What is acne?
Acne vulgaris or common acne is a condition that usually starts around puberty and is characterised by the presence of blackheads (comedones), pimples (pustules) and in the more severe cases cysts or nodules. Left untreated, acne can cause scarring and can affect the confidence of the suffer because of the appearance of the skin.
What causes acne?
Acne starts in teenage years because of the surge of male hormones in both males and females. During puberty, the oily glands in the skin produce more oils at the time when the top layer of the skin is also getting thicker. As a result, the excess oils can be trapped in the skin allowing bacteria to colonise it. The skin then reacts by generating inflammatory processes to try to get rid of the bacteria. These inflammatory processes can be seen on the skin surface as pimples or pustules. Face, shoulders, back and chest are the most common areas that are affected by acne.
Why should acne be treated?
It’s often thought that acne is a common skin condition that the sufferer will eventually get over, and it’s not necessary to seek medical help. While this is true in most cases, for some it may take many years before the acne is cleared naturally without treatment. This can cause the acne sufferers to have low self-esteem, and untreated acne may lead to severe scarring. It is important to remember that acne can be cleared but scars last a lifetime so getting treatment for acne before the formation of scars is advisable. Prevention is better than cure, and some of the treatments are used to prevent further outbreaks of acne as well as treating existing ones.
How can acne be treated?
Treatment of acne needs to address the four main causes of the problem: excess oil production, thickening skin, bacterial colonisation and inflammation. Doctors usually decide the treatment according to the following categories:
- Mild acne with few pimples and blackheads. It is often sufficient to just use over-the-counter face wash with anti-bacterial properties and benzoyl peroxide lotion or creams
- Moderate acne with more pimples and blackheads may need to be treated with the above plus retinoid creams such as adapelene or retin-A and topical antibiotics. Oral anti-biotics can also be prescribed if the topical ones are found not effective enough
- Severe acne is when most of the face is covered with pimples or when there are cysts. In these cases, oral retinoids are the most effective treatment
Lasers, IPL, microdermabrasion, botulinum toxin injections, blue and red light therapies and chemical peels can also be used to treat acne and prevent further outbreaks.
Botulinum toxin A, a naturally derived protein, is used to control excessive sweating (hyperhidrosis) and can have a positive impact on pores, as well as helping to reduce the amount of oil the skin produces.
Blue and red light therapies use light to kill bacteria and reduce inflammation, and medical facials can also be used to help rid the skin of bacteria.
It is advisable to seek the advice of a doctor in the first instance so the condition can be properly diagnosed and a treatment plan decided upon.
Can acne scars be treated?
The currently available treatments have limited efficacy and potentially problematic side effects. Therefore, it is best to get acne treated early before the scars form. There are a several treatments that can reduce or improve on the appearance of scarred skin including laser treatment, chemical peels, microneedling and microdermabrasion.
Use of sunscreen can prevent post inflammatory hyperpigmentation - hyperpigmented scars after acne. Patients should avoid picking pus-filled pimples and using harsh scrubs when active acne is present.