How Acne Can Be A Sign of An Underlying Illness

Acne breakout is a very common skin condition that usually occurs among teenagers and young adults, but can also strike at any age. Teen acne starts around the age of puberty, from 9 years old, depending on different individuals. It is safe to say, everyone will encounter an acne breakout at least once in their lifetime.

Acne is formed when the hair follicles on the skin are clogged with oil and dead skin cells.

Here are the various stages of Acne:

• Whiteheads (closed plugged pores)

• Blackheads (open plugged pores)

• Painful, pus-filled lumps under the skin (cystic lesions)

• Large, solid, painful lumps under the skin (nodules)

• Pimples (pustules), which are papules with pus

• Small red, tender bumps (papules)

Despite it being a common problem and here are the 5 most common acne scar questions people asking around. Acne breakout in some cases can be sign of an underlying condition. Acne can occur when an abnormality happens in the body.

• Hormonal changes:Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, usually among women, is the cause of acne breakouts.
• Diet: Diet with includes a high amount of carbohydrate-rich foods, such as bread, bagels and chips, and consuming high amount of dairy products may worsen acne.
• Stress:Stress doesn’t particularly cause acne, but if one is having an acne outbreak, the stress may make it worse.
• Food Allergy: Inability to tolerate certain kinds of food causes the body to fight off intruders, leading to inflammation and a breakout of acne as part of the allergic reaction.
• Underlying medical condition.In very rare cases, acne could be caused by an undiagnosed medical condition. In women, a condition called polycystic ovarian syndrome (PCOS) often underlies chronic or difficult-to-control acne. A dermatologist will take a careful history and perform a blood test to better identify underlying causes.  

Looking and diving deeper into these medical conditions that has acne outbreak as a symptom/ sign, here are 3 identified medical conditions.

1. Polycystic Ovary Syndrome (PCOS)

It is a hormonal disorder that causes enlarged ovaries and multiple cysts formation.

Up to 10 percent of teens and young women suffer from PCOS and women with higher levels of androgen can face complications. These imbalances, for instance can create problems in the ovaries; and with PCOS, a person’s eggs may not develop as they should or may not be released during ovulation. Apart from affecting a woman’s fertility, PCOS can cause a number of hormone-induced side effects.

Symptoms

• Females who experience irregularity in their periods or they may be teenagers who at the age of 15 or 16, have never had a period.
• Acne breakouts because of the hormone imbalances.
• Unwanted hair growth aka Hirsutism on chin, face, chest, back and stomach (due to hyperandrogenism or high male hormones)

As serious as it may sound, PCOS is actually a very treatable disorder.

2. Propionibacterium acnes

Propionibacterium acnes is the most commonly found bacterium on the human skin, especially in sebaceous areas such as pilosebaceous follicles of the skin. It is a fatty substance which grows well in an anaerobic (low oxygen) environment.

This bacterium is found to have positive and negative effects to the skin.

It helps to keep the skin waterproof. P. acnes is a benign skin bacterium which can help the skin by stopping harmful bacteria getting into the pores.

Despite playing an important part in the fight against harmful bacteria, P. acnes can still cause problems like acne breakout when overpopulated in the pores.

3. Acne Medicamentosa

It is acne that is caused or aggravated by medication and characterized by a sudden monomorphic eruption of inflammatory papules and pustules. It can also occur due to the usage of corticosteroids (also known as steroid acne).

Here is the list of hormonal medications which may cause or aggravate acne:

• Oral corticosteroids: also cause steroid acne by increasing yeast proliferation within the hair follicle
• Contraceptive agents: medroxyprogesterone injection (Depo-Provera™), implanted (Jadelle™ or Implanon™) or intrauterine progesterone (eg Mirena™), and oral contraceptives, which reduce circulating sex hormone binding globulin (SHBG), can sometimes aggravate acne in females
• Testosterone
• Anabolic steroids : Danazol, Stanozolol and Nandrolone can cause severe acne including acne conglobata and acne fulminans

Athletes and body-builders often overtake anabolic steroids excessively because they produce results in increasing muscle mass, but with side effects of severe acne outbreak.

Medications known to aggravate acne include:

1. Halogens (iodides, chlorides, bromides, halothane)
2. Antiepileptics (carbamazepine, phenytoin, phenobarbital)

• Antituberculous drugs (ethionamide, isoniazid, rifampicin)

1. Antidepressants (lithium, amoxapine)
2. Ciclosporin
3. B vitamins (B6, B12, cyanocobalamin)

• Epidermal growth factor receptor inhibitors
• Biologic agents, particularly TNF alpha inhibitors (rare)

1. Azathioprine and ciclosporin

How to treat Acne induced health problems

Whether it is caused by underlying medical conditions, or external factors, acne breakouts can be treated. Here are some of the solutions:

1. See a doctor / dermatologist.

It’s vital to seek professional help once the acne breakout happens as these medical professionals are able to assess the condition and determine the root of the problem. The rate of eradicating acne is always higher when the exact cause is known and when treatment is sought early.

There are various treatments and medication that can help to stop the breakout from getting out of hand. 

2. Using acne removal products for mild acne

There are various over-the-counter products such as Retinoid creams. They reduce outbreaks by preventing dead cells from clogging pores. Retinoid pills treat oil production, bacteria that cause acne, and inflammation.

3. Having a healthy diet

A healthy diet with includes a lot of vegetables, fruits and vitamins will play an important role in preventing and reducing acne. Some studies have shown that one can reduce or prevent acne breakouts by consuming more omega-3 fatty acids, fewer dairy products, and fewer foods with a high glycemic index.

Here are some of the examples of foods with high GIs:

• breads, especially white bread and bagels
• sweetened breakfast cereals, such as those with corn flakes, puffed rice, and bran flakes
• instant cereals, such as oatmeal and grits
• some fruits and vegetables, including melons, pineapples, and potatoes
• enriched pastas, such as rice-based pasta
• short grain white rice
• snack foods, such as pretzels, rice cakes, and popcorn

4. Leading a healthy lifestyle

Apart from a healthy diet, working out helps to detox the body through perspiration. Studies shown that exercise helps to reduce stress, an acne-causing factor, and increases blood flow, which helps oxygenate cells and boost their natural detox process.

5. Consult an aesthetic doctor / dermatologist for reducing acne scars.

Unfortunately, after the battle with acne, scars are often formed. Seek professional help from an aesthetic doctor or dermatologist to reduce the appearance of these scars. With the advancement of technology, there are various acne scar removal treatments in Singapore that can help to treat and reduce them.

It is indeed a painful battle against acne and it should never be taken lightly, as acne breakouts could be a symptom of underlying illnesses. Seek professional help to identify the cause of your acne, and find out the solutions which are suitable and tailored to and for you.

At M-Aesthetic Clinic, we take acne and acne scar issues seriously. If you are facing acne breakouts or having leftover acne scars, don’t hesitate and speak to us.

Dr Ho Rui Ming has years of experience in controlling and eradicating acne breakouts with proven treatments and medications.