What is Acne?
Acne is a skin condition that causes pimples to develop. Acne is the most common skin disorder in the world, affecting an estimated 85 percent of adolescents.
Effective acne treatments are available to treat existing pimples and prevent new ones from developing. In addition, cosmetic treatments can help to reduce scarring and changes in skin color caused by acne.
HOW DOES ACNE DEVELOP?
Hormonal changes — Hormonal changes during adolescence cause the sebaceous glands to become enlarged, and sebum production increases. In most people with acne, hormone levels are normal, but the sebaceous glands are highly sensitive to the hormones.
Less often, women’s hormone levels are affected by an underlying medical problem known as polycystic ovary syndrome (PCOS).
Acne tends to resolve between ages 30 to 40, although it can persist into or develop for the first time during adulthood. Post-adolescent acne predominantly affects women, in contrast to adolescent acne, which predominantly affects men. Acne can flare before a woman’s menstrual period, especially in women older than 30 years.
External factors — Oil-based cosmetics may contribute to the development of acne. Oils and greases in hair products can also worsen skin lesions. Water-based or “noncomedogenic” products are less likely to worsen acne.
People with acne often use soaps and astringents. While these treatments remove sebum from the skin surface, they do not decrease sebum production; frequent or aggressive scrubbing with these agents can actually worsen acne.
Diet — The role of diet in acne is controversial. Some studies have found weak associations between cow’s milk and an increased risk of acne, perhaps because of hormones that occur naturally in milk. However, there is no strong evidence that milk, high-fat foods, or chocolate increase the risk of acne.
Stress — Psychological stress can probably worsen acne. In several studies of students, acne severity appeared to worsen during times of increased stress.
There is no single best treatment for acne, and combinations of treatments are sometimes recommended. Since acne lesions take at least eight weeks to mature, you should use a treatment for a minimum of two to three months before deciding if the treatment is effective.
Acne skin care — Skin care is an important aspect of acne treatment.
Skin hygiene — Wash your face no more than twice daily using a gentle nonsoap facial skin cleanser (eg, Cetaphil, Oil of Olay bar or foaming face wash, or Dove bar) and warm (not hot) water. Some providers recommend avoiding use of a washcloth or loofah, and instead using the hands to wash the face. Vigorous washing or scrubbing can worsen acne and damage the skin’s surface.
Do not pick or squeeze pimples because this may worsen acne and cause skin swelling and scarring. It can also cause lesions to become infected.
Moisturizers — Use of a moisturizer minimizes dryness and skin peeling, which are common side effects of some acne treatments. Moisturizers that are labeled as “noncomedogenic” are less likely to block skin pores.
Sun protection — Some acne treatments increase the skin’s sensitivity to sunlight (eg, retinoids, doxycycline). To minimize skin damage from the sun, avoid excessive sun exposure and use a sunscreen with SPF 30 or higher that is broad spectrum (blocks both UVA and UVB light) before sun exposure.
Can I treat my own acne?
If you have mild acne, you can try to treat yourself with nonprescription products initially. Nonprescription acne treatments may include salicylic acid, benzoyl peroxide, sulfur, alpha hydroxy acids, adapalene, or tea tree oil, all of which are available in nonprescription strengths. A combination of these treatments may be more effective than using one single product alone. In rare cases, people have a severe allergic reaction to acne products, so for the first three days, try them on just a small area.
How can we help you with your acne?
We will assessed your acne severity, acne subtype as well as skin condition before recommending different modalities of treatment.
Noninflammatory acne causes whiteheads or blackheads without redness or skin swelling.
Retinoids — Topical retinoid medications are often recommended for noninflammatory acne. The most recommended will be the newest generation of retinoid, adapalene (Differin), which is available both by prescription.
Retinoids are usually applied once per day, although people who develop skin irritation can reduce this to every other day or less, then increase as tolerated over time. Most people become more tolerant of retinoids over time.
Most retinoids are available in a gel or cream. People with oily skin may prefer gels because they have a drying effect, while people with dry skin may prefer a cream.
Retinoids can cause skin irritation. While using topical retinoids, you should apply a sunscreen with SPF 30 or greater before sun exposure.
Mild to moderate inflammatory acne
Mild to moderate acne with some inflammation is usually treated with topical retinoids , topical antibiotics, or benzoyl peroxide.
A combination of medications, usually benzoyl peroxide with a topical antibiotic and/or retinoid (eg, tretinoin), is more effective than treatment with one agent alone.
Benzoyl peroxide — Benzoyl peroxide is usually applied twice per day. It may be combined with a topical retinoid, in which case the benzoyl peroxide is applied in the morning and the retinoid is applied at night. Benzoyl peroxide can irritate the skin, sometimes causing redness and skin flaking, and it can bleach clothing, towels, bedding, and hair.
Topical antibiotics — Topical antibiotics (creams or liquids) control the growth of acne bacteria and reduce inflammation. Topical antibiotics include erythromycin, clindamycin, sulfacetamide, and dapsone.
Moderate to severe inflammatory acne
For people with moderate to severe inflammatory acne , oral antibiotics or an oral retinoid known as isotretinoin may be recommended. Topical medication may be used in combination with oral antibiotics.
Women often benefit from hormonal treatment with a birth control pill.
Oral antibiotics — Oral antibiotics work to slow the growth of acne-producing bacteria. However, oral antibiotics can have bothersome side effects, including vaginal yeast infections in women and stomach upset.
Doxycycline and minocycline are the most commonly prescribed oral antibiotics for acne. They cannot be used during pregnancy or in children less than nine years of age.
Oral isotretinoin — Oral isotretinoin (Amnesteem, Claravis, Sotret, Absorica) is a potent retinoid medication that is extremely effective in the treatment of severe acne. It cures or significantly improves acne in the majority of patients. Oral isotretinoin is effective in treating the most disfiguring types of acne. Isotretinoin used to be sold as Accutane, but that brand name is no longer available.
Oral isotretinoin is usually taken in pill form once or twice daily with food for 20 weeks, then stopped. In some cases, acne can initially worsen before it improves. To reduce the risk for this initial flare of acne, isotretinoin is sometimes given at a lower dose for the first month of treatment. After treatment is stopped, improvement can continue for up to five months.
Hormone therapy — The hormone estrogen can help to offset the effect of androgens (hormones responsible for acne development). Estrogen treatment in the form of a birth control pill is sometimes recommended for women with moderate or severe acne.
Not all oral contraceptives should be used for the treatment of acne; some can actually worsen acne. Certain types of intrauterine devices (IUDs) and some injectable forms of birth control also may worsen acne. Discuss the best options with your healthcare provider.
Spironolactone is another medication that can be used to treat acne in women. Spironolactone reduces the effects of androgens.
The benefits of birth control pills and other hormonal medications may not be noticeable until three to six months after treatment is started. Treatment with hormonal medications is not recommended during pregnancy.
What other therapy can we add into your treatment?
We understand due to our busy life schedules, compliance to daily medication may be an inconvenience. At G Aesthetic Medical Wellness Clinic, we offer evidence based physical treatment to cater to our patients. These treatment are usualy scheduled once to twice weekyl These therapy can be used in combination to improve the final result.
- Laser at 1064nm can safely penetrate deep into the skin, reaching acne causing bacteria residing deep beneath. Using laser is safe and helpful for acne. Treatment is often delivered twice weekly for four weeks. The effect can be enhanced by use of a photosensitising agent applied to the skin before laser treatment.
- Injection of steriod into resistent acne nodule and cyst can rapidly shrink them.
- Comedones can be expressed or removed by carbon dioxide laser.
- Microdermabrasion can help mild acne.
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G Aesthetic Wellness Medical Clinic is dedicated to setting the highest standards in aesthetics treatments, while providing personalised and effective skincare solutions.
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