Whether you are 15 or 30, having spots can get you down. Acne is very common; it affects more than 80% of teenagers and 40% of adult women. The good news is that you can do something about it.
Sophie G., our head researcher, met with an expert dermatologist and a consumer to take stock of the situation:
SG: Doctor, explain to us what acne is. How would you define acne?
Dr B: Acne is an inflammatory condition of the pilosebaceous follicle, which can be caused by several factors:
• thickening of the horny layer at the opening of the sebaceous gland (hyperkeratinisation)
• over-production of sebum
• colonization of the skin by a bacteria called Cutibacterium-acnes (C-acnes)
• an imbalance in the skin microbiota that contributes to skin inflammation
• a genetic predisposition, especially if the mother had acne
• hormonal influence, as acne affects adolescents and women whose skin is sensitive to small doses of androgens
• environmental factors (the “exposome”): pollution, tobacco, stress, diet.
SG: What is the difference between acne in teenagers and acne in adult women?
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Dr B: We now talk about different types of acne. The acne we see in teenagers is typified by oily skin and spots on the forehead, sides of the nose, chin and sometimes, in more severe cases, the chest and back. This acne is measured on a scale from moderate to severe. |
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| Acne in adult women takes the form of spots on the lower face that are mainly inflammatory, subcutaneous, and painful, with dilated pores and premenstrual breakouts. |
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SG: What treatments are prescribed?
Dr B: It depends on the severity of the acne, the type of lesion – retentional (blackheads, whiteheads) or inflammatory (nodules, papules) – and the risk of scarring. As a first step, we prescribe topical retinoids (retentional acne) or benzoyl peroxide (inflammatory acne).
For moderate acne, we use treatments that combine two molecules working in synergy, which can be coupled with an oral medication (antibiotic or zinc gluconate). For severe acne, only isotretinoin, used under supervision, has any real effect. In addition, the individual should see their dermatologist for skin cleansing and a peel every three to four months.
SG: Why is acne recurrent?
Dr B: For women, we could describe it as terribly recurrent! Acne is a chronic pathology. To eliminate it, you must make sure you follow your treatment. To avoid recurrence, a maintenance treatment is prescribed, which consists of applying a topical retinoid two or three times a week, and using suitable skincare and makeup.
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Anne-Sophie, 24 years old
“I didn’t get acne as a teenager. Then two years ago I stopped the pill, and following that, I was diagnosed with polycystic ovary syndrome. I developed severe acne, which is one of the symptoms. It left me with marks and scars. I tried products from all sorts of brands, including expensive ones.
Then one day, an advisor in a shop showed me a new range of skincare products that had just been launched. I bought the serum and the moisturizer, which weren’t even that expensive. In less than two weeks my skin really changed. I had fewer spots, and the scars were less obvious. I stopped this summer. Since then, I’ve left my skin alone.”
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SG: What other solutions are there apart from medication?
Dr B:
• The right skincare, naturally!
Non-comedogenic creams and gentle cleansers are essential to complement medication. In fact, these are the first choice for moderate acne and pregnant women. It is important to continue to use them during maintenance treatment.
The right actives: zinc, fruit acids or salicylic acid, and anti-inflammatory actives (niacinamide, gluconolactone), etc.
• A healthy diet
You must steer clear of, or limit, junk food. Also, foods with a high glycaemic index (fats, sugar, refined cereals) are not only fattening, they also encourage acne, as does the over-consumption of dairy products (limit these to three per day). On the other hand, you can eat oily fish and nuts, which are rich in omega 3.
• Nutritional supplements and probiotics
Some studies show that soy isoflavones, green tea polyphenols and probiotics (lactobacillus rhamnosus SP1) might improve acne.
• Skin treatments
LED – blue and red – and pulsed dye laser (PDL) can help with the inflammatory aspect of acne, which is present in teenagers but is mainly found in the lesions of adult women. Kleresca, a treatment that uses fluorescent light energy, also acts on inflammation and can reduce acne by two grades over six months to a year.
SG: Let’s talk about forming the right habits – this is always worth repeating!
Dr B:
• do not touch your spots or blackheads, as this is a guaranteed way of encouraging marks and scars
• do not strip your skin with harsh lotions or peels, as it will just encourage more sebum production
• avoid heavy foundations, which can be comedogenic and encourage the appearance of new spots. Plus, they do not look good. It would be better to use a tinted moisturizer formulated for oily skin and imperfections.
SG: What about future treatments?
Dr B: New treatments are emerging:
• trifarotene, a new retinoid with fewer side effects that is better tolerated
• topical anti-androgens
• an acetyl-CoA carboxylase inhibitor that reduces sebum production
• a nitric oxide gel that could inhibit C.acnes
• a new more selective and anti-inflammatory antibiotic, sarecycline
• a vaccine – but who would we vaccinate, and when?
