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:
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 a trigger for occupations 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 – blackheads 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.
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 an alternative treatment option for improving inflammatory acne in those patients that are reluctant to take oral medications such as antibiotics or isotretinoin, or are intolerant of topical medications. 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 addressed until inflammatory acne has settled. The full course of treatment consists of 6 double (2 applications of gel followed by LED illumination in a single session) treatments, given on a weekly basis. An abbreviated course of 4 single treatments can be given to assist with improving residual acne scarring in those patients where more conventional therapies such as isotretinoin have brought the active acne into remission.
For further information on Kleresca refer to:
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 has 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 Fractional CO2 Laser under Cosmetic Services).
Dermatologists providing consultative and procedural services at Eastern Suburbs Dermatology are all Fellows of the Australasian College of Dermatologists.
Practising individual dermatologists at Eastern Suburbs Dermatology have sub-specialisation interests in paediatric dermatology, surgical dermatology, and women’s and cosmetic dermatology.