Acne and Acne Scar Management
What is Acne?
Acne or pimples is a very common skin disorder. According to one study, about 85% of people between the age group 13 to 25 years develop it at least once in their lifetime. The good part of the information however is, only 15% of affected people develop it after the age of 25.
Acne as a disease is very mild but it has tremendous psychosocial impact on the lives of the affected. The scars and marks can be a source of anxiety in many people.
With the right treatment, it is possible to control the crop of the acne and also to reduce the scars and dots. This is what we offer in our “Pimple Management program”.
Why and how of acne:
Acne usually affects face, neck, chest, shoulders and back. Our skin is full with hair follicles and oil producing glands. These tiny glands continuously produce oil called SEBUM. The sebum comes out of the gland on to the skin through the opening of the hair. When this opening gets blocked, acne develops. The opening can be blocked by production of excessive sebum which solidifies and / or a plug of dead skin cells.
When this blocking plug swells the hair follicle and the gland, a whitehead is caused.
When the plug is located close to the surface of the skin and is exposed to the atmosphere, it becomes black. This is called Blackhead.
When the gland and follicle unit becomes, infected, it is called Pimple.
When infected material along with pent up oil secretion forms lump under the skin, it is called a cyst.
Thus, excessive oil production, irregular shedding of dead skin cells and infection by bacteria causes different stages of acne.
Factors that aggravate acne:
- Hormonal changes in body. For example,
- In boys and girls in the age group of 12 to 25 years.
- During pregnancy.
- Between 2-7 days before menstrual period in women
- After starting or stopping or sometimes during oral contraceptive usage.
- Medicines: For example, Steroid or male hormone treatment can aggravate acne.
- Use of Greasy make up and cosmetics.
- Rubbing of acne prone skin by frequent inadvertent use of cell phones, cordless phones, helmets etc.
- Family history of having acne is a significant factor.
What does not cause acne?
Eating chocolates or oily foods, or exposure to dust does not cause acne. Acne is also not caused by any impurity of blood.
When Should I attend Pimple management clinic:
You may attend the Pimple Clinic:
- If your pimples in inflamed and infected stages are not cured by self care or other medications.
- If your pimples have left scars that bother you.
What is the treatment of Acne?:
Principle of treatment of acne involves:
- Reduction of sebum production
- Increasing removal of dead skin cell layer
- Controlling infection
- Or all of the above
Almost all the treatments of acne take about 3 to 6 weeks before showing results. At times, the skin may look worse during this initial phase. You must not stop taking treatment because of this.
Topical treatments: These are the lotions, creams and ointments to be applied on face. They work by using one of the principles mentioned above. At times they may be required in combination.
Antibiotics: They are required for the infected acne. They are to be taken orally for control of infection and inflammation. They may be prescribed in addition to topical treatment.
Isotretinoin: This agent, when taken orally, can cure cystic and nodular acne to a great extent. Its use has to be monitored by a medical doctor as it is associated with significant side effects. It can not be taken by the pregnant women because of the possibility of the birth defect in the baby.
Cosmetic surgery: Cosmetic surgery is mainly used for the treatment of acne scars. Here is an outline of different types of acne scars and its treatment.
- Ice pick scars: These are fine 0.5 to 1.5 mm scars, looking like pores. They go very deep in to the skin. These scars do not respond well to Dermabrasion or Laser Dermabrasion, because they are very deep. Currently best option suggested is to do “laser punching” treatment. Here the core of the scar is removed with the laser and the margins are sutured or approximated with tissue adhesives. Use of magnification may of help at times. The new scars are then subjected to conventional resurfacing techniques.
- Box Scars: These scars are wide and deep and rounded. They generally measure 5 to 10 mm and extend to a moderate depth in the dermis. These scars can be treated with surgical punching and closure of the edges. Again the new scars are now treated with resurfacing techniques.
- Rolling scars: These scars are flat, shallow and with edges that merge with the surrounding normal skin. Here the skin of the scar is quite like the normal skin, but is tethered to the deeper tissue due to subcutaneous fibrosis. They are marked in green circle. Subcision is useful only in these types of scars. The word subcision means subdermal incision
- All the treatments mentioned here require number of sittings. Most of them except dermabrasion, do not require general anesthesia and hospitalization.
Lights lasers and acne:
- Intense pulse light (IPL) controls bacterial infection remarkably. It is used in active infected acne.
- Laser resurfacing can treat acne scars improve the quality of the skin. It may not prevent further crops of the acne.
Dos and Don’ts of Acne:
- Wash the affected area 3- 4 times a day.
- Use only a gentle cleanser or mild soap.
- Shampoo your hair regularly especially if there are pimples around hairline.
- Use Sunscreens and cosmetics marked as “water based”, “noncomedoggenic” or “for oily skin”.
- Use facial scrubs and astringent as they may irritate the skin.
- Squeeze acne at any stage.
- Stop medications on your own.