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Acne (Pimples) (under construction)

What Is Acne?

Acne is a common, long term disorder affecting the hair follicle and sebaceous gland, in which there is expansion and blockage of the follicle and inflammation of the pore. 1


What Are The Features Of Acne?

Mild acne: non inflamed blackheads and whiteheads

Moderate acne: papules and cysts 

Severe acne: widespread papules, nodules or cysts, often with pain and scarring 2



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What Causes Acne? 

A whitehead forms when excess oil and dead skin cells build up and plug the opening of a pore. 3 When build up accumulates and is oxidised by oxygen in the air, the black colour appears.


When bacteria is trapped inside the pore blocked by excess oil and dead skin cells, the bacteria can multiply and lead to swelling (inflammation) and a pimple appears. Sometimes these pimples may or may not contain pus. When the inflammation goes deep into the skin, a tender or painful nodule or cyst can develop. Cysts are softer, pus-containing lesions. Nodules feel harder to the touch.

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What Are The Complications Of Acne?

Frequently people can develop a permanent scar from an acne breakout. Living with untreated or poorly treated acne for an extended amount of time is associated with a higher risk of developing scars.


Read our guide on acne scars: link


Acne may leave dark marks - flat discoloured spots which can be red, pink, purple, black or brown. These dark marks are called post inflammatory hyperpigmentation (PIH). Clearing these can last for a year or longer and takes time to fade. The darker the spot, the longer the period for it to clear. With appropriate skincare and treatments, the dark marks can be cleared more quickly. Some treatments which can speed up the recovery of PIH include chemical peels and lasers.


Read our guide on PIH: link

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What Should I Do When I Have Acne?

See a doctor early. Early treatment is crucial. Acne is not difficult to treat, if managed correctly, and with ample patience and absolute compliance to your doctor’s prescribed regimen. 


However, acne scarring is much harder  to treat. Hence, early treatment of acne prevents and reduces severity of scarring. Treatment for acne scarring is generally more painful, expensive and harder to achieve good results.

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What Are The Treatment Options For Acne?


Topical Preparations 

Many over the counter or pharmacy-sold skincare products promise to treat acne. They commonly contain ingredients such as salicylic acids to help unclog pores, but in low concentrations. Some of the topical ingredients are available at higher concentrations through a doctor’s prescription only. Below are some examples of common ingredients used to treat acne. 


Salicylic acid: helps unclog pores and prevent new breakouts. Possible side effects include mild stinging, skin discolouration and minor skin irritation. 4

Benzoyl peroxide: kills acne-causing bacteria, helps remove excess oil and dead skin cells which clog pores. Possible side effects include dry skin, scaling and irritation.

Azelaic acid: helps prevent pores from becoming plugged, is mildly antibacterial and helps correct dark marks (PIH)

Alpha hydroxy acids (AHAs): remove dead skin cells and calm inflamed skin. It stimulates growth of new skin cells which may improve the appearance of acne scars and pores. Examples: glycolic acid, lactic acid

Antibiotic creams: reduce the amount of P. acnes bacteria on your skin and lessen inflammation. Examples: tetracyclines, erythromycin


At VIDASKIN, we have formulated our own anti-acne skincare products to complement our clinic treatments, please refer to our catalogue at (link to ASTRAA)

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Oral Treatments 


Antibiotics: reduce the amount of P. acnes bacteria on your skin and reduce inflammation. 


Birth Control Pills: decrease circulation of androgens which decreases production of oil in pores. 


Isotretinoin: for more severe forms of acne. A retinoid that reduces oil production and kills bacteria in the pore. Possible side effects include increased sun sensitivity and dry skin. It must be avoided by conceiving or pregnant women as it can cause birth defects. 5

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Clinic Treatments 


Steroid injections may be recommended for a large, extremely painful and deep nodule. This can rapidly relieve the pain and size of the breakout (frequently within 48 to 72 hours). However, it is reserved for use sparingly.


LED phototherapy induces photodynamic destruction of P. acnes bacteria. A study in 2007 showed that blue and red light combination LED phototherapy is an effective and safe treatment for mild to moderately severe acne vulgaris. 6

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Lasers: the 532-nm potassium titanyl phosphate laser, 585- and 595-nm pulsed dye lasers, 1450-nm diode laser, and 1540-nm erbium glass laser have been used to treat acne with variable efficacy.


Laser therapies are a useful treatment modality and enhance treatment response when used in conjunction with topical and oral treatments. 8  A recently launched laser technology, the picosecond laser is highly recommended for people unable to follow an oral or topical medication regimen, such as busy individuals or women looking to conceive. 9


Drawbacks associated with lasers include potential discomfort, skin discoloration, and cost of treatment. Patients typically require multiple sessions to achieve the desired results, with future maintenance treatments possible to maintain the outcomes. Please consult a doctor for medical assessment and personalised advice.


Read about our lasers here: link

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Peels: lead to exfoliation and removal of superficial acne lesions, followed by regeneration of new epidermal and dermal tissues. Examples: salicylic acid, glycolic acid, lactic acid, mandelic acid. The appropriate peel is chosen based on the patient’s skin type, acne activity, and type of acne scars. 10


Consult a medical professional to have your acne assessed and professionally managed with an effective acne treatment plan. A combination of different treatments are often recommended in conjunction with each other to help give the best results possible.


Possible treatment outcomes may range from the reduction of severity to clearing of the breakout. Your doctor can take your lifestyle factors into account so as to maximise the chances of a successful treatment outcome. 

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VIDASKIN Tips 

Can I Use Cosmetics When I Have Acne?

The short answer is yes. However, remove all makeup before going to bed with an oil-free makeup remover and a gentle cleanser. Clean your makeup brushes every week to prevent onset of breakouts. 10



VIDASKIN Debunks Myths

Does Diet Cause Or Aggravate Acne?

Findings from a few  studies suggest that following a low-glycaemic diet (low sugar level) may reduce the severity of acne. Low-glycaemic foods include most fresh vegetables, some fresh fruits, beans and oats. An American study of 2,258 patients found that a low-glycaemic diet reduced acne, with 87% of patients saying they had less acne, and 91% saying they needed less acne medication. 12


In another study, 47,355 adult women were surveyed about their dietary habits. It found that women who drank 2 or more glasses of skimmed milk a day were 44% more likely to have acne than others. 13


More research is needed to confirm ongoing scientific theories regarding food-related worsening of acne. In our medical experience, food intolerances or specific dietary restrictions are also highly specific to each individual. Do note that what works for you may not work for someone else. 



Authors: 

Dr Vicki Leong, MBBS (Melbourne), MRCP (UK), PG Dip. Clinical Dermatology (Cardiff)

Dr Sarah Teo, MBBChBAO (Ireland)

More Information

References:

1. Jarvis, S. (2021, July 13). Acne. Patient.info. Retrieved January 9, 2023, from https://patient.info/skin-conditions/acne-leaflet 

2. Oakley, A. (2014, July). Acne. DermNet. Retrieved January 9, 2023, from https://dermnetnz.org/topics/acne 

3. American Academy of Dermatology Association. (2023). Acne: Signs and symptoms. American Academy of Dermatology Association. Retrieved January 9, 2023, from https://www.aad.org/public/diseases/acne/really-acne/symptoms 

4. Pruthi, S. (Ed.). (2022, July 21). Nonprescription acne treatment: Which products work best? Mayo Clinic. Retrieved January 9, 2023, from https://www.mayoclinic.org/diseases-conditions/acne/in-depth/acne-treatments/art-20045814 

5. NYU Langone Hospitals. (2023). Oral medications for acne. Oral Medications for Acne. Retrieved January 9, 2023, from https://nyulangone.org/conditions/acne/treatments/oral-medications-for-acne 

6. Lee, S.Y., You, C.E. and Park, M.Y. (2007), Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV. Lasers Surg. Med., 39: 180-188. https://doi.org/10.1002/lsm.20412

7 . Seaton, E. D., Charakida, A., Mouser, P. E., Grace, I., Clement, R. M., & Chu, A. C. (2003). Pulsed-dye laser treatment for inflammatory acne vulgaris: Randomised controlled trial. The Lancet, 362(9393), 1347–1352. https://doi.org/10.1016/s0140-6736(03)14629-6 

8. Wiznia, L.E., Stevenson, M.L. & Nagler, A.R. Laser treatments of active acne. Lasers Med Sci 32, 1647–1658 (2017). https://doi.org/10.1007/s10103-017-2294-7

9. Oku, K. (2021, May 26). The reason why picosure can be expected to improve even light stains and the difference from phot... KIREI. Retrieved January 10, 2023, from https://kirei.ai/en/articles/231#flow03

10. Kontochristopoulos, G., & Platsidaki, E. (2017). Chemical peels in active acne and Acne Scars. Clinics in Dermatology, 35(2), 179–182. https://doi.org/10.1016/j.clindermatol.2016.10.011 

11. Baumann L. “Cosmetics and skin care in dermatology.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008:2360.

12. Rouhani P, Berman B, et al. “Poster 706: Acne improves with a popular, low glycemic diet from South Beach.” J Am Acad Dermatol. 2009;60(3, suppl 1):AB14.

13. Adebamowo CA, Spiegelman D, et al. “High school dietary dairy intake and teenage acne.” J Am Acad Dermatol. 2005;52(2):207-14.

14. Zaenglein, AL, Pathy AL, et al. “Guidelines of care for the management of acne vulgaris.” J Am Acad Dermatol. 2016;74:945-73.

15. Zaenglein AL, Thiboutot DM. “Acne vulgaris.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018:588-92.