Hi,
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I understand your concern. Let me give you some information regarding acne. Acne is a disorder of the pilosebaceous unit, pilo-hair, and sebaceous, oil-producing gland. These pilosebaceous glands are densely distributed over the face, neck, chest, back, shoulder, and arms. It also has a genetic component, meaning the appearance or severity of acne depends on the parents' genes. The sebaceous gland produces oil that is expelled through the duct that opens on the skin surface. As long as this duct is intact, oil flows freely onto the skin. However, if there is any blockage in the duct, the oil cannot come out, then it starts irritating the surrounding skin and causes comedone (black and white heads). Our skin has a harmless commensal bacteria called Propionibacterium acne (P acne). This bacteria acts on the oil collected inside and causes inflammation leading to red bumps, pimples, and cysts or nodules as it progresses. If acne is not treated on time, it will leave scars. Hormones strongly affect acne; increased androgen hormone can cause thickening of the duct wall, leading to its blockage and causing comedones (black and white heads). PCOD (polycystic ovarian disease) or PCOS (polycystic ovarian syndrome) is the most frequent hormonal disease causing acne in teenagers and adult women. Environmental, external, and emotional factors like hot and humid climates, causing increased sweat, can clog the pores. Applying oil or oil-based cosmetics and steroid cream are other causes of acne. Psychological stress is one of the important factors in acne. Yet I would like to suggest a few general acne skin care tips here. Facewash. Wash your face with mild cleansers like Cetaphil cleanser (Water, Cetyl alcohol, Propylene glycol, Sodium lauryl sulfate, Stearyl Alcohol, Methylparaben, and Propylparaben) if your face is dry, or use Benzoyl peroxide face wash if your face is oily. Wash your face three times a day to remove excess oil and dust which accumulates over time on the face. Sunscreen. Use a good sunscreen with SPF (sun protection factor) 50, and apply it to the whole face 30 minutes before you step out, irrespective of the presence of sunlight. UV (ultraviolet) rays will always be there during the daytime (even if cloudy). Apply every four hours for maximum benefits. This is because sunscreen can protect your skin from UV rays for four hours. Hence it would help if you repeated it every four hours. Always use non-comedogenic sunscreen. Do not pick or squeeze your acne. It will leave dark pigmentation and scars, which are even more difficult to treat. Regular physical exercises. Very much essential to keep hormones under check. Exercise for at least 40 minutes a day, six days a week. No oil massage. Avoid oil massage to the scalp, as it will aggravate dandruff. In addition, if there is oil flow on the facial skin, it can clog the pores leading to comedones. Vitamin A and water. Eat vitamin A-rich fruits and vegetables like papaya, mango, musk melon, pumpkin, carrot, and beetroot; these have beta carotene, a good antioxidant, very helpful for healthy skin. Also, drink two to three liters of water per day; this keeps the skin hydrated. Cosmetics. Always use water-based cosmetics, which have the "non-comedogenic" label. Stress management. Stress (mental as well as physical) causes acne breakouts. Meditation is beneficial for controlling mental stress. No waxing of hairs on the face. Waxing irritates hair follicles and can aggravate pimples. However, threading to remove unwanted hairs over the face is fine. Threading does not affect acne. Never use steroid creams. Steroid causes very bad acne; it makes the skin very thin and sensitive. Avoid over-the-counter (OTC) steroid creams. I hope you find it helpful. Kind regards.