Acne vulgaris and its resultant scars have been associated with significant social and academic difficulties that can last into adulthood, including difficulties obtaining employment. Until the 1930s, it was largely seen as a trivial problem among middle-class girls – a trivial problem, because, unlike smallpox and tuberculosis, no one died from it, and a feminine problem, because boys were much less likely to seek medical assistance for it. During the Great Depression, dermatologists discovered that young men with acne had difficulty obtaining jobs, and during World War II, some soldiers in tropical climates developed such severe and widespread tropical acne on their bodies that they were declared medically unfit for duty.
We've already waxed poetic about the wonders of this brand's body sheet masks (one editor even wore hers topless!), which means we had high hopes for its citrus-scented cleanser. Luckily, it fulfilled its acne-fighting promises. Made with tea tree extract to target excess oil, salicylic acid to gently exfoliate skin cells, and niacinamide to smooth post-breakout texture, this formula targets every stage of a breakout.
Combined oral contraceptive pills contain progesterone and estrogen and help to balance out the levels of testosterone in the body12 One obvious effect of this is birth control, but dermatologists have also found it very useful for treating hormonal acne. Testosterone doesn’t directly cause acne, but when hormone levels fluctuate and testosterone increases above its baseline level, it can lead to increased acne for some. This is because increases in testosterone and other androgens leads to an increase in sebum production, which can cause more clogged pores and more p. acnes bacteria, leading to blackheads, whiteheads, pimples, or even cysts.
A major mechanism of acne-related skin inflammation is mediated by P. acnes's ability to bind and activate a class of immune system receptors known as toll-like receptors (TLRs), especially TLR2 and TLR4. Activation of TLR2 and TLR4 by P. acnes leads to increased secretion of IL-1α, IL-8, and TNF-α. Release of these inflammatory signals attracts various immune cells to the hair follicle including neutrophils, macrophages, and Th1 cells. IL-1α stimulates increased skin cell activity and reproduction, which in turn fuels comedo development. Furthermore, sebaceous gland cells produce more antimicrobial peptides, such as HBD1 and HBD2, in response to binding of TLR2 and TLR4.
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