ACNE THEORY

TRAINING MANUAL
CONTENTS

INTRODUCTION

THE LAYERS OF SKIN

ACNE FACTS

WHAT IS ACNE?

WHAT CAUSES ACNE?

ACNE IN WOMEN

ACNE IN MEN

TYPES OF ACNE

WHAT IS ROSACEA?

FOOD AND ACNE

SKIN ANALYSIS FOR ACNE

TOPICAL ACNE TREATMENTS

CLINICAL ACNE TREATMENTS

FACIALS FOR ACNE

CHOOSING SKINCARE

PRODUCTS
INTRODUCTION
Acne is a common skin condition that affects millions of people
worldwide, regardless of age or gender. Whether you're someone who is
personally dealing with acne or a healthcare professional seeking a
deeper understanding of this condition, this course is designed to provide
you with comprehensive knowledge about acne and its various aspects.

Throughout this course, we will delve into the causes, types, and
underlying mechanisms of acne. We will explore the factors that
contribute to the development of acne, including hormonal changes,
genetics, lifestyle choices, and environmental influences. By
understanding the root causes, we can better comprehend why acne
occurs and how to effectively address it.

Moreover, we will examine the different types of acne lesions, ranging

from blackheads and whiteheads to papules, pustules, nodules, and
cysts. Understanding the characteristics and distinctions of each acne
type is crucial for accurate diagnosis and appropriate treatment
selection.
WHAT IS SKIN?
The skin is the largest organ of the human body, serving as a protective
barrier between the internal organs and the external environment. It
covers the entire body surface and has a wide range of functions that are
essential for overall health and well-being. Here's a brief overview of
what the skin does for the body:

Protection: The skin acts as a physical barrier, protecting the body from
harmful environmental factors such as UV radiation, pathogens, toxins,
and physical injury. The outermost layer of the skin, the epidermis,
prevents the entry of microorganisms and helps maintain a sterile
environment.

Regulation of Body Temperature: The skin plays a crucial role in

thermoregulation, helping to maintain a stable body temperature. When
the body gets too hot, sweat glands in the skin produce sweat, which
evaporates and cools the body. Conversely, when the body gets cold,
blood vessels in the skin constrict to reduce heat loss and keep the body
warm.

Sensation: The skin is richly supplied with sensory receptors that allow
us to perceive touch, pressure, temperature, and pain. These nerve
endings send signals to the brain, enabling us to interact with the
environment and experience tactile sensations.

Excretion: Sweat glands in the skin excrete waste products, such as

water, electrolytes, and small amounts of toxins, through sweat. This
process helps eliminate metabolic waste and maintain fluid balance
within the body.
WHAT IS SKIN?
Vitamin D Synthesis: When exposed to sunlight, the skin can produce
vitamin D, which is essential for the absorption of calcium and
phosphorus, and plays a crucial role in maintaining bone health.

Immune Function: The skin houses various immune cells that are part of
the body's defense system. These cells help protect against pathogens
and play a role in immune responses and inflammation.

Appearance and Identity: The skin's appearance, including color,

texture, and integrity, contributes to a person's physical appearance and
plays a role in self-esteem, social interaction, and cultural identity.

The skin is a complex organ that performs numerous vital functions,

beyond its external appearance. Its role extends far beyond aesthetics,
as it acts as a vital interface between our bodies and the surrounding
environment, helping to keep us protected, regulated, and connected to
the world around us.
SKIN ANATOMY
The skin has three main layers:

Epidermis
The outermost layer that protects against pathogens and UV radiation. It
consists of several sublayers, including the stratum corneum and basal
layer.

Dermis
Located beneath the epidermis, it provides support, nourishment, and
houses various structures like blood vessels, nerves, and glands.

Subcutaneous (Hypodermis)
The deepest layer composed of fat tissue, providing insulation and
cushioning. It also contains blood vessels and larger nerves.
SKIN ANATOMY - EPIDERMIS
The skin is composed of three primary layers, each with its own unique
structure and functions. From the outermost layer to the innermost layer,
these layers are:

The epidermis is the outermost layer of the skin and acts as a protective
barrier against external factors. It is composed of several sublayers,
including:

Stratum Corneum: This is the topmost layer of the epidermis and

consists of dead skin cells called corneocytes. It provides protection
against moisture loss and environmental irritants.

Stratum Granulosum: This layer is responsible for the production of

keratin, a protein that provides strength and waterproofing to the skin.

Stratum Spinosum: The stratum spinosum contains cells called

keratinocytes, which produce keratin and help maintain the skin's
strength and integrity.

Stratum Basale: The stratum basale is the deepest layer of the

epidermis and contains cells called basal cells. These cells divide and
migrate upwards, replenishing the upper layers of the epidermis.
Melanocytes, which produce melanin (the pigment responsible for skin
color), are also found in this layer.
SKIN ANATOMY - DERMIS

The dermis is the middle layer of the skin, located beneath the epidermis.
It provides structural support and houses various important structures.
The dermis consists of:

Collagen and Elastin Fibers: The dermis is rich in collagen and elastin
fibers, which provide strength, elasticity, and resilience to the skin.

Blood Vessels: Blood vessels within the dermis supply nutrients and
oxygen to the skin cells and help regulate body temperature.

Hair Follicles and Sebaceous Glands: Hair follicles are located in the
dermis and produce hair. Sebaceous glands, which are connected to hair
follicles, secrete sebum (an oily substance) that lubricates and
moisturizes the skin.

Sweat Glands: Sweat glands are also found in the dermis and produce
sweat, which helps regulate body temperature.

Nerve Endings: The dermis contains sensory nerve endings that enable
the perception of touch, pressure, pain, and temperature.
SKIN ANATOMY - SUBCUTIS

Subcutis (Hypodermis)
The subcutis, also known as the hypodermis or subcutaneous tissue, is
the deepest layer of the skin. It consists primarily of adipose (fat) tissue
that provides insulation, cushioning, and energy storage. The subcutis
also contains blood vessels and larger nerve fibers.

These three layers work together to protect the body, regulate

temperature, provide sensory input, and maintain overall skin health.
Each layer has its own distinct functions and plays a crucial role in the
overall structure and function of the skin.
WHAT IS ACNE?
Acne comes in many shapes and forms, and knowing how to identify the
different types of acne can help you better understand how to treat them.
In this post, we’ll review the different types of acne that can appear on
your face and review various treatment options.

Fast Facts on Acne

Here are some facts about acne. More detail is in the main article.
Acne is a skin disease involving the oil glands at the base of hair
follicles.
It affects 3 in every 4 people aged 11 to 30 years.
It is not dangerous, but it can leave skin scars.
Treatment depends on how severe and persistent it is.
Risk factors include genetics, the menstrual cycle, anxiety and stress,
hot and humid climates, using oil-based makeup, and squeezing
pimples.
WHAT IS ACNE?
Acne is a skin condition that occurs when your skin pores are blocked
by oil, bacteria, dead skin cells, and/or dirt. The oil glands under our
skin release sebum (oil), which normally travels up the oil glands and
onto the surface of our skin, keeping our skin soft. However, a build-up
of oil, bacteria, or dead skin cells trapped in our pores can lead to
inflammation. Acne is a physical manifestation of this inflammation.

A common mistake people make is confusing acne with fungal acne

because they can look similar. While the two can have a similar
appearance, there are distinct differences when it comes to causes and
treatments.
WHAT CAUSES ACNE?
The exact causes of acne still remain unclear, but there is proof that a
few factors affect the presence or severity of acne.

Acne is caused when tiny holes in the skin, known as hair follicles,
become blocked.

Sebaceous glands are tiny glands found near the surface of your skin.
The glands are attached to hair follicles, which are small holes in your
skin that an individual hair grows out of.

Sebaceous glands lubricate the hair and the skin to stop it from drying
out. They do this by producing an oily substance called sebum. In acne,
the glands begin to produce too much sebum. The excess sebum mixes
with dead skin cells and both substances form a plug in the follicle.

If the plugged follicle is close to the surface of the skin, it bulges

outwards, creating a whitehead. Alternatively, the plugged follicle can
be open to the skin, creating a blackhead.

Normally harmless bacteria that live on the skin can then contaminate
and infect the plugged follicles, causing papules, pustules, nodules or
cysts.

Why does acne eventually clear up?

We do not understand why acne eventually clears up. It does not always
coincide with a reduction in sebum production or with a reduction in the
number of bacteria. It may relate to changes in the sebaceous glands
themselves or to the activity of the immune system.
WHAT CAUSES ACNE?
Nutrition and diet
First, nutrition and diet play a role in inflammation in our bodies and, in
turn, acne. Studies show that certain foods high in sugar and dairy can
raise hormone levels (IGF-1), which leads to an overproduction of
sebum and contributes to acne formation.

Build-up of dead skin cells

Second, a build-up of dead skin cells can contribute to acne. The skin’s
most outer layer, the epidermis, undergoes constant renewal. It
naturally sheds skin cells as new ones generate every 28 days.

When the dead skin cells stay and build up over time, they contribute to
a clogged pore and potentially, a pimple.
WHAT CAUSES ACNE?
When the dead skin cells stay and build up over time, they contribute to a
clogged pore and potentially, a pimple.

Testosterone
Teenage acne is thought to be triggered by increased levels of a hormone
called testosterone, which occurs during puberty. The hormone plays an
important role in stimulating the growth and development of the penis
and testicles in boys and maintaining muscle and bone strength in girls.

The sebaceous glands are particularly sensitive to hormones. It’s thought

that increased levels of testosterone cause the glands to produce much
more sebum than the skin needs.

Overproduction of sebum
Lastly, an overproduction of sebum from our oil glands can contribute to
acne. For example, using harsh products strips the natural oils from the
surface of our skin, making it feel dry and overly taut. As a result, the oil
glands respond by overproducing oil to try and compensate.
Compounded over time, this can result in clogged pores and
inflammation, which manifests in acne.

Runs in the family

Acne can run in families. If your parents had acne, it’s likely that you’ll
also develop it.

One study has found that if both your parents had acne, you’re more
likely to get more severe acne at an early age. It also found that if one or
both of your parents had adult acne, you’re more likely to get adult acne
too.
TEEN ACNE
The precise reasons that acne is most severe during the teenage years
are being studied. There are several theories.

Sex hormones are converted in the skin to dihydrotestosterone

(DHT), which stimulates sebaceous (oil) glands at the base of hair
follicles to enlarge.
The sebaceous glands produce sebum. Changes in sebum
composition may lead to acne lesions.
The activated sebaceous gland cells (sebocytes) also produce pro-
inflammatory factors, including lipid peroxides, cytokines, peptidases
and neuropeptides.
Hair follicles are tiny canals that open into skin pores (tiny holes) on
the skin surface. The follicles normally carry sebum and keratin
(scale) from dead skin cells to the surface. Inflammation and debris
leads to blockage of the skin pores — forming comedones.
The wall of the follicle may then rupture, increasing an inflammatory
response.
Bacteria within the hair follicle may enhance inflammatory lesions.

While acne is most common in adolescents, acne can affect people of all
ages and all races. It usually becomes less of a problem after the age of
25 years, although about 15% of women and 5% of men continue to have
acne as adults. It may also start in adult life.
ACNE AND HYGIENE
Poor hygiene can contribute to the development of acne by allowing
excess oil, dirt, and bacteria to build up on the skin, clogging pores and
leading to inflammation. Here are some poor hygiene habits that can
contribute to acne:

Not washing the face regularly: Failing to cleanse the skin regularly can
lead to a buildup of oil, dirt, and bacteria on the skin, clogging pores and
leading to acne breakouts.

Sleeping with makeup on: Sleeping with makeup on can clog pores and
lead to the buildup of bacteria and oil on the skin, increasing the risk of
acne breakouts.

Using dirty makeup brushes or sponges: Dirty makeup brushes or

sponges can harbor bacteria and oil, leading to acne breakouts.

Touching the face frequently: Touching the face frequently with dirty
hands can transfer bacteria and oil onto the skin, leading to acne
breakouts.

Wearing dirty or sweaty workout clothes: Wearing dirty or sweaty

workout clothes can lead to the buildup of bacteria and oil on the skin,
increasing the risk of acne breakouts.

Practicing good hygiene habits, such as washing the face twice daily with
a gentle cleanser, removing makeup before bed, washing makeup
brushes regularly, avoiding touching the face with dirty hands, and
changing out of sweaty clothes promptly, you can help reduce the risk of
developing acne.
STRESS AND ACNE
Stress causes a chemical response in your body that makes skin more
sensitive and reactive. It can also make it harder for skin problems to
heal.

Have you ever noticed that you break out more when you’re stressed?
This is because stress causes your body to make hormones like cortisol,
which tells glands in your skin to make more oil. Oily skin is more prone
to acne and other skin problems.

It can also be stressful to have problems with your skin. Some people
feel so bad about how it looks that they keep to themselves, which adds
more stress.

The relationship between stress and acne has been misunderstood by

many. Stress can’t directly cause acne. However, if you already have
acne, stress does make it worse.

Researchers have found that wounds, including acne, are much slower
in healing when a person is under stress. Slower healing of acne means
that the pimples stay longer and are more susceptible to increase in
severity. It can also mean that more acne is visible at one time because
it takes longer for each pimple to heal during a breakout.

Stress can also:

Make skin problems worse. For example, stress can aggravate

psoriasis, rosacea, and eczema. It can also cause hives and other types
of skin rashes and trigger a flare-up of fever blisters.

Interfere with daily skin care. If you’re stressed, you might skimp on
this part of your routine, which can aggravate skin issues.
WHY IS ACNE WORSE
IN SOME PEOPLE?
Some people have particularly severe acne. This may be because of:
Genetic factors (family members have bad acne)
Hormonal factors (higher levels of male/androgenic hormones) due
to:
Polycystic ovaries (common). Hyperinsulinaemia and insulin
resistance are characteristically found in women with polycystic
ovarian syndrome, who are prone to acne among other problems
Psychological stress and depression
Excessive corticosteroids eg Cushing disease (rare)
Enzyme deficiency eg sterol hydroxylase deficiency (very rare)
Environmental factors such as:
High humidity causing swelling of the skin
Cosmetics especially certain moisturisers, foundation and
pomades. Watch out for products that contain lanolin,
petrolatum, vegetable oils, butyl stearate, lauryl alcohol and
oleic acid.
Pressure from headbands and chin straps (eg “fiddler’s neck”, a
condition seen in violin or viola players, where continual pressure
from the violin against the neck causes skin irritation)
Excessive dairy products, meat protein and sugars in the diet.
Diets low in zinc or high in iodine can worsen pustular acne.
Certain medications may provoke acne.
Much of the individual variation in acne severity is due to variation in
the innate immune system and the production of inflammatory
mediators such as cytokines, defensins, peptidases, sebum lipids,
and neuropeptides. Evidence has emerged that inflammation leads
to distension and occlusion of the hair follicle, which then ruptures.
ACNE IN WOMEN

Acne in women can be caused by a variety of factors, some of which are

specific to women. These factors include:

Hormonal changes: Hormonal fluctuations, such as those that occur

during the menstrual cycle, pregnancy, or menopause, can trigger acne
breakouts by increasing oil production and inflammation.

Polycystic ovary syndrome (PCOS): PCOS is a hormonal disorder that

can cause a range of symptoms, including acne, due to the excess
production of androgens (male hormones).

Pregnancy: Hormonal changes during pregnancy can trigger acne

breakouts in some women.

Menopause: Changes in hormone levels during menopause can also

trigger acne breakouts in some women.

Use of certain medications: Some medications, such as corticosteroids

and oral contraceptives, can cause acne breakouts in some women.

Cosmetics and skincare products: Certain cosmetics and skincare

products can clog pores and lead to acne breakouts, especially if they
contain comedogenic (pore-clogging) ingredients.
ACNE IN MEN
Acne in men is typically caused by a combination of factors, including:

Hormones: Androgens are male hormones that increase during puberty

and can lead to an increase in oil production, which can clog pores and
lead to acne breakouts.

Testosterone: Teenage acne is thought to be triggered by increased

levels of a hormone called testosterone, which occurs during puberty. It’s
thought that increased levels of testosterone cause the glands to produce
much more sebum than the skin needs.

Genetics: Acne can run in families, and men with a family history of acne
may be more prone to developing it themselves.

Stress: Stress can trigger the release of hormones, such as cortisol,

which can increase oil production
Acneand lead to acne breakouts.
in women

Diet: A diet high in refined carbohydrates, sugar, and dairy products may
increase the risk of developing acne in men.

Environmental factors: Exposure to pollutants and other environmental

factors can also contribute to the development of acne in men.

Poor hygiene: Poor hygiene habits, such as not washing the face
regularly or using dirty towels or bedding, can contribute to the buildup of
oil and bacteria on the skin, leading to acne breakouts.
TYPES OF ACNE

There are several common types of acne, it's important to note that
some people may experience a combination of these types of acne, and
the severity of acne can vary from mild to severe. If you're experiencing
persistent or severe acne, it's best to consult with a dermatologist for
proper diagnosis and treatment.
TYPES OF ACNE
Whiteheads: Whiteheads occur when a hair follicle becomes clogged
with oil and dead skin cells. The pore stays closed, creating a white or
flesh-colored bump on the skin.

Blackheads: Blackheads occur when a hair follicle becomes clogged

with oil and dead skin cells, and the pore stays open. The top of the
bump may appear black or dark brown.

Papules: Papules are small, red, raised bumps that occur when the
hair follicle becomes inflamed.

Pustules: Pustules are similar to papules, but they contain pus. They
appear as small, red bumps with a white or yellow center.

Nodules: Nodules are large, painful, inflamed bumps that occur deep
in the skin. They can be red or flesh-colored and may not come to a
head.

Cysts: Cysts are similar to nodules but are larger and filled with pus.
They are often painful and can cause scarring.
TYPES OF ACNE
Whiteheads
Whiteheads are a form of clogged pores that are characterized by small,
white pus-filled blemish at the surface of the skin. Also known as closed
comedones, they are caused by hair follicles clogged with oil. As seen in
the above picture, whiteheads look like small, white
bumps and are not sensitive to touch.

What do whiteheads look like? Small, white bumps that have a white or
yellow fluid in the center.

In almost all cases, acne happens because the pores in your skin are
clogged. Clogged pores can happen when there is too much oil, bacteria,
or skin cell production, or as a result of hormonal changes.

Whiteheads, also known as closed comedones, happen when pores are

clogged all the way through. The length of the pore and the head of the
pore are closed, creating a little white bump on top of the skin. It’s
important to note that whiteheads can’t be removed or fixed by
squeezing them, so don’t try to pop them on your own. Otherwise, you
may end up with scarring.
TYPES OF ACNE
Blackheads
Also called open comedones, blackheads are similar to whiteheads in
that they are a result of clogged hair follicles and live at the surface of the
skin. However, unlike whiteheads, they are exposed to oxygen in the air
and go through an oxidation process that darkens their appearance. As a
result, blackheads look like small, black dots, often in groups and smaller
in size than whiteheads.

What do blackheads look like? Small, black dots that are grouped
together on the face, similar to freckles.

Unlike whiteheads, blackheads look black on the skin’s surface. They are
known as open comedones because the head of the pore remains open,
while the rest of the pore is clogged. Blackheads can be removed by
squeezing, although that’s not recommended because it can cause
scarring.

Treatment options for blackheads are the same as treatments for

whiteheads. Try to avoid using pore strips to pull out blackheads. Pore
strips are an abrasive, temporary fix that can damage the top layer of
your skin, making acne worse.
TYPES OF ACNE
Papules
Papules are a more severe form of acne that occurs when whiteheads or
blackheads become inflamed and infected. White blood cells rush to the
infected area to treat the infection, which
causes irritation to the infected area.

What do papules look like? Red or pink raised bumps that are inflamed
and sensitive to touch.

Papules are small red bumps that form when oil or excess skin cells block
a pore and mix with bacteria on your skin called Cutibacterium acnes or C.
acnes (formerly Propionibacterium acnes). The contents of this blocked
pore spill out, which allows the bacteria to escape into the surrounding
skin tissue. The bacteria then create an inflamed lesion. Papules do not
contain pus.
TYPES OF ACNE
Pustules
If you’ve ever been tempted to “pop” a pimple that looks ripe for your
picking, you’ve come across pustules. Pustules are also a more severe
version of closed comedones; they often look like whiteheads, but
bigger and more inflamed. The pus or fluid is much more visible to the
eye and the affected area is larger than that of a typical whitehead.

What do pustules look like? Pustules look like pink or red raised
bumps with a clear white or yellow pus-filled center.

Pustules are small, bulging bumps with a white centre and red,
inflamed skin surrounding them. They are usually found in clusters on
the chest, face, or back. Pustules form when a blocked pore gets
infected, but they can also be caused by hormonal changes in the body.
They are similar to papules, except pustules contain a
yellowish fluid known as pus.

Popping pustules may cause the bacteria to spread, so don’t try to pop
or squeeze them. Only your doctor can safely drain pustules.
TYPES OF ACNE

Nodules
A nodule is a solid dome-shaped lesion that extends below the surface,
deep into the layers of the skin. They are large, painful bumps that are
harder than cysts and are not filled with pus.

What do Nodules look like? Nodular acne consists of flesh-coloured or

red bumps that are deep under the skin’s surface. Nodular acne is
usually a result of the C. acnes bacteria causing a painful infection deep
within the pore.
TYPES OF ACNE

Cysts
Cysts form deeper within the skin surface and are indicative of
inflammation and infection under the epidermis, the top layer of the
skin. They are often bigger than papules or pustules, appear lighter in
the middle where the pus accumulates, and are more painful to touch.

What do cysts look like? Cysts look similar to boils, with a larger bump
deep under the skin’s surface.

Cystic acne is the most severe form of acne and is also the result of an
infection deep within the skin. Acne cysts are large, red, inflamed,
painful, and pus-filled. Cysts are softer than nodules because they are
pus-filled and often burst, infecting the surrounding skin.
WHAT IS ROSACEA?
If your face looks like you’re blushing and you get bumps that are a bit
like acne, you might have a skin condition called rosacea. Your doctor
can suggest medicine and other treatments to manage your symptoms,
and there are plenty of steps you can take at home to make yourself look
and feel better.
WHAT IS ROSACEA?
Symptoms
The biggest thing you’ll notice is redness on your cheeks, nose, chin, and
forehead. Less often, the color can appear on your neck, head, ears, or
chest.

After a while, broken blood vessels might show through your skin, which
can thicken and swell up. Up to half of people with rosacea also get eye
problems like redness, swelling, and pain.

Other symptoms you may get are:

Stinging and burning of your skin
Patches of rough, dry skin
A swollen, bulb-shaped nose
Larger pores
Broken blood vessels on your eyelids
Bumps on your eyelids
Problems with seeing

Your rosacea symptoms can come and go. They might flare up for a few
weeks, fade, and then come back.

Getting treatment is a must, so make sure you see your doctor. If you
don’t take care of your rosacea, redness and swelling can get worse and
might become permanent.
WHAT IS ROSACEA?
What Causes It?
Doctors don’t know exactly what causes rosacea. A few things that may
play a role are:

Your genes. Rosacea often runs in families.

Blood vessel trouble. The redness on your skin might be due to problems
with blood vessels in your face. Sun damage could cause them to get
wider, which makes it easier for other people to see them.

Mites. They’re tiny insects. A type called Demodex folliculorum normally

lives on your skin and usually isn’t harmful. Some people, though, have a
heightened sensitivity to the mites, or more of these bugs than usual..
Too many mites could irritate your skin.

Bacteria. A type called H. pylori normally lives in your gut. Some studies
suggest this germ can raise the amount of a digestive hormone called
gastrin, which might cause your skin to look flushed.

Some things about you may make you more likely to get rosacea. For
instance, your chances of getting the skin condition go up if you:

Have light skin, blonde hair, and blue eyes

Are between ages 30 and 50
Are a woman
Have family members with rosacea
Had severe acne
Smoke
FOOD AND ACNE

Some studies suggest there is a link between the food we eat and acne. It
is very difficult to study the role of diet and acne.

Acne is reported to be less common in people that have a diet with a

lower glycaemic index, eg, indigenous people from Kitava and Papua New
Guinea, the Ache people of Paraguay, Inuit, and rural residents of Kenya,
Zambia and Bantu. These people tend to become sexually mature at a
later age than in the cities where higher glycaemic index foods are
consumed. Early puberty is associated with earlier onset and more
severe acne that tends to peak at the time of full maturity (age 16 to 18).

Several studies, criticised for their quality, have shown benefits in acne
from a low-glycaemic, low-protein, low-fat and low-dairy diet.
The reasons for these benefits are thought to relate to the effects of
these foods on insulin and insulin-like growth factor-1 (IGF-1).

Insulin induces male hormones (androgens), glucocorticoids and growth

factors. These provoke keratinisation (scaling) of the hair follicle and
sebum production. An increase in sebum production and keratinisation is
a factor in the appearance of acne.

On the other hand, a large prevalence study of acne in military recruits

showed a lower prevalence in severely obese adolescents than in those
of normal weight.
FOOD AND ACNE
Foods that increase insulin production
Foods that increase insulin levels have a high glycaemic index. The
glycaemic index is a measurement of how carbohydrates have an effect
on our blood sugar levels. When we eat foods with a high glycaemic
index, such as white bread and baked goods, our blood sugar level rises.
This increases the amount of insulin produced in our bodies.

Although cow’s milk has a low glycaemic index, it contains androgens,

oestrogen, progesterone and glucocorticoids, which also provoke
keratinisation and sebum production. Milk also contains amino acids (eg
arginine, leucine, and phenylalanine) that produce insulin when
combined with carbohydrates. Other components of milk that might
induce comedones include whey proteins and iodine.

Caffeine, theobromine, and serotonin found in chocolate may also

increase insulin production.
FOOD AND ACNE
Food containing fatty acids
Fatty acids are needed to form sebum. Studies show that some
monounsaturated fatty acids, such as sapienic acid and some vegetable
oils, can increase sebum production. However, the essential fatty acids
linoleic, linolenic and gamma-linolenic acid can unblock the follicles and
reduce sebum production.

What to eat if you have acne?

Some people with acne have reported improvement in their skin when
they follow a low-glycaemic index diet and increase their consumption
of whole grains, fresh fruits and vegetables, fish, olive oil, garlic while
keeping their wine consumption moderate.

It’s a good idea to drink less milk and eat less of high glycaemic index
foods such as sugar, biscuits, cakes, ice creams and bottled drinks.

Reducing your intake of meat and amino acid supplements may also
help.
SKIN ANALYSIS FOR ACNE
Performing a skin analysis for acne involves examining the skin closely
to identify the type and severity of acne present, as well as any
underlying skin conditions that may be contributing to the acne. Here
are the steps for performing a skin analysis for acne:

Cleanse the skin: Begin by thoroughly cleansing the skin to remove

any makeup, dirt, or oil. Use a gentle, non-comedogenic cleanser that
won't irritate or strip the skin.

Examine the skin: Use a magnifying lamp or other magnifying tool to

examine the skin closely. Look for the presence of blackheads,
whiteheads, pustules, cysts, and other types of acne lesions. Note the
location, size, and severity of each lesion.

Assess the skin type: Determine the skin type of the individual,
whether it's oily, dry, combination, or sensitive. This will help you
choose the right products and treatments for their skin.

Identify any underlying skin conditions: Look for any other skin
conditions that may be present, such as rosacea, eczema, or psoriasis.
These conditions can affect how you treat the acne.

Evaluate the skin's overall health: Assess the overall health of the
skin, including its texture, hydration levels, and signs of aging. This will
help you determine which treatments and products are most
appropriate.

Determine the cause of the acne: Try to identify any factors that may
be causing or contributing to the acne, such as hormonal imbalances,
diet, stress, or medication use.
TOPICAL ACNE TREATMENTS
There are many topical treatments available for acne, including over-the-
counter products and prescription medications. Some common topical
treatments for acne include:

Benzoyl peroxide: Benzoyl peroxide is an over-the-counter medication

that helps kill the bacteria that causes acne. It also helps unclog pores
and reduce inflammation.

Salicylic acid: Salicylic acid is another over-the-counter medication that

helps unclog pores and reduce inflammation. It's often used to treat mild
to moderate acne.

Retinoids: Retinoids are a class of prescription medications that help

unclog pores and reduce inflammation. They can also help reduce the
appearance of acne scars.

Antibiotics: Topical antibiotics, such as clindamycin or erythromycin, are

prescription medications that help kill the bacteria that causes acne.

Azelaic acid: Azelaic acid is a prescription medication that helps unclog

pores and reduce inflammation. It's often used to treat mild to moderate
acne.

Dapsone: Dapsone is a prescription medication that helps reduce

inflammation and kill the bacteria that causes acne. It's often used to
treat moderate to severe acne.

It's important to note that some of these medications may cause dryness,
redness, or irritation, and it may take several weeks to see results.
Consult with a dermatologist to determine the best treatment plan for
your specific needs.
CLINICAL ACNE TREATMENTS
There are many facial treatments available for acne, and the most
effective treatment will depend on the severity of your acne and your skin
type. Some common facial treatments for acne include:

Facials: Certain types of facials can be effective for treating acne. Look
for facials that use ingredients like salicylic acid, which can help unclog
pores and reduce inflammation.

Chemical peels: Chemical peels use a combination of acids to exfoliate

the top layer of skin and unclog pores. They can help reduce the
appearance of acne scars and improve the overall texture and tone of
your skin.

Microdermabrasion: Microdermabrasion uses a special tool to gently

exfoliate the top layer of skin. It can help reduce the appearance of acne
scars and improve the texture and tone of your skin.

Blue light therapy: Blue light therapy uses a special type of light to kill
the bacteria that causes acne. It can be a highly effective treatment for
moderate to severe acne.

Extractions: Extractions are a manual process in which a professional

will use special tools to remove blackheads and whiteheads. This can
help unclog pores and reduce the appearance of acne.

It's important to note that while facial treatments can be helpful in

treating acne, they are not a substitute for a good skincare routine that
includes gentle cleansing, moisturizing, and sun protection. Consult with
a dermatologist to determine the best treatment plan for your specific
needs.
FACIALS FOR ACNE

Performing a facial for skin with acne can help improve the appearance
and health of the skin by removing excess oil, unclogging pores, and
reducing inflammation.

It's important to note that while facials can be helpful for acne-prone
skin, they should be done in moderation and under the guidance of a
licensed esthetician or dermatologist. Over-exfoliating or using harsh
products can actually make acne worse, so it's important to use gentle,
non-irritating products and avoid any techniques or products that can
damage the skin.
FACIALS FOR ACNE
Here are the general steps to follow:

Cleanse: Begin by cleansing the skin with a gentle, non-comedogenic

cleanser to remove any dirt, oil, and makeup. Use lukewarm water and a
soft cloth or your fingers to gently massage the cleanser onto the skin,
then rinse thoroughly and pat dry.

Steam: Next, use a facial steamer or place a warm, damp towel over the
face to help open up the pores and soften the skin. This can help make it
easier to remove impurities and dead skin cells during the facial.

Mask: Apply a clay mask or another type of acne-fighting mask to help

draw out impurities and reduce inflammation. Leave the mask on for the
recommended amount of time, then rinse thoroughly with lukewarm
water.

Exfoliate: Use a gentle exfoliating scrub or enzyme mask to remove dead

skin cells and unclog pores. Be careful not to be too rough or aggressive,
as this can irritate the skin and make acne worse.

Extract: Use a comedone extractor or your fingers (if they are clean and
properly sanitized) to gently extract any blackheads or whiteheads. Do
not attempt to extract cystic acne or pimples, as this can cause scarring
and make the acne worse.

Tone: Use a toner to help balance the skin's pH levels and remove any
remaining impurities or traces of the mask.

Moisturize: Finish the facial by applying a lightweight, non-comedogenic

moisturizer to help hydrate and protect the skin.
PRODUCTS FOR ACNE PRONE SKIN
When choosing professional skincare products for facials on acne-prone
skin, there are a few key factors to consider. Here are some tips to help
you choose the right products:

Look for products that are labeled specifically for acne-prone skin. These
products are formulated with ingredients that can help to reduce acne
and prevent breakouts.

Choose products that are non-comedogenic, meaning they won't clog

pores. Clogged pores can lead to breakouts and acne, so it's important to
choose products that are designed to keep pores clear.

Consider products that contain salicylic acid or benzoyl peroxide. These

are common acne-fighting ingredients that can help to reduce
inflammation and prevent breakouts.

Be gentle with the skin. Avoid using products that are too harsh or
abrasive, as this can further irritate acne-prone skin and cause more
breakouts.

Look for products that contain soothing ingredients like aloe vera or
chamomile. These can help to reduce inflammation and calm irritated
skin.

Consider using products that contain antioxidants. Antioxidants can help

to protect the skin from environmental stressors and can promote healing
and repair of damaged skin cells.

Choose professional skincare products that are designed to effectively

treat and prevent acne-prone skin while being gentle and soothing on the
skin.
CHOOSING A CLEANSER

When it comes to choosing a cleanser for acne-prone skin, it's important

to look for a product that is gentle and non-comedogenic, which means it
won't clog pores. Here are some types of cleansers that can be effective
for acne-prone skin:

Salicylic acid cleansers: Salicylic acid is a common ingredient in

cleansers for acne-prone skin because it helps unclog pores and exfoliate
dead skin cells.

Benzoyl peroxide cleansers: Benzoyl peroxide can be an effective

ingredient for treating acne, but it can also be harsh and drying. If you
choose a benzoyl peroxide cleanser, make sure to follow up with a
moisturizer to prevent dryness.

Sulfur cleansers: Sulfur is an ingredient that can help reduce oiliness

and kill bacteria on the skin. It can be a good choice for people with oily
skin or mild to moderate acne.

Gentle cleansers: If your skin is sensitive or prone to dryness, a gentle

cleanser that doesn't contain any harsh ingredients may be the best
option. Look for a non-comedogenic, fragrance-free cleanser that is
formulated for sensitive skin.

Oil cleansers: Some people find that using an oil cleanser can help
reduce acne by dissolving excess oil and unclogging pores. Look for an oil
cleanser that is specifically formulated for acne-prone skin.
CHOOSING A TONER
When it comes to choosing a toner for acne-prone skin, it's important to
look for a product that is gentle, non-comedogenic, and helps to balance
the skin's pH levels. Here are some types of toners that can be effective
for acne-prone skin:

Salicylic acid toners: Salicylic acid is a common ingredient in toners for

acne-prone skin because it helps unclog pores and exfoliate dead skin
cells.

Witch hazel toners: Witch hazel is a natural astringent that can help
reduce oiliness and inflammation in the skin. Look for a witch hazel toner
that is alcohol-free and non-drying.

Tea tree oil toners: Tea tree oil has antimicrobial properties that can
help kill bacteria on the skin. Look for a tea tree oil toner that is
formulated for acne-prone skin and doesn't contain any harsh
ingredients.

Aloe vera toners: Aloe vera has anti-inflammatory properties that can
help soothe and reduce redness in the skin. Look for an aloe vera toner
that is alcohol-free and non-irritating.

Niacinamide toners: Niacinamide is a form of vitamin B3 that can help

reduce inflammation and regulate oil production in the skin. Look for a
niacinamide toner that is formulated for acne-prone skin.

Toner is an optional step in a skincare routine and is not necessary for

everyone. If you have sensitive skin or are prone to dryness, you may
want to skip toner altogether or use it only occasionally.
CHOOSING A MOISTURIZER
When it comes to choosing a moisturizer for acne-prone skin, it's
important to look for a product that is lightweight, non-comedogenic, and
won't clog pores. Here are some types of moisturizers that can be
effective for acne-prone skin:

Oil-free moisturizers: Look for a moisturizer that is oil-free and won't

add any additional oil to your skin. Oil-free moisturizers are typically
lightweight and absorb quickly, making them a good choice for people
with oily or acne-prone skin.

Non-comedogenic moisturizers: Non-comedogenic moisturizers are

formulated to not clog pores, which can help prevent breakouts. Look for
a moisturizer that is labeled as non-comedogenic or oil-free.

Gel moisturizers: Gel moisturizers are typically lightweight and

hydrating, making them a good choice for people with oily or acne-prone
skin. Look for a gel moisturizer that is formulated for acne-prone skin.

Moisturizers with hyaluronic acid: Hyaluronic acid is a hydrating

ingredient that can help plump and moisturize the skin without clogging
pores. Look for a moisturizer that contains hyaluronic acid and is
formulated for acne-prone skin.

Moisturizers with ceramides: Ceramides are lipids that help strengthen

the skin's barrier and lock in moisture. Look for a moisturizer that
contains ceramides and is formulated for acne-prone skin.

Even if you have oily or acne-prone skin, it's still important to use a
moisturizer to keep your skin hydrated and healthy. Skipping moisturizer
can actually make acne worse by causing the skin to produce more oil to
compensate for the dryness.
AFTERCARE
After an acne facial, it is important to follow a proper aftercare routine to
maintain the health and appearance of your skin. Here are some tips for
acne facial aftercare:

Avoid touching or picking at your skin: Touching or picking at your skin

can introduce bacteria and irritate your skin, leading to more acne
breakouts.

Avoid sun exposure: Sun exposure can damage and irritate your skin,
making acne worse. Wear a broad-spectrum sunscreen with at least SPF
30 to protect your skin from harmful UV rays.

Use gentle skincare products: Use gentle, non-comedogenic skincare

products that are specifically formulated for acne-prone skin. Avoid
harsh ingredients like alcohol, fragrances, and sulfates.

Keep your skin hydrated: Use a lightweight, non-comedogenic

moisturizer to help keep your skin hydrated and prevent it from
becoming dry and flaky.

Avoid wearing heavy makeup: Heavy makeup can clog pores and
irritate your skin, leading to more acne breakouts. If you must wear
makeup, use non-comedogenic, oil-free products.

Keep up with regular facials: Regular facials can help keep your skin
healthy and prevent acne breakouts. Consider scheduling a facial every
four to six weeks.

Follow any specific instructions given by your esthetician: Your

esthetician may give you specific instructions for aftercare based on
your individual needs and skin type. Follow these instructions carefully
to get the best results from your facial.
MEDICAL HISTORY

Do you take any of the following?

Accutane Retin-A Benzoyl Peroxide

Glycolic Acid
Lactic Acid Salicylic Acid Other

Do you currently have or have ever been treated for any of the following?

Hypertension HIV Herpes Simplex Skin Disease

Diabetes Cancer Hormone Therapy Other

Do you have any allergies?

Do you have any metal implants in your body?

Are you pregnant or breastfeeding?

What is your current skincare regimine/routine?

Cleanse Tone Eye Cream/Gel Other

Exfoliate Serum Moisturize

By signing below, you agree to the following:

I have completed this form to the best of my ability and knowledge and agree to inform my
esthetician of any changes to the information listed on all the pages of this client intake form. I
have been informed of and understand the contraindications to the requested treatments and
agree that I do not have any condition(s) that would make the requested treatment unsuitable. I
will inform my esthetician of any discomfort I may experience at any time during my treatment
to allow them to adjust accordingly. I agree to waive all liabilities toward my esthetician and
"Company Name Here" for any injury or damages incurred due to my misrepresentation of my
health history.

Signature Date
INTAKE FORM

YOUR CONTACT INFORMATION

First Name Last Name

Address

City/State Zipcode

Phone Email

HEALTH INFORMATION
Do you have any allergies? If yes, please list:
_________________________________________________________________________________________________
Do you have any medical conditions that may affect the services you receive? If yes, please describe:
_________________________________________________________________________________________________
Are you currently taking any medications? If yes, please list:
_________________________________________________________________________________________________
BEAUTY HISTORY
Have you had any beauty services in the past? If yes, please list:
_________________________________________________________________________________________________
Have you experienced any problems with previous services? If yes, please describe:
_________________________________________________________________________________________________
Are you satisfied with your past beauty services? If no, please describe why:
_________________________________________________________________________________________________
CONCERNS
What is your skin type? (oily, dry, combination, sensitive, etc.)
_________________________________________________________________________________________________
Do you have any specific concerns or problem areas? If yes, please describe:
_________________________________________________________________________________________________
What do you hope to achieve through the services you receive today?
_________________________________________________________________________________________________
CONSENT/AGREEMENT
Please read and sign below to indicate your agreement with the following statements:

I understand the services I will receive and the risks involved.

I agree to follow any aftercare instructions provided.
I understand that there may be additional charges for services beyond what is listed on this form.
I give my consent for the salon to use photos of my hair/skin for promotional purposes.

Signature: ________________________________________
Date: ___________________________________________

ADDITIONAL INFORMATION
Please provide any other relevant information or requests:
_________________________________________________________________________________________________
Privacy Policy
We take the privacy of our clients very seriously. We collect and use personal information only for the purpose of providing our services. We will never share your
information with third parties without your consent. We take all necessary precautions to protect your personal information from unauthorized access or disclosure.
Skin Care Questionnaire

SkinCare
What are your current skincare concerns?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
What skin care treatments or procedures have you had in the past?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
If you’ve had previous skin care treatments were you pleased with the outcome? Yes No (If no, why were you dissatisfied)
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Please circle 3 things you would like to improve about your skin.

Lines Wrinkles Rough Texture Dull Pores Blotchiness Dry & Tight Age Spots Breakouts Oiliness Prevention

Do you have sensitive skin, occasional or recurring skin problems we should be aware of? Yes No (If yes, please explain)
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Have you ever experienced allergic reaction to skin products? Yes No (If yes, please explain)
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Are you currently using any skin lightening products (e.g. Retin A or Hydroquinone)? Yes No (If yes, what products?)
___________________________________________________________________________________________________

List your current skincare routine. List the brand names next to the products used.

Brand Name
Cleanser(s) Yes No

Exfoliation Yes No

Serum/Hydration Yes No

Toner Yes No

Moisturizer Yes No

SPF/Sunscreen Yes No

Masks Yes No

Eye Gel/Creams Yes No

Retin-A or similar product Yes No

Anatomical Face Map

With respect to facial aesthetics, please mark those areas of the face that bother or trouble
you. In the boxes provided please rate these areas on a scale of 1 to 5 (1 being least
bothersome, 5 being most both- ersome). Feel free to draw on the chart to identify any
other facial concerns.