Medical Management of Acne
Acne Vulgaris, Pimples, Blackheads, Pustules, Rosacea, Whiteheads, Zits, Backne, Bacne, Comedone
Acne is a very common skin condition that originates in the oil gland apparatus that is present in the skin. The natural purpose of this oil gland is to produce a natural moisturising and protective barrier oil that coats the surface of the skin.
If this process of the oil spilling out to the surface of the skin is blocked you will get an Acne, a pimple or a Zit. Please understand that this is a very simplistic explanation. There are generally 4 conditions that act individually or together to give you an Acne. There could be a block at the opening or skin pore (blockage with dried up oil, dead skin, makeup, sunscreen), there could be an over production of oil in the skin, there could be a bacterial infection (there are bacteria called P Acne that are most commonly implicated in Acne) or you could have a skin type which mounts an excessively aggressive inflammatory response to a small blockage in your oil glands.
Whatever the process the blockage, bacteria or the skin’s defence (inflammatory response) you will get a pimple or acne of some type.
Acne is an extremely common and relatively harmless skin condition. In some patients it can be quite aggressive and leave behind actual and emotional scarring. It can have many different causes as highlighted above.
All the different types of acne can be understood if you follow the explanation of the cause of acne above. If the oil gets clogged and dried up at the opening of the skin pore, then it gets oxidised to a black coloured plug often called a Comedone or Comedogenic Acne. If the plug does not get oxidised it appears white and is therefore called a Whitehead. When the blocked gland and skin tissue around it get inflamed, raised, red and painful and are felt like a solid bump inside your skin, you have Nodular Acne. If you have a blocked gland, that is infected, inflamed and has a point of pus at the tip on the skin you have a Pustular Acne. Finally if you have a large lump underneath your skin that is full of pus you have a Cystic Acne which sometimes is combined with Nodular Acne a condition which is described as Nodulo-Cystic Acne.
While an accurate diagnosis can be made in the clinic, if you have large acne pustules that heal with severe scarring, there is a high chance you have nodulo-cystic or cystic acne and will need a course of Oral treatment with Isotretinoin.
Given that acne is a disorder related to the sebaceous oil glands, it can occur where ever the density of these glands is high in the skin. It can therefore occur on the face, upper chest, upper back and the shoulders.
The treatment of Backne or Bacne or Back Acne is determined on the basis of the severity of the disease. Most patients will benefit with pre shower 5% Benzoyl Peroxide application, while a subset will need oral antibiotics or Isotretinoin treatments.
All food which has a high Glycemic Index (the ease with which the body can extract sugar from a food; so chocolate would be really easy, so High Glycemic; a piece of Brocolli wold be low glycemic) can predispose you or worsen your Acne Condition. Fast Food, Refined Carbohydrates, Sugar, Chocolate are certainly to be avoided or indulged in extreme moderation if you want to reduce your Pimples/Acne. Milk Products can also worsen acne, but this seems to be due in part to the intolerance or inability to digest milk that is quite prevelant in the population.
During puberty, the balance of female and male hormones rises and falls at different times till the levels stabilize to adult levels in the mid 20 years of age, in both sexes. Whenever the androgens (male hormone, which is also present in females) component is predominant there is a stimulus for overproduction of oil, which predisposes you to Acne.
As mentioned above the cause of acne relates to an imbalance between the androgens and oestrogen/progesterone (female hormones), the fluctuating hormonal levels are responsible for the menstrual cycle, consequently in patients with a bigger hormonal influence, the acne happen just before the periods start. Hormonal Acne are typically located around the lower jaw and chin.
Yes, there is a subset of women in whom the acne problem starts in the late 20s and continues into their 40’s . The acne in this group is generally hormonally influenced. Rosacea can often present like acne in this age group and needs to be diagnosed.
While in the younger age group up to 30 years of age, it is generally Acne that is the problem, Rosacea which is a very common skin condition can also have a presentation similar to Acne in the older age group of women. The distinction between the two conditions is that in Rosacea, triggers like spicy food, alcohol, heat, stress, or exercise can cause an intense redness or flushing of the skin around the nose and cheeks, it can also be associated with thread veins in these regions. When you have your consultation with Dr Prashant at his Reforme Medical Clinic in Cardiff, he will be able to help you with the diagnosis.
There is definite hereditary connection of acne and the chances that you will have acne if your parents had them growing up are high. Other familial conditions like Polycystic Ovary Syndrome or Metabolic Syndrome also show hereditary tendencies.
There are many extremely effective treatments for acne. But the first thing that will help is in your hands (it literally is). Touching your face either with your fingers or cell phone worsens blockage of the skin pores and should be avoided. Cut your nails short as sharp nails will cause micro injury to the skin when you touch your face and transmit aggressive bacteria into the area of the acne, worsening it.
Treatments of acne consist of :
Skin application of products that reduce the oiliness, reduce dead skin build up, have an anti-inflammatory (skin calming) effect these are :Vitamin A derivative creams like Tretinoin, Adapalene (Differin), Benzoyl Peroxide, combined Adapalene and Benzyl Peroxide (Epiduo), Azelaic Acid, Tazarotene.
Skin application of products that kill the bacteria that cause Acne: Benzoyl Peroxide, combined Adapalene and Benzyl Peroxide (Epiduo), Azelaic Acid, Clindamycin, Dapsone.
Oral medication that reduces the oil production: Isotretinoin (Roaccutane), Combination Oral Contraceptive pills, Spironolactone.
Oral medication that kills the bacteria: Minocycline, Doxycycline.
In Clinic Treatments: Incision and Drainage of Acne Pus, Chemical Peels, Steroid Injections, Scar Management with Peels and Lasers.
When you come to see Dr Prashant at Reforme Medical Clinic in Cardiff, we will go through with all your problems and give you a short and long-term solution that should start working within a 4 – 6 week period.
Home skin care is the bedrock of successful acne treatment. Wash your face just twice a day with a salicylic acid cleanser (if you have an oily skin) or a gentle non soapy cleanser (if you have dry sensitive skin). More frequent washing, scrubbing, exfoliating devices, exfoliating mask, scrubs will only make the problem worse. Use a non comedogenic spf 30 sunscreen and avoid sun exposure. Cut your nails, stop touching your face with your hands. Don’t pick at your acne, even if it is tempting, as trying to do this will only leave you with a scar. Please visit our clinic Reforme Medical in Cardiff, where we will you get rid of the acne without leaving you with scars.
Most patients who suffer from forehead acne have Dandruff and when the Dandruff is managed they see a dramatic relief of their forehead acne.
There are some very effective cleansers and creams that Dr Prashant can prescribe that will reduce both Blackheads and Whiteheads within a 4 – 6 week period.
* All prices quoted apply to surgery done at World Class clinic in Mumbai, India and are subject to variation based on prevalent exchange rates.
It is very difficult to give an accurate idea of the costs as there are so many modalities that can be prescribed. Dr Prashant does offer short 15 minute FREE CONSULTATIONS at Reforme Medical at Cardiff, detailed consultations will cost you £100.
We are ready to treat you.
General Medical Council
Associations of Plastic Surgeons of India
The International Society of Aesthetic Plastic Surgery
Royaldata-srcCollege of Surgeons of Edinburgh
Disclaimer: The content on this website is purely generated for awareness and educating purposes only. This shall not be considered as a substitute for professional advice or prescription. Every individual and their case is different, so the results mentioned on the website may vary from person to person.