Acne and spots

Acne

Acne is a common and multifactorial skin condition that affects individuals of all ages, but it is most frequently associated with adolescence, typically emerging during puberty when hormonal changes trigger an increase in oil production. Despite its prevalence during teenage years, acne can develop at any age, from infants to older adults, with the severity and types of lesions varying based on individual factors. It is primarily characterized by the clogging and inflammation of hair follicles, which are small openings in the skin that house hair and sebaceous (oil) glands^[1]. 

Causes of Acne

While hormonal changes play a major role, other factors can also contribute to acne development^[2]: 

• Excess Sebum Production: Sebum is the natural oil produced by the sebaceous glands in the skin. It’s essential for maintaining skin hydration and protecting against external elements. However, when these glands become overactive, they can produce excess sebum. This excess oil can combine with dead skin cells and dirt, creating a sticky substance that blocks hair follicles and pores. When pores are blocked, the buildup of sebum can form comedones (whiteheads or blackheads), which can progress into pimples, cysts, or pustules if bacteria start to accumulate in the area. The overproduction of sebum is often linked to hormonal fluctuations, particularly during puberty, menstruation, or conditions like polycystic ovary syndrome (PCOS), but can also be influenced by other factors such as diet and stress.

• Bacteria: The skin is home to a variety of bacteria. When a pore becomes clogged with excess oil, it creates an oxygen-deprived environment. This is the ideal condition for bacteria to thrive, which can cause inflammation in the surrounding tissue.
• Dead Skin Cell: The skin constantly sheds dead cells as part of its natural renewal process. Without proper exfoliation, the skin can become congested, preventing the pores from breathing and leading to breakouts. In some cases, the dead skin cells themselves can irritate the follicle lining, contributing to inflammation.
• Lifestyle and environmental factors: Poor diet, stress, and exposure to the sun can also contribute to flare-ups. Consider taking action by making some changes to your lifestyle by taming your stress level, getting better sleep, practising hygiene, and wearing appropriate clothing covering to prevent further breakouts. 

Signs of Acne

These are common signs associated with acne^[1]: 

• Recurring Breakouts: One of the hallmark signs of acne is persistent breakouts. These can appear as red, inflamed pimples that develop on the skin, typically on areas where sebaceous glands are most active, such as the face, chest, shoulders, neck, and upper back. These pimples may be filled with pus and often become inflamed, tender, or painful to the touch.

• Blackheads: Blackheads are small, dark spots when a pore becomes clogged with oils and dead skin cells. They are different from whiteheads as the blackheads are open at the surface, and the dark colour is due to the oxidation of the sebum exposed to air. 

• Whiteheads: Whiteheads are small, flesh-coloured or white bumps that appear beneath the skin. They do not have a visible opening at the surface of the skin and they appear when pores are completely blocked. 

• Papules: Papules are small, red, inflamed bumps that develop when a clogged pore becomes inflamed. Unlike whiteheads and blackheads, papules are typically tender to the touch and may feel firm or raised. These bumps are typically filled with pus and can form clusters, making the affected area appear bumpy or uneven. 

• Nodules: Nodules are larger, deep, inflamed lumps that develop beneath the skin. They are often painful and may be as large as an inch in diameter. Unlike papules or pustules, nodules form deep within the skin’s layers and can take longer to heal. Due to their depth, they have a higher chance of causing scarring if not treated appropriately. 

Skin Spot

Skin spots are common, and many people experience them at some point in their lives. These spots, which can range in size, shape, and colour, are often caused by exposure to ultraviolet (UV) radiation from the sun or tanning beds. UV rays damage the skin's cells and lead to the development of various types of spots, some of which are harmless, while others may require more attention due to potential health risks, including the risk of skin cancer^[3]. 

Causes of Skin Spots

The primary cause of skin spots is prolonged exposure to the sun's harmful UV rays, which penetrate the skin and damage the DNA of skin cells. This damage can result in the formation of spots, which can be temporary or permanent. When UV light triggers changes in the skin, the body produces more melanin as a protective response. Melanin is the pigment responsible for skin colour, and an increase in its production can lead to the formation of darker spots, such as freckles or age spots^[4]. 

Freckles

Freckles are small, flat spots on the skin that can range in colour from red to brown. They are typically found on areas of the body that are frequently exposed to the sun, including the face, neck, back, upper chest, hands, and arms. Freckles are often more prominent in people with fair skin and light hair, as they are caused by an increase in melanin production triggered by sun exposure. While freckles are generally harmless, they are a common sign of sun sensitivity and can sometimes become darker or more pronounced with prolonged sun exposure^[5].

Signs of Freckles

These are common signs associated with freckles^[5]: 

• Small, flat spots with varying shades of brown: Freckles are typically characterized by their small size and flat appearance. These spots can range in colour from light tan to darker brown or even red, depending on an individual's skin type and the amount of melanin in their skin. The size of freckles can vary, but they are generally small, often less than a quarter of an inch in diameter. The varying shades of brown are influenced by factors such as genetics and sun exposure, with some freckles appearing darker or lighter over time.
• Typically found on sun-exposed areas of the body: Freckles commonly appear on areas of the skin that receive frequent sun exposure, such as the face (particularly the cheeks and nose), neck, shoulders, arms, back, and upper chest. These areas are more exposed to UV radiation, which triggers the skin's production of melanin as a natural defence mechanism. Since melanin absorbs UV rays, it helps protect the deeper layers of the skin from sun damage, but it also causes pigmentation in the form of freckles. 
• More prominent during or after sun exposure: Freckles tend to become more prominent or darker after exposure to the sun. This is because ultraviolet (UV) light stimulates the skin to produce more melanin in order to protect against sun damage. In people who are prone to freckles, this excess melanin can cause existing freckles to darken or in some cases, new freckles to appear.

Age Spots

Age spots, also called liver spots or solar lentigines, are a common skin condition characterized by flat, oval patches of increased pigmentation. These dark spots typically develop on areas of the skin that have been frequently exposed to the sun, such as the face, hands, shoulders, and arms. Age spots are more common in people over the age of 40, although they can appear earlier, especially in individuals with fair skin or those with a history of excessive sun exposure. While they are harmless and generally do not require treatment, age spots can become more pronounced with time and are often a visible sign of skin aging and cumulative sun damage^[6].

Sign of Age Spots 

These are common signs associated with age spots: 

• Age spots are typically harmless and do not cause any pain or itching. The primary sign of age spots is their appearance: they are flat, oval-shaped patches of skin with a tan to dark brown color. These spots often resemble large freckles and vary in size, but they tend to be more uniform in shape and pigmentation^[6].

Actinic Keratoses 

Actinic keratosis (AK), also referred to as solar keratosis or senile keratosis, is a precancerous skin condition that develops as a result of prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. It appears as rough, scaly patches on the skin, often in areas that have received significant sun exposure, such as the face, ears, neck, scalp, chest, backs of the hands, arms, or legs. While actinic keratoses themselves are not cancerous, they carry a small risk of progressing into squamous cell carcinoma, a type of skin cancer. This transformation, although uncommon, makes it important for individuals with AK to monitor their skin closely and seek medical attention if the spots change in appearance. Early detection and treatment are key to preventing the development of skin cancer^[7]. 

Sign of Actinic Keratoses

These are common signs associated with Actinic Keratoses:

• Texture: Lesions are typically dry, scaly, and rough to the touch. They may feel gritty or uncomfortable, with some individuals experiencing itchiness.

• Appearance: They can be flat or raised, varying in size and shape, with a crusty or wart-like surface. The lesions range in colour from light pink or red to brownish or greyish, depending on skin tone and sun exposure.

Acne and Spots and TCIH Approaches

In addition to conventional treatments, several complementary health approaches can support the healing process and help manage acne and spots more effectively:

• Ayurveda: Ayurveda is commonly considered a safe approach for treating acne. It focuses on balancing the three doshas—Vata, Pitta, and Kapha—to maintain overall health. Acne, or Yuvana Pidika, is believed to arise from an imbalance of the Pitta dosha. Virechana, a detoxifying therapy, helps reduce excess Pitta and cleanse the body. Triphala, a well-known Ayurvedic remedy, is also used for its healing properties. Additionally, Ayurveda emphasizes the importance of proper digestion and metabolism in preventing acne^[8]. 
• Cupping: In Traditional Chinese Medicine (TCM), acne is commonly attributed to excess heat, dampness, and stagnation in the body. Wet cupping is a popular treatment for acne as it helps remove heat and stagnation. It is believed that wet cupping may have antioxidant and anti-inflammatory properties, which could explain its effectiveness in improving certain skin conditions^[9].
• Nutrition: Nutrition plays a key role in managing acne and reducing the appearance of spots. A balanced diet rich in antioxidants, vitamins, and minerals can help support healthy skin. Finding the right nutrition practitioner, such as a registered dietitian or nutritionist, can also be helpful in tailoring a diet plan specifically for your skin needs.