papules), or severe (nodules and cysts). Treatment depends on the severity of the condition.
What Causes Acne?
Acne is primarily a hormonal condition driven by male or ‘androgenic’ hormones, which typically become active during the teenage years. Sensitivity to such hormones, combined with bacteria on the skin, and fatty acids within oil glands, cause acne. Common sites for acne are the face, chest, shoulders, and back — the sites of oil glands.
Acne lesions include whiteheads, blackheads, small bumps, and nodules and cysts.
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Though acne is essentially a normal physiologic occurrence, certain conditions may aggravate the condition, including:
• Fluctuating hormone levels around the time of menses (women)
• Manipulating (picking/prodding) acne lesions
• Clothing (for example, hats and sports helmets) and headgear
How Is Acne Treated?
Only three types of drugs have proven to be effective for the treatment of acne — antibiotics, benzoyl peroxide, and retinoids. Most people require at least one or two agents, depending on the severity of their acne.
• Benzoyl peroxide, available as an over-the-counter product (for example, Clearasil, Stridex) and by prescription (for example, Benoxyl, PanOxyl, Persagel), targets surface bacteria, which often aggravate acne. Irritation (dryness) is a common side effect.
• Retinoids (vitamin A derivatives), for example, Differin, Retin-A, Tazorac, treat blackheads and whiteheads, the first lesions of acne. The most common side effect is irritation. While most are prescription only, there is an over-the-counter version of Differin now available.
• Antibiotics , either topically applied to the skin (clindamycin, erythromycin), or taken orally (tetracycline and its derivatives, ethoprim-sulfamethoxazole) control surface bacteria and reduce inflammation in the skin. Antibiotics are more effective when combined with benzoyl peroxide or retinoids. The oral retinoid isotretinoin(Absorica, Amnesteem, Claravis, Myorisan and Zenatane) is reserved for people with severe (nodular or cystic) disease. Isotretinoin shrinks the size of oil glands, the anatomic origin of acne. Without active, plump oil glands, acne actively diminishes. Side effects can include dry skin, elevated cholesterol and triglycerides, and birth defects. Women of childbearing age must practice birth control before, during, and after treatment (often a year) with isotretinoin. The use of isotretinoin requires rigorous testing (cholesterol, pregnancy) and follow-up for the prescribed period (5 or more months). It is reserved for the most severe types of acne that do not respond to other treatments.
• Hormone therapy may be helpful for some women with acne, especially for those with signs and symptoms (irregular periods, thinning hair) of androgen (male hormone) excess. The hormone therapy consists of low-dose estrogen and progesterone (birth control pills) or anti-androgen medications (spironolactone).
What Causes Acne? – Hormones
Common acne, known medically as Acne Vulgaris, is generally caused by hormonal changes in the body, and its onset usually can be found in teenage years when puberty rears its head. Acne is directly attributed to the rise of androgen hormone levels. The production of these hormones rise when a child begins puberty, and is the reason much acne is prevalent in adolescence. As androgen levels rise, the oil glands sitting directly underneath the skin enlarge and produce increased levels of oil, also known as sebum. When pores are filled with excessive sebum, it can cause surrounding skin cells’ walls to rupture and create a breeding ground of P. acnes bacteria. As the sebum attempts to push out of the pore, it can attach to this infectious bacteria and dead skin cells, causing a blockage that begins the formation of a pimple. According to Medical News Today, dermatologists purport that almost three quarters of 11 to 30-year-olds will deal with acne at some point, but acne breakouts can continue on into adulthood, and have been observed in patients in their fifties.
What Causes Acne? – The Role of Genetics
Genetics can also have an effect on acne breakouts, and may be the reason some people are acne-prone while others are not. One of the top cited studies took a look at 458 pairs of identical twins and 1099 pairs of fraternal twins to study acne prevalence. They found that genes explained a significant 81 percent of the difference in acne prevalence, while the other 19 percent was explained by non-shared environmental factors.
Yet another study took a look at the difference in rates of acne in first-degree relatives between patients and controls. The study used 204 acne patients, and 144 non-acne controls. Their study determined that having a first-degree relative who suffers from acne increases the risk of getting acne by four times. Genes play a role in several ways: firstly, they contribute to skin sensitivity. Acne-prone skin is more susceptible to oil production, and tends to shed and regenerate skin cells faster. Those prone to acne also exhibit strong inflammatory responses to skin irritants and bacteria in comparison to those who don’t have issues with acne.
While acne has been linked to genetics, it might also be plausible that shared habits and culture contribute to incidence of acne, although there’s been no significant science behind that claim.