Acne during summer: Why the heat causes skin issues and how to manage it according to a dermatologist

Acne is one of the most common chronic inflammatory skin diseases of the sebaceous glands. Sebaceous glands are oil-producing glands and are attached to hair follicles. They release a fatty substance called sebum into the follicular ducts which are then released into the skin.
Acne Skin Care Tips for summer from Dermatologist Steps to manage acne issues in summer
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Acne occurs as a result of excessive release of the fatty substance sebum and blockage of the ducts with superadded infection. If there is only blockage of the sebaceous glands, then it results in the formation of the whiteheads and blackheads. When there is a superadded infection, it results in the formation of papules and pustules and severe cases of nodules and cyst.

Acne is a multifactorial disease and depends on several factors like genetic predisposition, endocrine factors, hormonal factors, age, diet and many other factors including environmental factors. In places where summer is hot and humid, the intense UVR(ultraviolet radiation) can trigger inflammatory acne flare-up. This is one of the major environmental factors that lead to acne especially during summers. Both UVB and UVA have been reported to cause an increase in the size of the sebaceous gland, thickening of the stratum corneum, increase in sebum secretion and in the number of comedones. 

So primarily acne is caused because of several factors which are

  1. Size of glands - Increase in the size of the sebaceous glands because of several factors including heat and humidity.
  2. Increase production of sebum - As the heat increases the tendency to sweat increases. This leads us to wipe our face and wash our face more excessively which leads to drying of the face. This in effect leads to overcompensation of the oil glands and hence the amount of sebum production increases. 
  3. Thickening and clogging up of the pores - As the sebum production increases, this built up of the skin cells results in clogging up of the pores. 
  4. Increased colonisation of the propionibacterium infection - Increase sweat and sebum results in increased colonisation of the bacteria and result in pus, pustules and cysts. 

This acne is called acne Tropicana, acne Majorca or tropical acne.

It's important to rule out hormonal causes, diet, and genetic predisposition. Treating acne should have a combined treatment approach. A good skincare plan and also some clinic treatments would help to clean the sebaceous glands and prevent acne and acne marks. 

If hormonal causes are ruled out then a good skincare plan in summer can keep the acne at bay. 

A good skincare plan would depend on the skin type

A) Oily skin with acne 

  1. Cleanser can be used which is SLS free with active ingredients like mandelic acid, glycolic acid and salicylic acid.
  2. Exfoliating polish once or twice a week with magnesium crystals and other ingredients like vitamin C or glycolic would help to exfoliate the dead skin cells and prevent clogging up of the pores. 
  3. A good non-comedogenic sunscreen that could be water gel-based could help prevent acne marks.
  4. A moisturiser could be avoided for some time, instead, opt for a vitamin C serum or antioxidant serums containing niacinamide. 
  5. Night creams for treating acne could be a combination of creams or alternate application of creams like azelaic acid (10%) which work well as an anti-inflammatory and others like Aadapalene or glycolic acid. To prevent marks, creams like kojic acid and niacinamide work well. I like to stay away from antibiotic creams as these are not required for treating acne. 

B) Dry skin with Acne 

Sometimes in summer, dry skin could even break out as the clogging up of the skin and excessive moisturizing of the skin could result in acne. 

So the skincare plan for dry skin is quite complex and requires a consultation with a dermatologist as one has to start slow and use gentle face wash and scrubs which would help to clean the oil gland without over-drying the skin. One could shift to a more non-comedogenic barrier repair cream as opposed to a moisturiser with shea butter as it could clog the pores. Also, one can choose active ingredients for acne like azelaic acid which could be liposomal and remember to stay away from benzoyl peroxide as it could be very drying and irritating. Even newer acne patches can be applied only on the affected area and could remain for over 12 hours. These acne patches with hydrocolloid dressing increase the effectiveness of the active ingredient in reducing the active acne effectively without irritating the surrounding skin.

So, treating acne with a good skincare plan is very effective. Sometimes if there is active inflammation and too many whiteheads and blackheads then it is difficult for the creams to penetrate for it to be effective, so consulting with a dermatologist and in-clinic treatments like chemical peels, lasers or micro-needling works well.

About the author: Dr. Batul Patel, medical director, and Dermatologist, The Bombay Skin Clinic

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