Acne, Simplified

  Acne occurs most commonly during adolescence, affecting more than 89% of teenagers and frequently continues into adulthood. For most people acne diminishes over time and tends to disappear after one reaches one?s early twenties. There is, however, no way to predict how long it will take to disappear entirely and some individuals will carry this condition well into their thirties, forties and even beyond. The face and upper neck are the most commonly affected, but the chest, back and shoulders may have acne as well.

What is Acne?

  Acne is defined as excessive oil production combined with dead skin cells and bacteria that obstructs the follicle opening. The oil hardens and presents itself as a black plug, commonly known as a blackhead. Once the follicle is closed bacteria multiplies causing the body to produce local inflammation. Excessive oil production is mainly caused by a fluctuation in hormone levels most commonly during adolescence. During puberty the hormone androgen causes oil glands to be overactive. The consistency of the oil changes and becomes wax like. This along with insufficient shedding of dead skin cells block follicles. The oil hardens and presents itself as a black plug. Local inflammation is produced due to leakage of oil (sebum) into the dermis. The oil in the follicle serves as a good breeding ground for proprioinibacterium acnes. This produces inflammation and naturally puss is present. This is known as a pimple.

Types of Acne

• A Blackhead (open comedone) is a dilated follicle filled with dead skin cells, oil and bacteria. Whitehead (closed comedone) formation occurs similarly with exception of the dilated follicle opening and a black plug
• Pimples are formed once the content of the follicle has leaked into the dermis and local inflammation is produced. Usually puss is present. Most scarring occurs when this form of acne is not treated and the local inflammation damages surrounding tissue.
• Pustules and Nodules are raised red lesions and could have puss components, varying in size.
• A Cyst presents itself in the same manner as pustules but is bigger than 5mm in diameter.

Treatment Options

  There are many products available for the treatment of acne, these treatments fall under two main categories, i.e. topical and oral treatments.

1. Topical and Oral antibiotics: The most common oral antibiotics include erythromycin or any of the tetracycline antibiotics. The abovementioned are very effective in the treatment of the bacteria that is found in the follicle but will not reduce the excessive oil production. Topically applied antibiotics such as erythromycin, clindamycin or tetracycline kill bacteria that is found in all follicles. Oral and topical antibiotics are equally effective but topical application avoids side effects such as an upset stomach and does not interfere with the oral contraceptive pill, however treatment is limited to the area that the antibiotic is applied to.

2. Hormonal Treatments: Hormonal acne is seen mostly in women due to the natural cycles a woman goes through, such as menstruation, pregnancy and menopause. Because of this, doctors prescribe low-dose birth control pills and/or androgen receptor blockers to reduce blemishes by keeping androgens steady. This in turn will allow shedding of dead skin cells within the follicle to normalize, reducing blockages and therefore pimples.

3. Topical and Oral Retinoids: Because Isotretinoin (eg. Roaccutane & Orratane) treats several aggravating factors simultaneously that no other medicine can do all at the same time, it is a very popular treatment. It accomplishes the following:
   • Reduces oil production (sebum) by reducing sebaceous glands (oil glands),
   • Decreases cell build up leading to whiteheads or blackheads,
   • Kills acne bacteria deep inside the skin, and
   • Reduces inflammation.

   Topical retinoids are any creams or gels that have a derivative of and/or Vitamin A in it. This treatment is aimed at regulating the skin?s ability to shed dead skin cells thus preventing blockage in follicles and ultimately blackhead formation.

4. Photo therapy: This involves the use of a so called light-box that uses UVR at a certain wavelength ( 311 nm) of light to treat severe acne. The light is used to reduce inflammation and to produce a micro-peeling effect on the skin this allowing the skin to shed dead skin that would other wise cause blockages within the follicle. This treatment last approximately 5min and it is recommended to have 2 treatments per month.

5. Topical treatment with Alpha Hydroxy Acids: Commonly known as chemical peel. Acids such as glycolic and salicylic acid are applied onto the skin. Once applied the acid works its way though the top part of the epidermis ( stratum corneum ) loosening cell bonds between the dead skin cells ( corneocytes ) This allows for the body to shed accumulated dead skin cells and produce new cells. This naturally reduces dead skin cell accumulation and oil in follicles that generally cause blockages, reduces existing blackheads and is beneficial anti-ageing effect as regular chemical peels thicken the dermis, evening out fine lines/wrinkles.

   Scarring is usually present in severe acne cases. Two main types of scarring is found in acne cases namely ?Ice pick? scarring and Keloid scarring. Ice pick scarring, named after the indentation that is formed on the skin, the scar appears to have been caused by ice picks. Most cases of ice pick scarring is treatable. Mesotherapy is a very common method of treating uneven skin texture and scarring. It is a non-invasive yet very effective treatment involving the use of needles to make micro channels in the epidermis in order for collagen stimulants such as huyluronic acid to penetrate rough, scarred skin. Keloid scarring however is not so easily treatable, as the risk of producing new scarring when attempting to treat it is high. Keloids usually form due to an over production in collagen cells. This scar appears raised and unevenly shaped. Treatment of acne scar, laser treatment may correct scarring. Consult Dr H A DE BEER on 012- 343 5592 to correct these scars.

Myths

• Certain foods causes acne
• Acne is only for teenagers, they outgrow it
• Acne is caused by dirt
• Makeup causes acne
• Sun helps acne
• Scrubbing reduces acne

Acne Facials

  Acne treatment duration is from 45min ? 1 hour
  Steam
  Drainage
  Either UVB or chemical peelings depending on medication or condition
  Chemical Peel ? either Glycolic Lamelle or Neostrata peels
  For a free consultation, call us on 012-809 6090 to make an appointment.

Recommended routine treatment of Acne (Either Creme Classique OR Neostrata

Twice a day follow the following rules:
• Step 1. Wash the effected areas with Créme Classique soap free cleanser.
• Step 2. Apply Créme Classique Acne Gel 2x daily all over the face, as this preparation contains Benzoyl peroxide, it may bleach eye brows, hair, clothing, towels, pillow cases. Apply all over the face to acne spots. This application should not be applied on back and chest, as clothing may be bleached. NOTE: Do not squeeze or pick acne lesions as this may lead to scarring. Lesions can be treated with Créme Classique Spot treatment to dry them out quickly. To be applied 2 or 3x daily.
• Step 3. Apply Créme Classique Beta Hydroxy Gel 2x daily. Wait to dry before getting dressed as gel may bleach clothing.
• Step 4. Consult Dr H A DE BEER for the appropriate oral treatment if the condition is severe, by phoning 012-343 5592 for an appointment. Oral treatment may involve various oral treatments like antibiotics oral Vitamin A derivatives. Explanation on how to take the medicines and for what length of time to be discussed. Some of these medicines may cause side effects like: dry lips, dry eyes and dry skin. NOTE: Oral treatments may be suppressive or may lead to permanent healing.

• Step 5. Contact us for ?Acne Facials? treatments involving deep cleansing chemical peels, steampack, removal of blackheads on 012-809 6090 to make an appointment for a free evaluation consultation.

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