Acne Unit

– Acne Specialists

– Information About Acne

– Related Units

– Treatment Centers

As we have mentioned, acne is not a skin disease exclusive to adolescence. Infants and young children can be affected by it. Neonatal acne appears in the first weeks of life; there are even cases in newborns. As for infantile acne, it usually begins when the child is between four and six months old and lasts until they are two or three years old.

Both types of acne in such young patients are more common in boys than in girls, and their skin manifestations are very similar to those of juvenile acne. That is, both typical comedones and inflammatory lesions are observed, with the latter being much more frequent in neonatal patients.

Generally, the diagnosis of neonatal and infantile acne is clinical, although depending on the context, it is necessary to carry out complementary analytics and refer the case to the pediatrician, given that some cases of infantile acne may be related to mild forms of congenital adrenal hyperplasia or other types of hormonal alterations.

Juvenile acne is the most prevalent form of this dermatological pathology and perhaps represents the health problem that most concerns patients in this age range; both due to the aesthetic impact produced by the pimples and the emotional sequelae it entails.

It is estimated that around 80% of teenagers suffer from acne to a greater or lesser extent. Although until a few years ago there was a clear tendency not to apply treatment, mistakenly thinking it was something temporary, dermatologists now advocate for early diagnosis and treatment to avoid immediate skin damage and aesthetic sequelae in the medium and long term. It has been proven that the longer the disease lasts, the more likely it is to leave marks, spots, and scars.

Another reason to establish an effective treatment against acne is related to the emotional health of patients, as there is extensive scientific evidence indicating that acne is one of the elements that most deteriorates the self-esteem and psychological balance of young people who suffer from it.

The typical lesions of juvenile acne are associated with hormonal variations characteristic of adolescence, so they usually manifest around 11 years old, remain chronic or intermittent until 15 (approximately), and begin to progressively subside towards 18-20.

Generally, comedones are distributed in areas of the face where there are more sebaceous glands; that is, in the famous T-zone (axis formed by forehead, nose, and chin) and on the cheeks. However, patients with more severe forms of juvenile acne may have pimples on the chest, back, and upper arms, especially males.

Normally, boys experience more virulent forms of juvenile acne due to the influence of testosterone and the fact that their skin is thicker and has more sebaceous glands, which favors the obstruction of pilosebaceous follicles and the formation of comedones.

However, also due to hormonal causes, girls tend to suffer from less aggressive acne, but for a longer time. In them, it is common for acne to worsen during the second half of the menstrual cycle, as an increase in sebum secretion occurs prior to the arrival of menstruation, one of the factors that trigger the appearance of pimples.

Adult acne is an increasingly frequent reason for consultation in Dermatology. Within this class of acne, which affects patients over 25 years old, dermatologists speak of persistent adult acne, when it occurs in patients who have been suffering from it since their adolescence, and late-onset adult acne, in cases where the pathology debuts beyond 25 years of age.

It is much more common in women than in men; 30% compared to less than 10%, and it tends to manifest more severely. So much so that currently there is more talk about adult female acne than adult acne itself.

Although the characteristic lesions of adult acne are the same as those of juvenile acne, they are distributed according to a different pattern; specifically in a U-shape (axis formed by the mandibular angles, the peribuccal area, and the neck), compared to the T-shape (forehead, nose, chin) of younger patients.

Likewise, the diagnosis and treatment of adult acne are conditioned by hormonal factors and by the fact that acne lesions at this age tend to have a much greater inflammatory character, which in turn increases the risk of leaving scars.

There are other types of acne that require specific treatments according to the diagnosis established by the dermatologist to avoid aggravating the clinical picture and the state of the lesions:

Summer acne

It is a type of acne triggered by ultraviolet radiation. It is much more inflammatory than common acne, very virulent, and manifests mainly on the upper torso and arms of people who already have or have had common acne and expose themselves to the sun without adequate photoprotection. Summer acne, also known as Mallorca acne, persists in part thanks to false beliefs that sunbathing makes pimples disappear and that people with acne should not use photoprotectors because they provide a lot of oil. Neither is correct.

On the one hand, although it is true that the sun dries out the skin and has some anti-inflammatory effect, the reality is that the improvement in terms of the presence of comedones and blackheads is transitory. Additionally, it must be taken into account that the sun produces a thickening of the corneal layer of the skin (the outermost) and favors the obstruction of pilosebaceous follicles, worsening acne and causing a very frequent rebound effect at the end of summer.

Regarding the use of photoprotectors, there are currently oil-free sunscreens that also incorporate active ingredients that help treat acne.

Friction acne

Also known as mechanical acne, it is caused by direct and permanent contact of sweat with areas where clothing rubs (straps, belts, laces…). This sweat irritates the skin and leads to an increase in sebum production and obstruction of the pilosebaceous follicles, resulting in pimples and comedones. Frictional acne can cause itching; continuous scratching can spread acne-causing bacteria, damage the skin, and worsen its condition. This friction acne is relatively common in athletes due to the rubbing of sports clothing.

Excoriated Acne

It results from continuous and compulsive scratching and manipulation of pimples, leading to large marks and scars. Far from removing comedones, these habits favor the proliferation and spread of bacteria and aggravate skin lesions due to the pressure exerted with fingernails or other objects used to pop pimples and blackheads. It is more commonly found on the face, as it is an easily accessible area.

Drug-Induced Acne

This type of acne is induced by treatments with certain drugs, such as corticosteroids, barbiturates, oral contraceptives… and its treatment depends on the drugs that have triggered it.

Inverse Acne

It occurs when the sweat glands in the armpits, groin, and breasts become clogged, leading to an inflammatory process and the formation of nodules that can become quite painful. It is important to treat this type of acne, as the lesions tend to reappear, become hyperpigmented, or leave scars.

Topical treatments for acne can be formulated as gels, masks, creams, or lotions. They contain various active ingredients (alpha-hydroxy acids, azelaic acid, beta-hydroxy acids, benzoyl peroxide…) that are presented at different concentrations:

• Sebum regulators. They modulate the production of oil so that it is not excessive.
• Keratolytics. They prevent the accumulation of keratin and the obstruction of the pilosebaceous follicle. They refine the skin surface.
• Comedolytics. They destroy pimples and blackheads.

Our dermatologists choose the most suitable option for each patient, taking into account that the higher the percentage of active ingredient, the more effective the treatment is, but it also has greater potential to irritate the skin.

Therefore, low concentrations are usually indicated for more sensitive skin, and higher ones are used as the patient tolerates the treatment better. That’s why it’s important for the acne specialist to periodically monitor the patient’s progress to modify the dose according to the response and tolerance of the skin.

There are various oral therapeutic options for the treatment of acne that the dermatologist should prescribe according to each case. These treatments are aimed at controlling oil production, reducing inflammation, eradicating Cutibacterium acnes (a bacterium that feeds on sebum and waste substances closely linked to acne), balancing the hormonal profile in case that factor is behind excessive oil production, or reducing inflammation.

The goal of these therapies, which are increasingly safe and effective using minimal doses, is to control acne and prevent marks, scars, or pigmentation alterations associated with this skin condition.

Although these medications are subject to prescription, it is important for each patient to consult with the dermatologist to design a therapy adapted to the specific needs of each patient to act on the triggers of acne, control outbreaks, and prevent or treat the sequelae of this skin disease, such as marks and scars.

Laser is gaining ground in the therapeutic range for acne due to the multiple alternatives offered by different devices. The most up-to-date scientific evidence supports the use of laser in acne treatment, generally alongside other acne therapies and, depending on each case, combining different types of laser.

Thus, depending on the type of acne, its manifestations, and possible sequelae, we have:

Pulsed dye laser

To reduce inflammation associated with comedones and cysts caused by acne. It accelerates the healing of lesions.

Vascular laser

It is used to improve inflammation and reduce the redness of pimples and improve the appearance of the skin.

Pigment laser

To lighten hyperpigmented (dark) spots and scars left by acne after the pimple has disappeared, a very common problem in people with darker skin tones.

Ablative and non-ablative fractional laser

These devices can be used alone or combined to treat skin atrophy and acne scars.

The dermatologists in our Acne Unit are experts in handling different laser devices for treating this skin condition. Additionally, they have the support of technology and specialists from the Laser Unit of Grupo Pedro Jaén, the largest in Europe in the private sector, which ensures the best selection of treatments to achieve maximum effectiveness.

Regardless of the therapeutic protocol recommended by the acne specialist, it is important for the patient to follow their instructions in order to eradicate lesions, improve skin appearance, prevent outbreaks, and avoid the appearance of scars, marks, or spots.

Biophotonic therapy consists of applying a lamp with three panels equipped with high-power LED lights that emit blue light at a short distance from the patient’s skin, on which a photoconverter gel is previously applied.

The light emitted by the biophotonic device eliminates bacteria and exerts an anti-inflammatory effect on acne lesions. Likewise, this treatment activates microcirculation in the treated area, normalizes cellular activity, and relieves the redness of pimples. It also induces the production of natural collagen, which has a positive effect in reducing acne scars and improving the overall appearance of the skin.

One of the greatest advantages of biophotonic therapy is that it is useful for all forms of acne, even the most severe ones. On the other hand, the treatment consists of several sessions of only nine minutes each, applied over six weeks. It is painless and significantly improves skin quality, making it also a resource used for skin rejuvenation.
After each session, a moisturizer is applied, preferably with sun protection factor, and the patient can immediately resume their social and work activities. Makeup can be used, taking care to choose oil-free formulas. It is also advisable to drink plenty of water to help hydrate the skin.

Acne lesions remit in 90% of patients within 12 weeks of starting treatment. The good results are enhanced several weeks after the treatment has concluded.

Are there foods that cause acne?

Some research has linked diets high in refined sugars, ultra-processed products, and dairy to acne. However, the relationship between specific foods, such as chocolate, chorizo, or fried foods, is not real and responds more to myths about acne that should be dispelled. Except in cases where food allergies or intolerances exist, consuming a specific food does not directly aggravate acne or skin condition.

Does stress cause acne?

Stress and emotional tension are not direct causes of acne. However, as with other dermatological conditions such as rosacea, psoriasis, or atopic dermatitis, stress aggravates existing acne, as they share certain biochemical mechanisms.

Does sunbathing cure acne?

It has always been said that acne is cured in summer by sunbathing. However, this is not exactly true. The sun has an anti-inflammatory effect and dries out the skin, which can temporarily improve acne. Nevertheless, the hormonal factors and overproduction of sebum responsible for the appearance of pimples and comedones remain present, so the condition is not cured by sunbathing. Moreover, solar radiation can hyperpigment typical acne lesions and promote the permanence of marks and scars.

On the other hand, sun exposure also promotes the obstruction of pilosebaceous follicles due to the thickening of the stratum corneum, which results in a rebound effect that we frequently see at the end of summer.

Why shouldn’t you pop pimples?

Touching, squeezing, or popping pimples are behaviors we should avoid at all costs for several reasons. On one hand, this action increases the risk of causing infections by spreading bacteria and due to the trauma we cause to the skin by pressing the area or injuring it with our nails. On the other hand, these factors in turn increase the possibility of leaving marks and scars that may require specific treatment for their removal.

Therefore, the best way to make a comedone disappear is to have a little patience and apply specific products prescribed by an acne specialist, aimed at relieving inflammation and unclogging the pilosebaceous pore.

Are oral medications for acne safe?

Yes, but they are not over-the-counter; they can only be obtained with a prescription. The specialist must prescribe and supervise oral acne treatment to ensure its safety and avoid side effects.

Facial cleansing and acne… the more the better?

There is a marked tendency to overuse cleansing and exfoliating products in the hope of removing comedones and permanently ending acne. It’s true that, according to specialists, facial cleansing is key to keeping it at bay. However, overdoing this habit or using overly aggressive products can irritate the skin and cause a rebound effect. In the opinion of dermatologists, it’s best to clean the skin with products specific for acne-prone skin, use oil-free cosmetics, and protect from the sun with oil-free sunscreens that also incorporate active ingredients that help treat acne.

How can I care for my acne-prone skin

Clean it with specific products for acne-prone skin aimed at cleansing the pore and removing excess sebum.

Use oil-free cosmetics and light, non-comedogenic makeup. Don’t share it and don’t forget to clean your makeup brushes, sponges, and applicators frequently.

Don’t self-diagnose and don’t self-medicate. The dermatologist is the professional who can best help cure acne. Otherwise, the condition may worsen and leave difficult-to-treat sequelae.

Regularly visit a specialized beauty center and apply a specific facial hygiene routine for acne-prone skin.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén following our editorial commitment, through which we guarantee the truthfulness and updating of the information provided.

References about acne:

1. Gabriella Fabbrocini, corresponding author Sara Cacciapuoti, and Giuseppe Monfrecola. A Qualitative Investigation of the Impact of Acne on Health-Related Quality of Life (HRQL): Development of a Conceptual Model. Dermatol Ther (Heidelb). 2018 Mar; 8(1): 85–99. Published online 2018 Feb 12. doi: 10.1007/s13555-018-0224-7. PMCID: PMC5825329. PMID: 29435857.

2. A.U. Tan, MD,⁎ B.J. Schlosser, MD, PhD, and A.S. Paller, MD. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol. 2018 Jun; 4(2): 56–71. Published online 2017 Dec 23. doi: 10.1016/j.ijwd.2017.10.006. PMCID: PMC5986265. PMID: 29872679.

3. Alexander KC Leung,corresponding author Benjamin Barankin, Joseph M Lam, Kin Fon Leong and Kam Lun Hon. Dermatology: how to manage acne vulgaris. Drugs Context. 2021; 10: 2021-8-6. Published online 2021 Oct 11. doi: 10.7573/dic.2021-8-6. PMCID: PMC8510514. PMID: 34691199.

4. Darren D Lynn, Tamara Umari, Cory A Dunnick and Robert P Dellavalle. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016; 7: 13–25. Published online 2016 Jan 19. doi: 10.2147/AHMT.S55832. PMCID: PMC4769025. PMID: 26955297.

5. Jianting Yang, Haoran Yang, Aie Xu, and Li He. A Review of Advancement on Influencing Factors of Acne: An Emphasis on Environment Characteristics. Front Public Health. 2020; 8: 450. Published online 2020 Sep 17. doi: 10.3389/fpubh.2020.00450 PMCID: PMC7527424. PMID: 33042936.

6. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, Bowe WP, Graber EM, Harper JC, Kang S, Keri JE, Leyden JJ, Reynolds RV, Silverberg NB, Stein Gold LF, Tollefson MM, Weiss JS, Dolan NC, Sagan AA, Stern M, Boyer KM, Bhushan R. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016 May;74(5):945-73.e33. doi: 10.1016/j.jaad.2015.12.037. Epub 2016 Feb 17. Erratum in: J Am Acad Dermatol. 2020 Jun;82(6):1576. PMID: 26897386.

7. John S. Strauss,Daniel P. Krowchuk,James J. Leyden,Anne W. Lucky,Alan R. Shalita,Elaine C. Siegfried,Diane M. Thiboutot,Abby S. Van Voorhees,Karl A. Beutner,Carol K. Sieck,Reva Bhushan. Guidelines of care for acne vulgaris management. Journal of the American Academy of Dermatology Volume 56, Issue 4, April 2007, Pages 651-663. DOI: 10.1016/j.jaad.2006.08.048.

8. B Dréno. What is new in the pathophysiology of acne, an overview. J Eur Acad Dermatol Venereol. 2017 Sep;31 Suppl 5:8-12. doi: 10.1111/jdv.14374. PMID: 28805938.