Acne is an upsetting skin condition that commonly affects teenagers but which can also affect adults. Disfiguring scars may appear if acne is left untreated, therefore early acne treatment is advisable.
Acne can be categorized by different types of bumps on the skin, ranging from clogged pores (blackheads and whiteheads), pimples (red bumps or pustules) and deeper lumps (nodules or cysts) that may become painful. These often occur on the face, neck, chest, back, shoulders and even the upper arms.
At Our Skin Centre, our doctor takes a comprehensive approach in evaluating your condition and determining a suitable acne treatment regimen for your skin. We offer a wide range of topical and oral medications, chemical peels and microdermabrasion to help control and prevent acne, minimizing potential scarring. Large acne nodules and cysts may be treated by injecting steroids into the bump. In severe cases of acne that is unresponsive to other acne treatments, isotretinoin may be used. A range of treatments that reduce the disfiguring appearance of scars are also available.
Acne scars may be treated by a combination of surgical treatments, such as subcision and punch excision, fractional laser resurfacing, and the injection of dermal fillers to reduce the disfiguring appearance of scars.
What causes acne?
Acne is caused by clogged pores. These pores are medically known as sebaceous follicles. They are in essence sebaceous (oil) glands connected to a hair-containing canal. These sebaceous follicles are found mainly on the face and upper chest and back regions. The sebaceous glands secrete sebum (oil), and are most influenced by male hormones (androgens). During adolescence, androgen levels in both females and males rise, stimulating the sebaceous gland to produce more sebum. In addition, during puberty skin follicle cells are shed more rapidly, and mixed with excess sebum, the opening of the follicle becomes plugged or clogged, creating what we commonly refer to as blackheads and whiteheads (comedones). Normal skin bacteria, known as Propionibacterium acnes multiplies rapidly within the plugged follicle, releasing irritating substances which in turn cause an inflammation and rupture of the follicle walls, resulting in redness, swelling and pus – the pimple.
Skin care advice:
For daily care of your skin, you should wash your face twice a day with a mild cleanser and warm water. Acne is not caused by dirt, therefore frequent or rigorous scrubbing will not help.
A moisturizer should be used when the skin is dry, even if you feel you have oily skin. However, choose a moisturizer that is oil-free and “non-comedogenic” (which should not cause whiteheads or blackheads).
Remember not to squeeze, pick, scratch or pop your pimples. When pimples are squeezed, as a result there may be more redness, swelling, inflammation and susbsequent scarring.
If you use cosmetics, look for products that are “non-comedogenic” (do not clog pores) and remember to remove your makeup each night with a mild cleanser and water.
Treatment
Treatment of acne depends on the severity of the condition and the individuals’ skin type, age, and medical history. Treatment option can be suggested as follows:
- Topical medications
Topical medications is an approach for individuals with mild symptoms by applying medications directly to the skin and can help to reduce inflammation, unclog pores, and kill bacteria. Common topical medications for acne include benzoyl peroxide, retinoids, salicylic acid, antibiotics and 4th generation retinoids (Aklief).
- Oral medications
Oral medication is suggested to individuals with moderate to severe symptoms and have experience ineffective in topical medications. This approach includes intake of antibiotics especially doxycycline and minocycline. These medications work by suppressing the growth of P. acnes, a bacteria that can contribute to the development of acne. Some of these antibiotics also possess intrinsic anti-inflammatory properties.
Moreover, hormonal therapy is an established second-line treatment for female patients with acne and can be very effective, irrespective of whether or not the serum androgen levels are abnormal. Combined oral contraceptive pills, which block both ovarian and adrenal production of androgens, are particularly effective for inflammatory acne.
It is important to note that these medications can come with side effects, which shall be considered according to individual needs and preferences.
- Medical Procedures
Chemical peels involve the application of a chemical solution to the skin, which causes the outer layer of skin to peel off. This can help to improve the acne and improve the overall texture and tone of the skin.
Intralesional Steroid can directly suppress the inflammation and help resolve the acne in a short time.