ACNE

Acne is a multi-factorial, inflammatory skin disease caused by excessive sebum, dead skin cells, and bacteria. They build up under the skin and plug the skin pores and follicular openings leading to different types of acne.

How does a pimple develop?

The oil glands produce a certain amount of oil/ sebum regularly in every individual. Pimples develop when there is excessive production of sebum or when the sebum carrying skin cells and hair cannot reach the skin surface because of blocked follicles. This leads to the development of a plug, which appears as whiteheads or blackheads.

When there is a block, bacteria starts to grow inside the plug which results in the development of pus-filled pimples called pustules, cysts, and nodules. they are associated with pain. these pus-filled lesions can give rise to post acne pigmentation spots and scars

Types of Acne
  • Whiteheads: These are small skin coloured lesions. They remain under the skin surface and not associated with pain.

 

  • Blackheads: These are small and appear on the surface of the skin as black coloured lesions because of oxidation of the sebum. there are not painful and can be extracted.

 

  • Papules: The pink or skin coloured bumps appearing on the skin are called papules. these are bigger than whiteheads and rarely associated with pain.

 

  • Pustules: Red at the base with pus head on the top, pustules are visible on the surface of the skin. and are associated with mild pain because of the inflammation.

 

  • Cysts: These type of acne are big, filled with pus and thus are quite painful. They can cause pigmentation and scars.

 

  • Nodules: Embedded deep in the skin, nodules are solid, large and painful pimples that protrude out of the skin surface. these lesions also cause pigmentation and scars on healing. they can be chronic and recurrent in nature.
Classification of Acne

Depending upon the severity acne is divided into 4 grades.

Grade 1: Mild non- inflammatory acnes which contains comedones and few papules

Grade 2: Mild inflammatory acne which has comedones, papules, and few pustules.

Grade 3: Inflammatory acne with many pustules, few cysts and nodules

Grade 4: Severe inflammatory acne with many cysts and nodules that have formed tracts and become confluent.

For treatment purpose, we divide the acne into 3 grades and plan treatments accordingly,

Mild,

Moderate and

Severe.

Reasons for Acne

Although acne commonly occurs during puberty as the sebaceous glands get activated; it has no age barrier and can occur at any age (against the common misconcetion).

Amongst the various causative factors for acne, a rise in androgen levels is considered to be the main cause. The level of Androgen (estrogen in women) increases in adolescence.

Other causes of acne can be:

  • Hot and Humid climate
  • Medications that contain androgen, lithium, OCPs, etc;
  • Cosmetics that are greasy or oil-based
  • Hormonal changes
  • Stress
  • Menstruation ( due to hormonal changes)
  • Comedogenic diet
  • Genetics.
Why Acne should be treated?
  • Acne affects the mental health causing depression, anxiety, and low self-esteem.
  • Acne is sometimes painful and gets infected by the bacteria on the skin, causing pus.
  • Acne can leave scars and pigmentation on the skin, if not treated on time or left untreated.

Treating Mild, Moderate and Severe Acne

Treatment of acne is based on their severity and how persistent the acne is.

Mild acne

This is a minor form of acne. There are some bumps and blackheads and the presence of occasional papule or pustule. They are not widespread nor are very inflamed. Nodules or cysts are absent.

Treatment

Topical medications:

topicals containing ingredients like benzoyl peroxide, clindamycin, adapalene will help in reducing these lesions.

Chemical peels:

Peels will help in clearing the plug and thereby, faster clearance of acne. peels also help to put excessive sebum production in control. Commonly done peels include salicylic acid, Jessner’s peel, etc. 

Moderate acne

Topicals:

topical medications like benzoyl peroxide, adapalene and clindamycin are generally prescribed depending on the type of lesions that are present.

Skin care:

A suitable face wash made for acne prone skin and appropriate skin care creams are prescribed. These will help in controlling excessive sebum and maintain a healthy and ph balanced skin.

Oral medications:

oral medications like antibiotics, retinoids are prescribed, depending on the type and number of lesions. These are given to reduce the infection and inflammation under the skin. However, these are prescribed very diligently and under good supervision. They should not be taken without a doctor’s advise. Depending on the lifestyle, antioxidants can also be added.

Chemical peels:

Peels will help in clearing the plug and thereby, faster clearance of acne. peels also help to put excessive sebum production in control. Commonly done peels include salicylic acid, Jessner’s peel, etc. 

Light therapy: 

this helps in reducing the inflammation under the skin. Commonly, red light therapy is used. The procedure is shown in our videos. This can be combined with chemical peels.

 

 

 

 

Sever Acne

Topicals:

topical medications like benzoyl peroxide, adapalene and clindamycin are generally prescribed depending on the type of lesions that are present.

Skin care:

A suitable face wash made for acne prone skin and appropriate skin care creams are prescribed. These will help in controlling excessive sebum and maintain a healthy and ph balanced skin.

Oral medications:

oral medications like antibiotics, retinoids are prescribed, depending on the type and number of lesions. These are given to reduce the infection and inflammation under the skin. However, these are prescribed very diligently and under good supervision. They should not be taken without a doctor’s advise. Depending on the lifestyle, antioxidants can also be added.

Chemical peels:

Peels will help in clearing the plug and thereby, faster clearance of acne. peels also help to put excessive sebum production in control. Commonly done peels include salicylic acid, Jessner’s peel, etc.

Light therapy: 

this helps in reducing the inflammation under the skin. Commonly, red light therapy is used. The procedure is shown in our videos. This can be combined with chemical peels.

 

 

 

 

Practices that help control acne

Lifestyle modification, which includes certain practices, right skin care products are very important to control acne and reduce the aftermath like scars.

 

  • Use appropriate face washes and skin care creams that are made especially for acne prone skin

 

  • Wash your face at least twice a day with cold water. If your face gets excessively oily frequently, you can sprinkle some water to wash your face even without a face wash. Do not use wipes to clean your skin. NEVER.

 

  • Never scrub the skin or rub the pimples, as they may burst and push the infection further down the skin. Popping pimples can give you scars!

 

  • Touching the face repeatedly should be avoided to prevent bacterial infections. Always keep your hands clean before touching the face to apply creams or makeup.

 

  • Wear loose cotton clothing if acne is on the back, shoulders, or chest. This helps the skin breathe.

 

  • Avoid oil-based or greasy cosmetics.

 

  • Remove makeup before sleeping. Always clean your make up brushes and change them frequently. Avoid using layered makeup for long periods of time.

 

  • Cover your face with a cotton cloth when the weather is humid or when there is dust exposure. Wash your face immediately after at least with cold water.

 

  • Shave or trim carefully. Soften your skin and hair. can use a conditioner on the hair to make it soft at regular intervals. This also reduces the chances of ingrowing of hair.

 

  • Hair collects sebum and skin residue, so should be kept clean. Greasy hair and skin products are best avoided.

 

  • Sweat management: This is very important especially in people who have back, shoulder and chest acne. Reduce the time your sweat sits on the skin. Take a shower immediately after workouts or any activity where you sweat a lot. At least wipe the area with a wet cotton cloth if showering is not a possibility.

 

  • Avoid comedogenic diet that can increase sebum production like dairy and dairy products.

 

  • Anxiety and stress increase the production of hormones like cortisol and adrenaline. These hormones can exacerbate acne. try different things like medication, walks to put your stress under control.

 

  •  Be safe when following home remedies that you see on the internet. Do not buy over the counter medications. Always consult a dermatologist if you are seeking help to treat your acne.

 

 

 

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