Issue link: https://www.ascpskindeepdigital.com/i/1101652
52 ascp skin deep may/june 2019 THE BIG CHALLENGE Regardless of gender, acne is one of the most prevalent skin issues on the rise in recent years. In fact, it's become the most common skin condition in the US, affecting nearly 60 million Americans. According to the American Academy of Dermatology, 85 percent of individuals between ages 12 and 24 experience some form of minor acne.1 But it's not limited to adolescents—20 percent of those impacted are adults. Though women tend to experience acne more often, dermatology experts at Cleveland Clinic report an uptick in male acne among those in their 20s and 30s.2 While the majority of cases tend to be persistent acne (acne that develops in adolescence and continues), late-onset acne can also occur. Additionally, some individuals never really outgrow it, either experiencing prolonged acne side effects that linger into their 30s, 40s, and beyond. And, if left untreated, it can cause significant scarring, not to mention the potential negative effects on one's emotional well-being and confidence. While acne doesn't discriminate based on gender, it does affect men and women differently. Beginning during puberty, men develop larger quantities of the hormones (androgens) that stimulate the oil production glands. These hormones are also what stimulate some of the more distinct male characteristics, including facial hair and muscle development. Because of this hormone, men tend to experience more severe cases of acne that last longer and, therefore, can be more vulnerable to scarring than women. Additionally, men's pores are often more open, which makes them more susceptible to accumulating bacteria, triggering inflammation, and producing the comedones and redness associated with acne. Hats and certain beard oils can further exacerbate the problem if the skin is not properly cleansed and exfoliated on a regular basis. That said, it is important to identify the potential triggers prior to developing a treatment plan. WHAT CAUSES AN OUTBREAK? While there are numerous theories as to the exact cause of acne, we have at least identified some of the common triggers. This makes proper diagnosis a quintessential part of restoring the skin to optimal health. If you can identify the trigger, you can start by eliminating it or building a course of treatment to directly address it. Let's look at some of the common acne triggers. Hormones: Oil production is regulated heavily by hormones, specifically testosterone, which stimulates the development of sebaceous follicles and attached oil glands. Because of this, women are five times more prone to acne later in life than men. Stress: Stress is one of the top triggers of acne, as it stimulates the adrenal glands to produce more cortisol, which can cause excess sebum and inflammation. Acne flare-ups can occur from 14 days to a month after the stress response. Medication: Certain medications can have an adverse effect on hormones (adrenals), which can spur on blemishes. Nutrition and Diet: Alcohol, caffeine, and foods with iodide (salt, processed and fast foods, MSG, and excessive dairy) can trigger existing acne. When foods high in starch or sugar are consumed, it can spike insulin, and some research suggests this can also instigate sebum production. Improper Cleansing: Bacteria forms when oil builds up on the skin, and this creates an environment for blemishes to occur. In some cases, simply showing male clients proper cleansing techniques may help eliminate the issue. It's worth noting, however, that acne is not an indicator of hygiene, as there is often much more going on beneath the surface. Skin Irritants: Detergents, fabric softeners, certain shampoos and conditioners, and fragrances or dyes can irritate existing acne conditions. Picking: Improper squeezing, picking, and inept extractions may rupture the follicle wall, causing bacteria to spread. It may also lead to deeper impaction and scarring. Male clients, in particular, can be guilty of improper squeezing and picking, so talk to them about icing as a way to reduce inflammation when they feel the pressure of a lesion. Overstripping the Skin: Overuse of certain drying skin care products may cause the skin to overproduce sebum as a way of maintaining a healthy level of oils. When there is an overproduction of oil, it can then get trapped in the pores, causing bacteria buildup. Genetics: Some people are simply predisposed to acne, based on genes. When you do an intake with a new male client with an acne condition, it's essential to learn as much as you can about what could be contributing to his acne. Understanding his skin histology and lifestyle will better prepare you to map out an effective treatment plan. TYPES OF ACNE MOST PREVALENT IN MALES The types of men's acne you might see in the treatment room vary widely, and knowing which type you are working with, in addition to the possible trigger, will help you better treat the skin. While there are numerous types of acne, there are a few primary types most common to men. Hormonal Acne (acne vulgaris): This is the most common type of acne across both genders. It is characterized by comedones, papules, pustules, nodules, cysts, and sequelae—such as pitted or hypertrophic scars. Acne vulgaris is caused by Propionibacterium acnes (P. acnes). Acne cosmetica: As the name implies, this is acne caused or stimulated by cosmetics. But this is not limited to makeup. It also includes products like hair gels, conditioners, and certain beard oils. This type is usually noninflammatory and indicated by small, slightly raised red lesions, whiteheads, and occasional pustules. This can usually be corrected by eliminating the acne-producing product and educating clients on proper cleansing techniques.