Acne

Aunque existen tres niveles de gravedad que son leve, moderado y severo, existen unas categorías más específicas de acuerdo con el tipo de lesiones y su extensión:

Mild: a few lesions appear as small pimples or blackheads, red or white spots that are not inflamed.

Moderate: red pimples or whiteheads with pus may appear, along with more noticeable inflammation.

Severe: the bumps are larger in number and intensity. They often include inflamed nodules and cysts accompanied by pain and pus. Within this category, there are specific classifications such as:

• Nodular or cystic: this is one of the most severe forms of acne, characterized by inflamed, painful nodules that can develop crusts and may even bleed.
• Conglobata: this type can extend to the neck, chest, and back, presenting multiple lesions such as nodules, cysts, and abscesses that may interconnect.
• Fulminant: although rare, this type may occur with symptoms such as fever, joint pain, and ulcerations.

Hormonal influence is a key factor in the appearance of acne. It often occurs during stages when androgen hormones cause excessive sebum production, which, when mixed with dead skin cells, clogs the pores. These conditions create the ideal environment for bacterial growth, ultimately leading to the formation of pimples, blackheads, and comedones, among others. This is why acne is most common during adolescence, although it can also appear after the age of 25 or even 40, in which case it is known as adult-onset acne.

It can also occur during hormonal peaks, such as ovulation or while taking contraceptives.

To determine whether acne is caused by hormonal sensitivity, laboratory tests can help guide the treating physician. On the other hand, genetics and hormonal imbalance are not always directly related.

Some patients show hereditary factors in the origin of their condition, as it is often determined that their parents also experienced acne.

Because hormonal factors can trigger acne, taking certain medications such as steroids or hormonal contraceptives may contribute to the development of this condition.

It has been determined that chronic stress, which causes inflammation in the body, can lead to dermatological conditions such as acne. Likewise, other emotional factors such as depression or anxiety can also contribute to the appearance of blackheads, pustules, and other types of blemishes.

It can result from the use of creams, makeup, oils, or any other product that disrupts the skin’s balance and clogs the pores.

One of the most common questions patients ask is: What should I stop eating to prevent acne? [1] [2] Diet is indeed one of the factors that influence this condition. Clinical studies have shown a close relationship between the appearance of comedones and a high intake of ultra-processed foods, gluten, and dairy products, as these increase sebum production in the skin and can trigger inflammatory processes. Fried foods and animal fats have also been identified as contributing factors.

It is essential for patients to pay attention to their diet by creating balanced meal plans that include natural foods while minimizing the intake of ultra-processed products, fats, soft drinks, and refined carbohydrates. Patients should also monitor their eating habits to identify and limit the foods that may exacerbate their condition.

The appearance of acne can also be associated with endocrinological conditions such as polycystic ovary syndrome (PCOS) or hyperandrogenism syndrome, among others.

Indeed, hormones are only one of the factors that influence the development of acne, which is why it appears more frequently during hormonal peaks such as adolescence, pregnancy, or the premenstrual cycle. However, to confirm hormonal sensitivity as the cause of comedones, it is the physician who must order the appropriate tests.

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Both cleansers and over-the-counter dermocosmetic products for acne-prone skin should avoid oily ingredients. Gel-based products and exfoliating cleansers that help regulate oil production are recommended. However, in severe acne cases, products must be medicated and incorporated into a treatment plan aimed at reducing comedones and improving the overall appearance of the skin.

For severe acne, treatment often combines topical products (applied directly to the lesions), pharmacological or hormonal therapies, and laser procedures. In the case of acne scars, the Morpheus8 laser is effective in stimulating collagen and elastin production in the skin. Fractional CO2 laser may also be used, as it creates a controlled micro-injury on the skin’s surface. When combined with biostimulators, this treatment helps reduce the tendency for comedones and pimples to reappear, depending on the stage of acne. The treatment plan should always be based on a prior diagnosis to assess the origin, condition, and expectations of each patient.