ACNE

What is acne?

Acne is a disorder of the hair follicles and sebaceous glands. Acne involves blocked pores which progress to pimples, cysts,   and possible scarring.

Acne is very common.   90% of the population are affected by acne   at some time.   It most   often begins in puberty.

What causes acne?

During puberty, the male sex hormones, called androgens, increase in both boys and girls, causing the sebaceous glands to become more active and, thereby, increasing the production of oil   (also called sebum).     Dried oil, dead skin cells, and bacteria can cover the hair follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes, or P. acnes) begin to grow inside the follicles, causing inflammation.

Other factors playing a role in acne include the following:

·     hormone level changes during the menstrual cycle in women

·     certain drugs (such as corticosteroids, lithium, and barbiturates)

·     oil and grease from the scalp, mineral or cooking oil, and certain cosmetics

·     friction or pressure from helmets, backpacks, or tight collars

·     environmental conditions (such as pollution or humid conditions)

.   Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard.

What are the symptoms of acne?

Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands:

·                                   face

·                                   chest

·                                   upper back

·                                   shoulders

·                                   neck

The following are the most common symptoms of acne. However, each person may experience symptoms differently:

·                                   blackheads

·                                   whiteheads

·                                   pus-filled lesions that may be painful

·                                   nodules (solid, raised bumps)

Treatment of acne:

The goal of acne treatment is to minimize scarring and relieve symptoms. Specific treatment will be determined by your dermatologist based on:

·                                   the severity of the acne

·                                   your overall health and medical history

·                                   your tolerance for specific medications, procedures, or therapies

·                                   expectations for the course of the condition

·                                   your opinion or preference

Treatment may include drug therapy to treat acne. Depending upon the severity of acne, topical medications (medications applied directly to the skin) or systemic medications (medications taken orally) may be prescribed by your dermatologist. In some cases, your dermatologist may recommend a combination of both topical medications and systemic medications.

Topical medications to treat acne:

Sometimes prescription topical medications are prescribed to treat acne. Topical medication can be in the form of a cream, gel, lotion, or other solution for the skin. Examples include:

Benzoyl Peroxide: kills the bacteria (P.acnes) and reduces oil production

Antibiotics: helps stop or slow down the growth of P. acnes and reduces inflammation

Tretinoin: stops the development of new acne lesions (comedones) and encourages cell turnover, unplugging pimples

Adapalene: decreases comedone formation

Azelaic acid: helps stop or slow down the growth of P. acnes and reduces inflammation

Systemic medications to treat acne:

Systemic medications are often prescribed to treat moderate to severe acne.

Oral antibiotics are often used to treat acne and many patients stay on these medications for some months.  They have an excellent safety record in acne patients.

Treatment for severe, cystic, or inflammatory acne:
We sometimes use a specialised medication, based on a vitamin, to treat patients with severe, cystic, or inflammatory acne to prevent extensive scarring.  This medication can only be prescribed by dermatologists.  It reduces the size of the sebaceous glands that produce the skin oil, reduces skin cell shedding, and affects the hair follicles, thereby reducing the development of acne lesions. Isotretinoin can clear up acne in 90 percent of patients.

However, the drug may have some side effects. It is very important to discuss this medication with your dermatologist.

Photodynamic therapy:

A new treatment for acne involves the application of a special cream on the skin which is absorbed especially by the sebaceous glands. A special light is then applied to the skin and results in shrinkage of the sebaceous glands.   This treatment is suitable for some patients to whom we do not wish to give oral medications.   A series of treatments is required.

Before   treatment                             After treatment

Before   treatment                                                               After treatment