ACNE- Your Worst Enemy

At some point in your lifetime, we all have had a pimple here and there; whether it be a simple pus filled cavity, or scar forming cystic acne all over your face.  Have you ever been guilty of being in a bad mood due to a blemish on your face, or better yet decided not to go out one night since you felt uncomfortable with your complexion? If this is the case, I think it is time to see the dermatologist as they have many treatments that can really help.

Here is a brief overview of acne and treatment options available to you depending on your complaint and what treatment you will most likely be given if you see the dermatologist:

Overview

-          Oil and/or dead skin cells clog your pores.

-          This causes the hair follicle underneath the skin to rupture when there is a huge blockage and/or by manipulation(touching your face harshly).

-          The follicle ruptures, oil and dead skin cells are spilled everywhere and the bacteria from your skin start to feed off the lipids in the oil.

-          Your inflammatory cells rush to the site to control the bacteria and they release several inflammatory mediators to help kill the bacteria and increase blood flow(the redness of the pimple).

-          Once your inflammatory cells kill the bacteria, they come to the top of pimple(whitehead).

-          The whitehead eventually spills its contents and flattens out.  You are then left with a nasty post-inflammatory scar(usually dark on ethnic skin) that lasts anywhere from 6 months to a full year.

With that said, here are some treatment options and how they work.  Most of them work by increasing the shedding of dead skin cells so they don’t clog pores, and others work by killing the bacteria.

Treatment Options:

Benzoyl Peroxide-Kills the bacteria causing the inflammation.  Available over the counter.

Salicylic Acid-Increases shedding of dead skins cells and aids in post-inflammatory scarring.  Available over the counter.

Vitamin A Compounds-Differin, Retin-A Micro are some examples of these.  There mechanism of action is unknown; however they have been proven to increase shedding of dead skin cells that can block pores. They also reduce post-inflammatory scarring. Have stretch marks? This stuff really works well on them.

Accutane-Beware. This stuff is used as a  last resort to the treatment of acne and the only resort for nodular acne(painful blockages deep under the skin).  It works by permanently shrinking your sebaceous glands(produce oil) in your skin. However it came with several side effects which warranted a liver function test before, during, and after treatment with it.  It has recently been recalled from the market due to claims of causation to inflammatory bowel disease in several patients.

Laser Treatment-Used for pitting scars left after nodular acne.  Usually not used in ethnic skin since it has a greater chance of leaving hypopigmentation.  Dermatologist only.

Dermabrasion-Helps slough off dead skin cells and keep pores open. Accelerates healing of post-inflammatory scars. Available at spas or dermatologist.

Mixture of Steroid and Retin-A-Can help reduce post-inflammatory scarring.

Antibiotics-These kill the bacteria and reduce inflammation. Microdoses are given for 3 months and a bacteriostatic(stops bacteria from growing) effect lasts for 9 additional months usually.

I recommend the following:

Cleansing

Everyone can benefit from a mild, non-irritating, and oil-free cleanser such as Cetaphil. Cleansers with salicylic acid can help clear acne too but can be very irritating and have a drying effect to the skin, leading to a worsening of the acne. As always scrub mildly. Prescription cleansers with benzoyl peroxide can be prescribed by your dermatologist.

Mild Acne-You may have small red bumps with only a few on the face.  You can purchase a topical benzoyl peroxide medication over the counter such as Clearasil for spot treatment throughout the day and before bedtime.  In most cases, this will clear mild acne.  In fact, the active ingredient in the ever so popular ProActiv is benzoyl peroxide, so don’t waste your money.

Moderate Acne-You have many scars and/or bumps on your face.  You need to see a dermatologist to help prevent scarring. Scarring is permanent. They will most likely start you on an antibiotic in addition with a vitamin A compound at night.  They may prescribe a prescription cleanser and a lotion to help with the dryness, as this is a side effect of several acne medications.

Severe Acne(Nodular)-Your face is painful and you have a severe amount of acne that is large and bumpy.  You may also see pitting scars left where acne was. You need to see a dermatologist immediately.

Acne on other parts of the body: Topical antibiotics can help. The post-inflammatory scars last as long as three years.  It is impossible to rub your entire body with acne medication, therefore oral antibiotics are your best choice.

Currently, no food has been linked to acne.  Studies have shown that dairy products can aggravate acne, however these results are not consistent.  Find what works for you.  If you feel chocolate aggravates it, lay it aside.

As always, a consult with a dermatologist is a must for almost everyone.  Acne cannot be cured but can be controlled.  Allow 6 months to a year to clear your skin.

-HealthGuru