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ACNE IS YOUR ENEMY, BUT HOW?
Acne or pimples is a very common problem, especially in adolescents. Almost every one of us has borne its brunt at least once in our lives.
WHAT IS ACNE?
Acne vulgaris commonly known as pimples is a soreness of the sebaceous glands (oil glands) of the skin. These glands are mostly found on the face, upper back, upper chest and shoulders.
HOW?The exact cause of acne is difficult to pin point. Usually, there is more than one factor involved. However there are 4 major causes:
1. Follicular hyper-proliferation leading to blockage of the glands. It occurs under the influence of androgen hormones.
2. Excessive sebum production, usually due to hormonal influence or dietary causes, leads to plugging of the ducts of glands.
3. Activity of Propionibacterium acnes, a type of bacteria which usually live in the sebaceous glands in humans and break down the sebum into fatty acids.
4. Acne prone skin is more prone to inflammation as compared to normal skin, and some amount of underlying inflammation is always present in acne prone skin.
WHY?Acne are flared up by a number of factors, and by taking certain measures, these factors can be taken care of.
1. Some young females with acne have an association with irregular periods, hirsutism, precocious puberty etc. 2. Many medications like anabolic steroids, corticosteroids, B-complex vitamins, anti-tubercular drugs, halogenated compounds and phenytoin can lead to acne.3. Stress leads to flare due to release of endogenous steroids.4. Oily cosmetics containing parabenes, mineral oils etc. can irritate the skin leading to aggravation of existing acne. Improper cleansing and leaving make-up on for long periods also aggravates acne.5. Foods with high glycemic index, chocolates, dry fruits, carbonated drinks, dairy products especially milk can also lead to a flare-up.6. Excessive sun exposure and hot and humid climate also aggravates acne.7. Use of over the counter steroid ointments over the face for a long time also leads to acne, hirsutism, thinning of skin and facial erythema (redness) due to dilated blood capillaries.
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WHERE?
The primary site is the face, upper chest and upper back. On the face, acne is found on the cheeks, forehead and chin.
Having active acne or scars of acne has great psychological impact on the patient. Psychological and psychiatric issues faced by 30–50% of adolescents with acne.
Acne-II Treatment:
Diet
1. Patients prone to acne should avoid high glycemic index foods, milk, processed foods, foods with high fat content.2. If there is an underlying hormonal cause like PCOS, it should be treated simultaneously for better outcome.3. Regular cleansing of the face with a mild cleanser helps in keeping the skin clean. Maintenance of skin pH is very important.
MEDICAL TREATMENT:Depending on the severity and grade of your acne, your dermatologist will prescribe you either a topical ointment to be applied on the face, or a tablet to be taken orally, or both.
1. Topical antibiotics: these are used as first line of treatment in mild acne.2. Topical retinoids: these agents act by reducing the hyperproliferation of the epidermis and thus reduce the clogging of the ducts of the sebaceous glands. 3. Topical Azelaic Acid and Benzoyl Peroxide: these agents have both anti-microbial and keratolytic properties. 4. Oral Antibiotics: Depending upon the cause of acne and the severity, a dermatologist can prescribe either one or a combination of antibiotics.5. Oral Retinoid: These are used in patients with severe acne, and need constant monitoring for side effects. Again, these are NOT to be used in PREGNANCY or in females planning for a pregnancy.
MANAGEMENT OF ACNE SCARS:
Acne scars need special care. Superficial scars respond to topical and oral treatment. For deep scars and pigmentation, some sort of procedural intervention may be required. These can be:
1. Chemical peels: different types of chemical peels are used to treat active acne as well as post acne scars.2. Surgery: Various types of scar revision surgery is available, depending on the type and number of scars present. 3. LASER Treatment: a variety of LASERS are available for scar revision. Being an office procedure with minimal downtime, these are the preferred treatments for acne scars these days. 4. Dermabrasion and derma roller treatments can be used to even out the skin5. Fillers can be injected in cases of depressed scars.
