Acne

What it is

Acne is a common condition of the oil glands and hair follicles that causes blackheads, whiteheads, red bumps and sometimes deep painful lumps on the face, chest and back. It affects most teenagers and many adults, especially women in their twenties and thirties.

How it works

Acne starts inside the hair follicle. Hormones (androgens) increase oil production, dead skin cells stick together and block the pore, and a skin bacterium (C. acnes) multiplies in the trapped oil. The body responds with inflammation, producing red or dark bumps, pustules and sometimes deep painful lumps that can scar.

Why it matters on darker skin

Acne itself is similar across skin types, but in darker skin it often leaves dark marks (PIH) that last longer than the spots, and deep acne is more likely to cause keloid scars. Heavy oils and pomades used on hair and skin can also trigger "pomade acne" along the hairline.

Causes and triggers

Puberty and hormonal shifts, family history, heavy or greasy products on the face and hair (pomade acne), some medicines, picking, and possibly high-glycaemic diets and dairy in some people. Stress can worsen flares. Sweat and tight headwear trigger body and forehead acne.

What helps — and why it works

Wash twice daily with a gentle cleanser and use non-comedogenic moisturiser and sunscreen. Pharmacy options with good evidence include benzoyl peroxide, adapalene and azelaic acid; start slowly to avoid irritation. Persistent or scarring acne responds well to prescription treatment, so seek help early. Adapalene at night: retinoids stop pores clogging and calm inflammation; also fade marks. Expected timeline: 8–12 weeks for clear improvement. Benzoyl peroxide wash or gel: kills acne bacteria without causing antibiotic resistance. Expected timeline: 2–4 weeks for fewer inflamed spots. Azelaic acid: reduces bacteria and inflammation and fades dark marks — useful on darker skin. Expected timeline: 8–12 weeks. Non-comedogenic moisturiser and sunscreen: reduce irritation from actives and protect marks from darkening. Expected timeline: immediately reduces dryness. See a doctor if moderate or scarring: prescription combinations, tablets or isotretinoin prevent permanent scars. Expected timeline: review at 12 weeks.

What to avoid and why

Do not pick, squeeze or scrub. Avoid heavy oils, shea or cocoa butter on acne-prone areas, and skip toothpaste, lemon or bleaching products. Do not use steroid creams on acne; they make it worse.

Common mistakes

• Changing products every week before they have time to work.
• Applying toothpaste, lime or spirit to spots.
• Over-washing or scrubbing, which inflames skin.
• Using heavy hair oils that run onto the forehead.
• Stopping treatment as soon as skin clears — maintenance prevents relapse.

Building a routine that lasts

Most skin problems improve with a short routine used every day rather than many products used occasionally. A practical base is a gentle cleanser, a fragrance-free moisturiser and a broad-spectrum sunscreen in the morning, with one targeted treatment at night. Introduce one new product at a time and give it two weeks before adding another, so that if your skin reacts you know the cause. Patch-test on the inner arm or behind the ear for a few days first. Skin renews itself roughly every four to six weeks, so most treatments need two to three cycles — eight to twelve weeks — before you can judge them fairly. Photographs taken in the same light every four weeks are more reliable than memory. In the Nigerian climate, heat, humidity and harmattan all change what your skin needs: lighter gels in the humid season and richer creams in dry months are both reasonable. If a product stings for more than a few minutes, causes swelling, or leaves new dark patches, stop it. Buy from registered pharmacies or official stockists, and use the Authenticity Check if you are unsure whether a product is genuine.

Reading labels and choosing products

On the label, look first for the active ingredient and whether the product is fragrance-free and non-comedogenic. Ingredients are listed in order of amount, so an active at the end of a long list may be present only in a small quantity. Be wary of products that promise results in days, that list no ingredients, or whose label is a sticker or handwritten. Words such as 'natural', 'herbal', 'organic' and 'dermatologist-inspired' are marketing terms, not safety standards. Hydroquinone, mercury compounds (sometimes listed as calomel or mercurous chloride) and strong steroids such as clobetasol do not belong in an over-the-counter cosmetic. A real NAFDAC registration number should be printed on the pack and should match the product on the official Greenbook register. Price is not proof: counterfeiters copy expensive brands. When in doubt, ask a pharmacist, keep your receipt, and use Melanin & Me's Authenticity Check and barcode scanner as a first screen.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.