Oil Acne: Causes, Symptoms, and Treatment

What Is Oil Acne?

Oil acne is a common skin condition when the hair follicles become clogged with oil, hair, bacteria, and dead skin cells. These blockages cause blackheads, whiteheads, or pimples. The condition is most common among teenagers but can affect people of all ages. It is estimated that about 80 % of people aged 11 to 30 experience at least mild acne, and most people are impacted by it at some point in their lives. The severity of oil acne can lead to emotional distress and scarring, thus affecting the quality of life. Efficacious acne treatments are available, but acne can be persistent. The pimples and bumps clear up slowly, and when one starts to go away, others appear to crop up.

Who Does Oil Acne Mainly Affect?

Although oil acne primarily affects teenagers and young adults undergoing hormonal changes, most people struggle with it into their 20s, 30s, and beyond. Some people can even develop acne for the first time as adults. The most common locations where one might have acne are the face, forehead, shoulders, chest, and upper back. Oil (sebaceous) glands are present all over the body, but the glands are present the most in these areas. The most useful way to treat oil acne depends on its severity. Acne can be mild (a few pimples), moderate (inflammatory papules), or severe (nodules and cysts).

What Causes Oil Acne?

Oil acne is primarily a hormonal condition caused by androgen hormones, typically active during teenage and young adulthood. Sensitivity to these hormones and surface bacteria on the skin and fatty acids within oil glands can cause oil acne.

A few things can cause trigger acne or make it worse:

• Androgens are a group of hormones that increase in boys and girls during puberty and cause the sebaceous (oil) glands to enlarge and produce more sebum. Fluctuating hormones during midlife, especially in women, can lead to breakouts too.

• Certain medications, such as drugs containing corticosteroids, testosterone, or lithium.

• Picking or popping at acne sores.

• Certain weather conditions, particularly high humidity, and air pollution.

• Clothing items and headgear, such as hats and sports helmets.

• Stress increases the hormone cortisol, which can also cause flare-ups.

• Applying oily or greasy personal skin care products like heavy creams, lotions, hair pomades, or waxes).

• Working in a greasy area where one routinely comes in contact with greases, such as working in a food industry where there are greasy food surfaces (kitchen with fry vats) and frying oil.

• Genetics.

• Certain foods high in carbohydrates, such as bread, chips, or fries, can promote or worsen acne.

What Does an Oil Acne Look Like?

The signs and symptoms of oil acne vary depending on the severity of the condition:

• Whiteheads: These are the bumps that remain clogged by oil and dead skin.

• Blackheads: These are open bumps on the skin that plug with excess oil and dead skin.

• Papules: Small red, tender, pink bumps that become inflamed.

• Pustules: These are the papules containing pus at their tips. They often look like whiteheads enveloped by red rings.

• Nodules: These are large, solid pimples deep under the skin. They are large and painful.

• Cysts: They are pus-filled pimples that can cause scars.

Can Oil Acne Cause Scars?

Oil acne can sometimes result in scarring. It occurs when acne penetrates the skin and damages the deeper layers. Inflammation causes the acne pores to swell, and breakdown occurs in the wall of the pore. Scarring can be an extreme source of anxiety, which is normal. But fortunately, it can be treated. Several treatment options, such as dermabrasion, chemical peels, laser resurfacing, micro-needling, and surgery, can all be used to treat acne scars.

How Is Oil Acne Diagnosed?

The healthcare professional can easily diagnose acne through a physical examination. They may also ask if the person is undergoing significant stress or obtain a family history of acne. In addition, teenage girls and women may also be asked about their menstrual cycles. Sudden, severe acne outbreaks in older adults can sometimes signify another underlying condition that requires medical attention.

How Is Acne Treated?

The healthcare professional may recommend some non-prescription medications for acne. However, one may need more potent prescription medications depending on the severity, age, type of acne, and how effective the over-the-counter medications have been. A healthcare professional can help control acne, avoid scarring or further damage to the skin, and make scars less noticeable.

Topical Medications:

• Retinoids and Retinoid-Like Drugs: Drugs containing Retinoic acids or Tretinoin are often helpful for treating moderate acne. They are available as creams, gels, and lotions. Examples include Tretinoin, Adapalene, and Tazarotene. These medications prevent the clogging of hair follicles. However, topical retinoids increase the skin's sun sensitivity and cause dry skin, irritation, and redness, particularly in people with black skin. Also, these medications are not spotted treatments, so they must be used on the whole skin affected by acne to prevent new outbreaks.

• Antibiotics: Topical antibiotics like Clindamycin and Erythromycin are effective in controlling surface bacteria that aggravate and often stimulate the swelling of acne. Antibiotics are more efficacious when used in combination with Benzoyl peroxide. Therefore, topical antibiotics are not recommended alone.

• Azelaic acid and Salicylic acid: Salicylic acid is available over the counter for acne as a cleanser or lotion. It helps remove the upper layer of damaged skin. In addition, it dissolves dead skin cells to prevent the hair follicles from plugging. Azelaic acid is a natural dicarboxylic acid produced by yeast that kills microorganisms on the skin and reduces swelling. A 20 % azelaic acid cream or gel is known to be effective as many traditional acne treatments when used twice a day. In addition, prescription Azelaic acid can be used during pregnancy and while breastfeeding. It can also help manage discoloration that happens with some forms of acne. Side effects of azelaic and salicylic acid include skin redness and minor skin irritation.

• Dapsone 5 % topical gel also has antibacterial properties, often recommended for inflamed acne, particularly in women with acne. It is typically applied to the skin twice a day. Side effects include redness and dryness.

Oral Medications:

• Antibiotics: One may need oral antibiotics to reduce bacteria for moderate to severe acne. Usually, tetracycline (Minocycline, Doxycycline) or a macrolide (Erythromycin, Azithromycin) is the preferred acne treatment. In addition, a macrolide can be advised for people who can not take tetracyclines, like pregnant women and children under eight years old. However, oral antibiotics should be used only briefly to prevent antibiotic resistance. Also, they should be combined with other drugs, such as Benzoyl peroxide, to decrease the likelihood of developing antibiotic resistance. However, these drugs can increase the skin's sun sensitivity.

• Combined Oral Contraceptives: The U.S Food and Drug Administration (FDA) has approved three kinds of oral contraceptives for treating acne in women who want to use them for contraception. These contain a combination of two hormones-estrogen and progesterone. One may overlook the benefit of oral contraceptives for a few months, so using other acne medications for the first few weeks can help. However, combined oral contraceptives carry side effects such as weight gain, breast tenderness, nausea, and increased risk of cardiovascular problems, cervical cancer, and breast cancer.

• Anti-Androgen Agents: Spironolactone may be suggested for women and adolescent girls if oral antibiotics are not working. It stops the effect of androgen hormones on the oil (sebaceous) glands. Potential side effects are breast tenderness and painful periods.

• Isotretinoin: It is a derivative of vitamin A, which may be prescribed for people whose moderate or severe acne does not respond to other treatments. Oral Isotretinoin can cause depression, inflammatory bowel disease, and severe birth defects.

Other Therapies:

Depending on the condition, the healthcare professional may suggest one of the following therapies, either alone or combined with medication.

• Lasers: Laser therapy is mainly used to treat acne scars. A laser projects heat to the scarred collagen under the skin, which depends on the body's wound-healing response to make new healthy collagen. There are different types of laser resurfacing, including ablative and non-ablative. The health care professional determines the best treatment according to skin type and nature of acne scars.

• Steroid Injections: Rarely can steroids be injected to treat nodular and cystic lesions to reduce inflammation. However, this can cause skin thinning and discoloration in the treated area.

• Chemical Peels: This procedure uses unique chemical solutions like salicylic acid, retinoic acid, or glycolic acid to remove the upper layer of old skin. This treatment can help treat mild acne. In addition, it may enhance the appearance of the skin, though the change is short-lasting, and repeat treatments are often needed.

• Drainage and Extraction: The health care professional may use special tools to gently remove blackheads and whiteheads or cysts that have not healed with topical medications. This procedure temporarily enhances the appearance of the skin, but it can also cause scarring.

How Is Oil Acne Prevented?

Preventing acne is difficult but not impossible. One can try to avoid mild or moderate acne with non-prescription products, an excellent basic skincare regime, and other self-care techniques:

• Wash the face daily with a gentle facial cleanser and water.

• Use a moisturizer daily.

• Switch to non-comedogenic products and remove makeup before going to bed.

• Use over-the-counter acne products to dry excess oil and encourage peeling.

• Avoid irritants like sunscreens, oily or greasy cosmetics, and hairstyling products that can worsen acne. Try to stay out of the sun and regularly use a non-comedogenic moisturizer that includes sunscreen.

• Protect the skin from the sun.

• Avoid pressure or friction on the skin. Protect acne-prone skin from contact with phones, tight collars, helmets, straps, and backpacks.

• Avoid picking or touching acne-prone areas. This can trigger more acne to form or lead to infection or scarring.

• Shower or take a bath after strenuous activities. Oil and sweat on the skin can lead to breakouts.

What Is the Outlook for People With Oil Acne?

Oil acne usually goes away in early adulthood, though some people develop acne throughout adulthood. The healthcare professional can help manage this challenging condition. See a healthcare professional as soon as someone notices the breakout so that one can start treatment immediately before scarring occurs.

Conclusion

Oil acne is a common skin problem among teenagers and can have a profound psychosocial impact on those with it. But treatment is available and effective in most cases. The condition is most often seen on the face, forehead, chest, shoulders, and upper back. There are a variety of causes, including fluctuating hormone levels, genetics, stress, high humidity, and using oily or greasy personal care products. See a healthcare professional as soon as someone notices the breakout so that one can start treatment immediately before scarring occurs. Early intervention leads to better outcome for acne.