The Basis of Acne
Acne is a common chronic skin condition which occurs when your hair follicles become clogged and inflamed with sebum and dead skin cells. It causes pimples, open comedones (whiteheads), closed comedones (blackheads), and it usually appears on the face, chest, upper back and shoulders. Acne is the most common skin condition among teenagers, though it also affects people of all ages.
There are two basic types of acne:
- Non-inflammatory acne – blackheads (open comedones), whiteheads (soft closed comedones), and milia (hard closed comedones)
- Inflammatory acne – pustules, papules, nodules, and cysts
Causes and Factors for ACNE formation
Four main factors of acne formation:
- Hyperproliferation of shedded dead skin cells block the follicles
- Excess sebum(oil) production
- The presence of Cutibacterium acnes which formerly known as Propionibacterium acnes(P.acnes) which thrives on sebum, erupting into pimples
Causes for acne:
- Genetic predisposition
- Hair and skin care products.
- Medications side effects which can promote acne production
- Underlying medical conditions such as polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia, and pregnancy may trigger development of acne.
- Fluctuating hormone level.
- Friction or pressure on your skin with handphones, helmet, tight collars,headbands, backpacks, or under-wire bras.
- Excessive sunlight may either improve or flare acne. In any case, the ultraviolet exposure ages the skin.
10 Best Treatments for ACNE
We shall not be biased with the treatment we offer at our clinic 😉 , lets start with the most basic modification*
1. Lifestyle change
Change your diet to a healthy diet rich in antioxidants ,more fruits, less dairy products, more exercise, less late nights, less stress . This all helps to keep the pimples away. Stay out of the sun. As sun exposure actually worsens acne as it induces the sebaceous glands to produce more oil and clog up your pores even more.
No Facials and no extractions! Facials and extraction at wrong hands especially during active acne period create the fastest road to a pitted scar.
2. Skin care products for Acne
Lotions and serums containing retinoids, salicylic acid and benzoyl peroxide have been shown in numerous studies to help reduce acne. However, caution must be exercised as these agents can cause redness and irritation to the skin, resulting in flaking and discomfort. For severe acne conditions , over the counter skin care products might not help and can even worsen the condition . Do stop by at our clinic for a free consultation , our doctors are more then willing to recommend the best and most effective skin care routine for you .
3. Topical Medication for Acne:
Topical antibiotics such as Clindamycin,Erythromycin, Minocycline in gel/cream form usually require prescriptions from our doctors Vitamin A derivatives, or retinoids, are extremely useful in acne. They work by increasing cell turnover, and thus unclogging pores. Benzoyl peroxide, salicylic acid, acetic acid, tretinoin acid – Acne clearing ingredient which will be prescribed in higher concentration.
Certain Medications eg : Benzoyl peroxide @ lower strength are available over the counter . Which might be useful for those having occasional breakouts
4.Oral medication for Acne
I. Oral Antibiotics
Certain Oral antibiotics might help for certain groups of patient ; Acne isn’t an infection, but a systemic antibiotic can provide real relief from deep, painful breakouts. Those medications reduces the amount of P. acnes bacteria on your skin and lessen inflammation. When that happens, you may see less acne and sometimes clearing.
This group of medications are prescriptional medicine for selected severe acne. Suitable for acnes that causes deep, painful cysts and nodules. These can be the size of a pencil eraser or larger. As this acne clears, scars often appear.
Severe acne can be difficult to treat. When other treatments fail to clear the skin, Retinoids may be an option. Treatment with isotretinoin often results in prolonged clearance of acne, which can be permanent for some patients.
Warning: You put your health at serious risk when you buy prescriptional medicine from an online source without advice / prescription from certified doctors
Course of such medications ( oral antibitoics and retinoids ) is depending on the severity of your acne and the doctors will often advise u during the consultation. Oral medications for Acne might cause severe adverse reaction if taken without advice from medical professional
5. Hormonal Therapy
Any medication that acts on our hormones is called hormonal therapy. Two hormonal therapies that can effectively clear acne in women are:
- Oral contraceptive pills
Many studies have looked at how well oral contraceptive pills fight acne. It has been found effective at treating blackheads, whiteheads, pimples, and acne nodules and cysts. It is generally considered safe for women. Some women, however, should not take it. Your doctors need to assess your health condition in order to prescribe such medications .
6. local Injections
If you absolutely have to get rid of a painful cyst or nodule quickly, the dermatologist may inject the cyst with an antiinflammatory solution to bring it down. This helps to quickly reduce the size and pain.
Our ‘lunchtime peel’ is a popular treatment as it has no downtime and the effects are prominent. The skin is exfoliated using an alpha or beta hydroxy acid. Done in a series, these peels can improve mild to moderately severe cases of acne, and can be given over the face or another body area where acne is a problem. They rapidly exfoliate the skin, allowing dead skin cells to shed more effectively. By keeping dead skin cells and excess oil from clogging the hair follicle, pore blockages (comedones) and pimples can be reduced.
It is also called visible light therapy as you can see the colors, these devices can treat pimples. Continuous blue light kills the P.acnes in the upper parts of the sebaceous gland, and is FDA approved for the treatment of acne.Red light also affects the P.acnes in the sebaceous glands. It also causes some direct heating of the upper layers of the skin, and exerts some anti-inflammatory effects.
Studies have shown that combining both Red and Blue light therapies, performed once a week, each, is beneficial in the treatment of acne
9. ACNE LASER
Quasi long pulse Nd:YAG laser light safely penetrates into skin to effectively target overactive sebaceous glands and to reduce the risk of developing new acne inflammation. Plus, the laser does an excellent job at skin rejuvenation, making this a popular treatment choice for many.
For active acne, Nd:YAG laser treatment reduces acne inflammation through photoselective absorption and controlled heating effects. It safely penetrates the skin to an optimal treatment depth to thermally and selectively destroy overactive sebaceous glands.
In addition to its thermal penetration effects, the Nd:YAG acne laser treatment also accelerates the healing process and stimulates collagen remodeling, an important step in the long-term treatment of acne.
Conclusion : Combination Therapy works best !
Combination of different modalities – topicals, medications, and aesthetic treatments, to act synergistically to keep acne under control. The important thing is, controlling acne needs your commitment as well! It can take weeks to months, and will require constant care to see improvement.
Does acne only affect adolescents and teenagers?
In fact, we are seeing more and more adult onset acne. We do not know if this is due to the stresses of living in a city, altered bacterial colonisation of the body, or simply, more people seeking help for it. In a tropical climate like Malaysia, the hot and humid climate results in increased sebum production, and also allows the P.acnes bacteria to multiply even faster, resulting in more frequent cases and more severe cases of acne.
Women who smoke also seem to be more prone to acne.
Acne tends to run in families, so if a parent had adult acne, you’re at higher risk. People can get acne into their 40s and beyond.
I wash my face a lot but still get blackheads. Why?
Washing your skin can’t get rid of blackheads or acne. Why? Blackheads form below the skin’s surface, when oil, also called sebum, reacts with air in a partially clogged pore. When the pore is totally blocked, you get a whitehead.
Wash your face twice a day and after sweating, using a mild cleanser and warm water, not hot water. Do not scrub your skin as that can worsen acne.
Do birth control pills cause or cure acne?
Birth control pills may help some women control acne. The hormones in birth control pills can help block androgen hormones. Androgen puts oil glands into overdrive. Some birth control pills, though, can make acne worse. So even if you take birth control pills, you’ll still need a good acne skin care routine
Is my makeup causing my acne?
Yes. In fact, anything you put on your face has the potential to clog pores. Look for oil-free makeup, sunscreens, and other skin products. Non-comedogenic products can be better for acne-prone skin.
You might also try using powder cosmetics instead of cream foundations. If you do want to use foundation, some dermatologists recommend oil-free liquid silicone matte foundations, such as those containing dimethicone or cyclomethicone.
I’m so stressful. Is that a factor in acne?
Researchers have found a relationship between stress and acne flare-ups. In response to stress, our bodies produce more androgens (a type of hormone). These hormones stimulate the oil glands and hair follicles in the skin, which can lead to acne. This explains why acne can be an ongoing problem when we find ourselves under constant stress.
Does certain diet worsen acne?
Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
Why Do Some People Get Acne and Others Don’t?
It is not clear why some people are more prone to acne than others. The exact cause of acne is not known, but hormones called androgens can play a role. Androgens increase in both boys and girls during puberty. Androgens make the skin’s oil glands get larger and make more sebum. Androgens also can increase because of hormonal changes related to pregnancy or starting or stopping birth control pills.
Genetics may also matter. If your parents had acne, you may have inherited that tendency.
Some medications (for example, androgens taken as medicine, epilepsy medication, lithium, and prednisone) can cause acne. Cosmetics that have a greasy consistency may also clog pores. Water-based products are less likely to cause acne than oil-based makeup.
Am I stuck with acne forever?
On its own, acne does seem to go away with age. According to one study, acne becomes less common after age 44. And for some women, acne ends with menopause.
Until then, fortunately, there are treatments for adult acne. Most people find a combination of products work best. Treatment takes time , usually 4 to 12 weeks and you need to continue it for it to work.
While severe acne can be stubborn, it’s not impossible to get clearing. Thanks to advances in treatment, virtually all acne can clear with a dermatologist’s help.
How to prevent acne?
Don’t over-wash or use harsh scrubs. Acne is not caused by dirt. Two gentle washings a day is enough. Too much cleaning can leave skin irritated and dry, triggering glands to produce more oil, increasing the likelihood of pimples.
Use oil-free or non comedogenic products (those that won’t clog pores) on your face.
Don’t squeeze or pick blemishes. Popping pimples can drive acne bacteria deeper into the skin. Picking can lead to more inflammation and permanent scarring.
Avoid touching your face. Touching your face can increase oiliness, irritate your skin, and encourage the growth of bacteria. Develop a hands-off policy.
Prevention is better than cure. Having a good skin care regime will keep the acne under control, and minimize the problem of having to deal with pimples. Consult your doctor for a suitable skin care regime for you!