Acne is a common skin problem experienced by upto 80% of individuals at some point of their lives. This condition is not only limited to teenagers as previously believed, as adult acne today forms an important chunk of everyday dermatology practice. Acne occurs due to clogging of pores as a result of excess oil (excessive sebum/ hyper seborrhea) or dead skin cells (hypercornification) on face, neck, shoulders and back in most cases.
Acne appears in the form of blackheads, whiteheads (grade 1/ comedonal), papules, pustules (grade 2 and 3 / mild to moderate),cysts and nodules (grade 4 / nodulocystic) which can cause permanent scars and blemishes if not treated early and adequately. At
Acne is typically neglected by many of us and passed as simple pimples which will go away with age, but data suggests that acne has significant psychosocial impact and should be treated early to prevent scars and marks, which are not only more challenging to treat but also at times permanent.
Root cause of acne
There can be multiple reasons for the occurrence of acne. Knowing the reasons becomes relatively important for individuals as they can opt for preventive measures to avoid a further breakouts.
Typically acne is a result of a cocktail of 4 factors – excessive oil production/ active oil glands, blocked oil gland ducts (hypercornification), presence of P.acnes (the bacteria responsible for acne) and the resultant inflammation. This maybe aggravated or triggered by the following:
- Excessive cosmetic use / not washing or cleansing the make-up well.
- Oil application
- Occlusive clothing
- Excessive time in the sun or heat which hydrates the duct of the oil gland – typically seen in women who spend time in the kitchen (Mc Donalds Acne) or in people coming back from a vacation on the beach (Goa Acne)
- Whey protein / steroidal supplements – this type is seen typically ont he back, chest and shoulders.
- Hormonal imbalance such as polycystic ovarian disease or thyroid disease – this forms one of the most important associations with acne today.
- Stress
- Medications – anti convulsants, occlusive creams, steroids (oral/topical), etc.
Right & timely treatment of the acne by a certified dermatologist after assessing your signs and symptoms can save time and a whole lot of frustration. Acne is a curable disease and few individuals may require recurrent treatment although largely the severe form the condition settles with appropriate treatment and identification of the cause.
The acne treatment largely depends on the condition or state of the acne.
- Mild acne – good cleanser, one with niacinamide and hyaluronic acid may help in order to decrease oil and enhance hydration at the same time. Maybe combined with topical anti acne medication as prescrbibed by your dermatologist. Role of cosmeceuticals in the form of niacinamide and salicylic acid help with this form of acne.
- Moderate to severe acne - Cleanser as mentioned above with cosmeceuticals and topical and oral medication. The topicals and oral medication prevent in the formation of scars and marks associated with acne. However, in many individuals marks are a common issue and they maybe tackled with depigmenting agents such as topcial glycolic acid, salicylic acid, polyhydroxy acids, silymarin, tranaxemic acid and others.
Moreover, Acne is associated with a defect in barrier dysfunction and is aggravated by UV light, where the use of a sunscreen with barrier restoration is key to improvement along with medical treatment under the supervision of a certified dermatologist
For acne scar reduction fractional lasers or fractional microneedling are gold standard treatments, along with fillers.