In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each hair follicle and then spills out onto the surface of the skin, taking with it sloughed-off skin cells. With acne, the structure through which the sebum flows gets plugged up. This blockage traps sebum and sloughed-off cells below the skin, preventing them from being released onto the skin’s surface.
Makeup and other products with chemicals can add to acne. Even regular toothpaste has so many chemicals in it that it can add to peri-oral acne. We have toothpaste recommendations as well as product recommendations for people with acne that will work with your body avoiding harsh chemicals. Always use non comedogenic products and try and use the “cleanest” product you can find that contains no parabens, no phthalates, and no petroleum products.
Dietary changes are hotly debated by dermatologists but I tell every patient to not drink skim milk if they are having a problem with acne. The skimming process has been found to contribute to acne and I have seen many people benefit from dietary changes. Change to whole or 2% milk, skip milk altogether, or drink almond milk or similar products.
Hormonal changes also contributes both in teen/young adult years and our perimenopausal years (which vary widely). I hear often from women who have not had any problems since their teen years, now in their 40s having severe acne eruptions. These need to be evaluated by Dr. Silkey and recommendations can be individualized based on your exam and even possibly blood work to assess hormonal status.
Our hormonal status is being challenged by many things in our environment these days, so I am seeing younger and younger men with low testosterone and women with estrogen excess and depleted progesterone. There are many “endocrine disruptors” and we will teach you how to avoid these.
There are several things that we can do to treat hormonal flares of acne but most of the time, it is beneficial to know what is elevated or depressed to target hormonal balance and overall health. This way we can target your therapy specifically to balance your levels. There are several ways to approach this including, non-pharmaceutical and pharmaceutical approaches, and this will be tailored to your specific needs and desires.
“Our skin is a prime indicator of what is going on underneath the surface. If one just treats the superficial layer without looking deeper than one potentially misses the root cause of the issue.” ~ Dr. Silkey