ACNE VULGARIS

It is usually called ‘pimples’ and appears more commonly in adolescence. Acne involves the sebaceous glands over the face leading to skin colored solid raised lesions. Comedones are common and they can be black heads or white heads. They can get infected resulting in pus filled lesion. Sex hormones (estrogen / progesterone/ androgens) are the circulating chemical substances that influence the growth of sebaceous glands and its secretions. Apart from face, they can also present over the chest, back and thighs. The most common complications are pigmentation and scarring.

The treatment of acne is aimed at dissolving the follicular plug, reducing sebum production, removing oiliness, killing the bacteria and blocking the inflammatory mediators produced by the white blood cells. This is done by local applications and sometimes in addition, tablets/pills. Various antibiotic creams like Erythromycin, Clindamycin and comedolytics like Benzyl peroxide, Retinoic acids, Adapelene in various concentrations are available for its treatment. Supportive care to maintain compliance with mainline therapy are therapeutic moisturizers which help in reducing adverse effects of above medications, if any and to support good skin health. The redness left on the skin after pimples heal may be very obvious in fair skinned individuals and disappears in 1 to 3 months. Pigmentation too reduces in 3-9 months, but can be expedited with creams, chemical peels or microdermabrasion. The acne spots should not be manipulated or pricked, and creams given by friends/chemist or home remedies should not be applied. Surgical procedures like acne scar revision are done to minimize the post acne scar.

 FAQ – Acne

How do I manage Acne scars or pigmentation?

Acne scars are managed effectively with various procedures -Chemical peels, Dermarollers, Fractional CO2, Microdermabrasion, Subcision, and Punch elevation. Ideal type of procedure will be decided by the dermatologist. Each patient would have different types of acne scars at any given time. Hence, every patient may require more than one treatment modality as each type of acne scar responds to a different technique.

 What foods do I need to avoid?

There is no definite relationship between acne and diet. However, high glycemic loads, dairy products, and refined sugar products can flare/aggravate it. A balanced diet is important.

I get acne frequently, is there a hormone defect in me?

Acne although more frequent in adolescents can appear in any age group. Adult onset acne or other symptoms may suggest a hormonal problem. The dermatologist may examine and advice some tests accordingly.

I have acne, pigmentation and scar over the face. Will it be treated?

Acne causes pigmentation and scarring. Topical antiacne and skin lightening agents are available that can effectively treat acne and pigmentation. Surgical procedures to correct acne induced scars are available. Dermatologists practice these surgical procedures.

I get acne from several years. What I should do?

Acne causes remissions and exacerbations. You will be advised maintenance anti acne treatment  once it has been well controlled. Do not stop the treatment.

My neighbor had suggested creams for the management of acne. Shall I follow the advice?

It is one of the commonest mistakes that results in unscientific and undesirable response. These creams contain steroids in various strengths. The temptation to use such creams is due to the immediate temporary relief observed over the applied areas. Sustained use of these steroids based creams over the face result in pus filled lesions and increased unwanted hair growth, reddish discoloration with severe itching /burning. Multiple white patches and wrinkles can appear. Patients are advised to be careful and not to accept such suggestions from unqualified persons.

 

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