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Acne: Skin Care Tips and Treatment Options

Author: Dr. Ashwini V Swamy - Skin and Beauty  

How Does One Develop Acne?

Acne is a disorder of pilosebaceous unit, pilo meaning hair, and sebaceous meaning oil-producing gland. These pilosebaceous glands are densely distributed over the face, neck, chest, back, shoulder, and arms. It also has a genetic component, meaning the appearance/ severity of acne depends on the genes from parents.

Sebaceous gland produces oil that is expelled out through the duct which opens on the skin surface. As long as this duct is intact, oil flows freely out onto the skin. If there is any blockage in the duct, the oil cannot come out, and it starts irritating the surrounding skin and causes comedone (black and whiteheads).

Our skin has a commensal harmless bacteria, called Propionibacterium acnes (P. acnes). This bacteria acts on the oil collected inside and causes inflammation leading to red bumps, pustules, cyst/ nodule as it progresses. If acne is not treated on time, it will leave scars.

Hormones have a strong-effect on acne. Increased androgen hormone can cause thickening of the wall of the duct, leading to its blockage causing comedones (black and whiteheads). PCOD/ PCOS (polycystic ovarian disease/ syndrome) is the most frequent hormonal disease that causes acne in teenagers as well as adult women.

Environmental/ External/ Emotional Factors:

Hot and humid climate, causing increased sweat, can clog the pores. Application of oil/ oil based cosmetics/ steroid creams are other causes of acne. Psychological stress is one of the important factors in acne.

What Are the Treatment Options Available?

Treatment for acne ranges from simple creams to LASER.

The most common factor determining the treatment regimen is the grade of acne and type of acne lesions.

Grades of Acne

Grade I – Black heads and white heads (comedonal).

Grade II – Predominantly red bumps (papules), few pustules, and few comedones.

Grade III – Lot of pustules and few red bumps.

Grade IV – Cysts and nodules (bigger bumps and cysts).

Treatment Options

1. Topical medications:

  • Clindamycin 1 % topical gel/ lotion for inflammatory acne lesions like red bumps, and pustules.
  • Retinoids - Follow all the instructions from your dermatologist regarding the usage of this group of medicine.
  1. Tretinoin (0.025 %, 0.05 %, 0.1 %)
  2. Adapalene (0.1 %, 0.3 %)
  3. Isotretinoin (0.05 %)
  4. Tazarotene (0.05 %, 0.1 %) for comedonal acne. As these cause peeling of superficial layer of skin, you need to be very cautious while using it.
  5. Benzoyl peroxide (2.5 %, 3.75 %, 5 %, 7.5 %, 10 %) - for comedones and inflammatory acne.
  6. Dapsone (5 %, 7.5 %) topical gel for inflammatory acne.

2. Comedone extraction - Manual.

3. Oral medications: (Dose depends on the body weight of the patient).

  • Isotretinoin (5 mg to 40 mg).
  • Doxycycline (100 mg) and Minocycline (50 mg to 135 mg).
  • Azithromycin (250 to 500 mg).
  • Hormonal treatment - Oral contraceptive pills (Estrogen/ Progesterone), antiandrogen pills.

4. Intralesional injection of Triamcinolone - for cystic acne.

5. Cosmetic treatment:

Specific Skin Care Tips for Acne-prone Persons:

1. FACE WASH

Wash your face with mild cleansers like Cetaphil cleanser if your face is dry, or use Benzoyl peroxide face wash if your face is oily. Wash your face three times a day to remove excess oil and dust which accumulates over time.

2. SUNSCREEN

Use a good sunscreen with SPF 50, apply to the whole face 30 minutes before you step out irrespective of the presence of sunlight. UV rays will always be there during day hours (even if cloudy). Apply every four hours for maximum benefits. This is because sunscreen can protect your skin from UV rays for four hours. Hence you need to repeat every four hours. Always use non-comedogenic sunscreen.

3. DO NOT PICK / SQUEEZE YOUR ACNE

It will leave dark pigmentation and scars, which are even more difficult to treat.

4. REGULAR PHYSICAL EXERCISE

Exercise is very much essential to keep hormones in check. Exercise for at least 40 minutes a day, six days a week.

5. NO OIL MASSAGE

Avoid oil massage to the scalp. It will aggravate dandruff. And, if there is oil flow on to the facial skin, it can clog the pores leading to comedones.

6. VITAMIN A AND WATER

Eat vitamin A rich fruits and vegetables like papaya, mango, muskmelon, pumpkin, carrot, and beetroot. These have beta carotene in them, a good antioxidant which is very helpful for healthy skin. Drink two to three liters of water per day. This keeps the skin hydrated.

7. COSMETICS

Always use water-based cosmetics, which has the “non-comedogenic” label on it.

8. STRESS MANAGEMENT

Stress (mental as well as physical) causes acne breakouts. Meditation is very helpful for controlling mental stress.

9. WAXING THE HAIR ON FACE

Waxing irritates hair follicle and can aggravate pimples. However, threading to remove unwanted hairs over the face is fine. Threading has no effect on acne.

10. USE OF STEROID CREAMS

Steroid causes very bad acne. It makes skin very thin and sensitive. Avoid over-the-counter (OTC) steroid creams like Betnovate and Panderm.

For more information consult an acne specialist online -->https://www.icliniq.com/ask-a-doctor-online/dermatologist/acne

Image: Acne: Skin Care Tips and Treatment Options Last reviewed at: 07.Sep.2018

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