Understanding the 4 Stages of Acne

While the problem of acne is most commonly reported by teenagers, people of all ages can be affected by it. The problem is typically categorized by a painless outbreak of whiteheads and blackheads on the face, neck, chest, and back region. However, in more severe cases, acne can cause red, swollen, and painful bumps. To understand the treatment, it is important to first get clarity on the stages of acne. Let’s understand what causes acne, its symptoms, and the stages of acne healing. 

What Causes Acne?

Acne is typically caused by increased activity of the sebaceous glands. The sebaceous glands are present under the surface of the skin and are responsible for producing sebum, the oil which makes the skin supple. Acne occurs when the hair follicles get clogged with sebum or by the thickening of the skin and dead cells. 

The most common causes of acne are:

1. Hormonal changes: Hormonal changes during the onset of puberty stimulate the sebaceous gland to produce more sebum. Thus, pimples are most commonly seen in teenagers. 
2. Hereditary: Acne is not infectious but the problem can pass through genes to the next generation.
3. Cosmetics: Use of a new skin product that does not suit your skin type.  
4. Food Allergy: People with sensitive skin types are likely to be allergic to certain foods.
5. Irregular Facial Cleansing: When dead skin is not removed regularly, it tends to clog pores.  
6. Underlying Health Problem: Metabolic issues, PCOD, diabetes, and thyroid can cause the onset of acne. 
7. Toxin Increase: Chronic constipation or compromised kidney function hinders the body’s mechanism of excreting body waste. This toxic build-up is then released through the skin, leading to an acne upsurge.
8. Stress and Inadequate Sleep: High levels of stress and inadequate sleep or irregular sleeping patterns aggravate acne problems.

Stages of Acne

The presence of acne can broadly be divided into 4 stages or grades. The classification of stages of acne is done on the basis of its appearance and severity. On the basis of appearance, one can clearly comprehend the acne stage. This is helpful in finding the right acne treatment, thereby quickening the acne healing process.

Stage 1: Mild Acne

Stage 1 acne is the mildest form of acne. The appearance of acne in Stage 1 typically consists of comedones or blackheads, mostly on the nose, with a few occasional outbreaks of pimples on the cheeks and under the lips. The breakout increases in humid weather and during hormonal changes like the onset of periods or during pregnancy. Heavy pollution levels and an increase in stress levels also increase the pimple outbreak. 

Treatment:

The treatment of mild acne is possible through home remedies and over-the-counter medicines. These include:

1. Remove excess skin oil with the help of a good skin cleanser. Cleansing should be done in circular motions twice a day.
2. Occasional use of skin exfoliating gels helps remove dead skin and unblock pores.
3. Steam inhalation before the use of skin exfoliating products yields the best results.
4. The use of acne gel containing Azelaic acid or Salicylic acid on pimple heads accelerates the stages of acne healing.
5. Use of blackhead extractor or blackhead removal tool helps remove deep-rooted blackheads.

As the stages of acne healing can be slow, it is important not to squeeze the pimple heads with fingernails. This can increase inflammation and redness and cause damage to the skin, leading to permanent scars.

Stage 2: Moderate Acne

The presence of blemishes and pimple heads are more in stage 2 i.e., moderate acne. Though the pimples typically appear in the T zone but can show anywhere on the face and neck region. Moderate acne is marked by the presence of whiteheads which are also known as closed comedones. 

The surrounding area around a whitehead can be red due to mild inflammation. In addition to whiteheads, there can be papules, firm elevated bumps, and pustules (also known as pimples), which are small blisters filled with yellowish pus which is the accumulation of dead skin cells coupled with white blood cells and bacteria.

Treatment: 

The treatment of moderate acne includes home remedies for pimples along with over-the-counter medicines. These include:

1. Wash the face and affected area with an oil-controlling cleanser twice a day. Pat dry softly.
2. Do not use exfoliating face scrubs. 
3. Do not squeeze or pick pimples (pustules) as it increases skin infection and scarring.
4. Apply over-the-counter face creams which contain benzoyl peroxide on pimple heads. Repeat this twice a day.

Over-the-counter treatment for moderate acne must be continued for at least a month. Consult a dermatologist if the condition persists or worsens. 

Stage 3: Severe Acne

As the name suggests, severe acne is marked by numerous papules and pustules not only on the face and neck but also on the chest and back. As the lesions are close together, it leads to skin damage and scarring even without picking and squeezing. As the nodules are often inflamed, swelling and redness of the area are common. 

Treatment:

In severe acne, the cause of infection is deep within the skin. Topical treatment is not enough and therefore requires a specialized dermatological treatment. After assessing closely, the dermatologist can put one on oral antibiotics along with a local application for about 3 months to reduce the severity of the infection. 

In addition to oral medication, local hygiene is mandatory. Things to keep in mind are:

1. Keep the skin clean. 
2. Do not squeeze or pick pimples. 
3. Use medicated oil-controlling face cleansers.
4. Avoid dust.
5. Do not expose yourself to excessive sunlight.  

Stage 4: Cystic Acne

This is the stage of acne where the outbreak is extremely severe and the size as well as the count of lesions are large. They spread across the face, neck, shoulders, chest, back, and arms. While they are firm to touch, they contain a cyst which makes them appear like big blisters or a boil. The cyst often contains pus. In addition to cysts, firm or hard bumps called nodules are also present which do not contain pus. The affected area is extremely painful. 

Treatment:

Cystic acne is hard to treat. The situation resurfaces despite proper control and effective treatment. A visit to a dermatologist is crucial as over-the-counter medicines and home remedies for pimples show no effect. In fact, regular follow-up and routine visits to the dermatologist are required to control and prevent future recurrence. In case required, steroid injections in nodules to reduce inflammation may be prescribed.

In addition to prescribed medical treatment which will include both topical and oral medications, it is important to follow the basic skin hygiene steps. These include:

1. Keep your skin clean and dry.
2. Remove excessive oil. 
3. Use medicated oil-free face cleansers twice a day.
4. Do not squeeze or pick lesions.
5. Do not use skin exfoliating products. 

General Tips to Prevent Acne

It is always better to thwart the problem at the onset. A few lifestyle changes can help reduce the chances of getting acne. These are:

1. Do not eat too many chocolates or sugary foods.
2. Do not consume high amounts of dairy products.
3. Avoid stressful situations
4. Practice relaxation and meditation techniques.
5. Get a good night’s sleep.
6. Drink plenty of fluids, preferably water.
7. Use a good skin-hydrating moisturizer.
8. Keep your face clean. Wash it two to three times a day with an oil-free cleanser
9. Do not expose yourself to excessive sunlight.
10. Use quality cosmetics. 
11. Use products to suit your skin type.
12. Remove make-up before going to bed. 
13. Avoid using greasy creams 

Conclusion

Acne is a common problem. It can be cosmetically distressing but thankfully it is treatable. Self-care steps with changes in diet to topical and oral medication; different stages of acne are handled differently. But as you go through the stages of acne healing, it is important not to panic and follow the treatment plan patiently.