Acne

Acne or pimples is a very common skin complaint seen in Western societies. It is a disorder that involves the sebaceous glands which are most plentiful on the face and upper body.

Acne is reported to affect both sexes of different races and ethnicities. The majority of those that are affected are adolescents and young adults but can be seen in infants and adults of all ages.

The factors involved in causing the clinical picture of acne are:

  1. Hyperkeratinisation of the pore (too many skin cells lining the pore)
  2. Obstruction of the pore by a combination of skin cells and sebum (oil made by your sebaceous glands)
  3. Hormones stimulating the oil glands causing overproduction of sebum
  4. Bacterial colonisation of the oil gland unit by a microbe called Propionibacterium acnes – which leads to the development of inflammatory lesions of acne – red pimples

Acne can be familial, it can also be associated with other disorders such as polycystic ovarian disease. Medications can also trigger or worsen acne such as oral steroids, hormones (especially testosterone), antiepileptic medications amongst others.

Topical applications can also aggravate acne such as cosmetic products especially liquid foundation. Working in both hot and humid environments and where there is exposure to oil can also be triggers such as kitchen workers and mechanics.

There is also some evidence to suggest a diet high in dairy consumption, or with high glycaemic index foods will trigger or worsen acne.

The clinical spectrum of acne starts from open and closed comedones (non-inflammatory acne – black heads and whiteheads) to inflammatory lesions of acne – papules (red bumps), pustules (yellow heads), nodules and cysts (large lumps). In rare cases of severe acne they may also have inflammatory lesions of the scalp, armpits, groin and buttocks. The residual signs of inflammatory acne are red marks and scars (from icepick scars to trough like depressions to keloid scars). Patients that suffer with acne even if perceived to be mild may suffer with adverse social and psychological effects.

Treatment:

This depends on the severity of the disease but always begins with a good routine for cleansing the skin and choosing the right products to use on your face. Your dermatologist can guide and suggest appropriate OTC products.

Topical medications include benzoyl peroxide, topical retinoids and combinations with topical antibiotics.

Chemical peels – refer to Chemical Skin Peels under Cosmetic Services.

Kleresca Gel – this is a new treatment that Eastern Suburbs Dermatology is pleased to offer our patients. This represents a new paradigm in the treatment of acne. The treatment consists of the application of a biophotonic gel to the affected skin followed by white LED light activation. This kills the bacteria involved in the inflammatory acne and at the same time appears to normalise sebum production to give lasting benefit long after the treatment course is completed. The major advance that this treatment offers is its effects in promotion of skin healing and scar reduction. This is something that traditionally could not be addressed until inflammatory acne had settled. The treatment course consists of 2 treatments a week for 6 weeks.

Kleresca Patient Information

The treatment was also featured on the channel 7 evening news on 3rd of August 2016. To view the story, click here: https://au.news.yahoo.com/video/watch/32228049/new-acne-product-kleresca-makes-bad-skin-disappear/.

Oral medications – different antibiotics are used to settle inflammatory acne. In female patients the use of the oral contraceptive pill can be very helpful in bringing acne under control. Oral isotretinoin for severe cystic acne had been available for over 30 years now and still remains a most effective treatment. However there are a number of side effects that patients need to be aware of prior to commencement. Your dermatologist will guide you through if this is appropriate to your case.

Scar treatments – depending on the type of scars and location your dermatologist can suggest appropriate therapy including fractional ablative laser (refer to Laser under Cosmetic Services).

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