Acne is a skin condition that affects most teenagers and many adults. It is often viewed as a rite of passage and treated inadequately, resulting in permanent scarring. Good skin care is essential in the management of acne, and many treatment options exist to reduce the number and severity of acne outbreaks. Skincare from pharmacies may help, but early medical advice should be sought to reduce the risk of long-term complications.
Acne is a condition affecting the “pilosebaceous unit“. This fancy term refers to hair and the sebaceous gland which is attached to it. Sebaceous glands produce a sticky substance (sebum) to grease the hair and skin.
When these glands are over-active (caused by hormones), or if there is any blockage in the channel to the skin surface, the sebum accumulates to form a comedone (whitehead). Although relatively harmless, comedones can transform smooth skin into an irregular landscape. Self extraction should be avoded as careless gouging can harm the skin ad cause scarring. Products containig Glycolic Acid (AHA) and Salicylic Acid (BHA) can help reduce comedone formation as these reduce the thickness of the horny layer at the surface of the skin. Long-term use of the prescription drug Differin is extremely effective in reducing the number of comedones.
Other treatments that can greatly speed up the rate of comedone clearance incude chemical peeling and the Derma RF in rejuvenation mode which causes collagen contraction and squeezes out the comedones without the need for extractions!
If the comedone eventually opens to the skin surface, oxidation of the keratin plug turns it black in colour, producing a blackhead. Treatment is similar to comedones.
Bacterial infection can occur, causing redness and pain. This is known as a papule. Creams such as Benzac can be applied to hasten the drying up of papules. Papues can heal rapidly with no sign of their prior existence, so they may leave a bit of pigmentation behind (post-inflammatory hyperpigmentation – PIH).
If pus forms inside, this becomes known as a pustule. Finger surgery must not be performed on pustules, however large and tempting! Careless gouging can leave permanent scars and are high risk for PIH. Antibiotic creams as well as Benzac can speed up the healing process. Chemical peeling is excellent for controlling papulo-pustular acne. Oral antibiotics may also be required.
Sometimes the acne lesions are very large and deep. These are known as cysts. These are the ones that are highly likely to cause deep scarring that is permanent. Although Roaccutane is often prescribed for this condition, I have found that oral antibiotics, good skincare and a series of chemical peels is just as effective, without the any health risks associated with Roaccutane.
Importance of Treating Acne
Psychological: Whether adult or teenager, most people who suffer from acne feel very self conscious about their appearance. Many just don’t know how to treat it, and feel very ashamed of their poor complexion. There is often magnification both in size and number, so it always feels even worse than it already is.
Hyperpigmentation: Even after the pimple is no longer inflamed, it can leave a dark spot in its place. The larger and deeper the pimple was originally, the larger and darker the discoloration. For people with post-inflammatory hyperpigmentation, this dark spot can last for months before finally fading away.
Permanent Scarring: Squeezing and picking at pimples can increase your risk of permanent scarring. Various types of scars can form, ranging from soft waves to deep ice picks. This legacy of teenage acne can haunt an adult for the rest of his life.
The treatment of acne is thus divided into: