Acne treatment

Acne treatment

Acne treatment should focus on root cause which further prevent recurrences

Why choose us :- 

Pimple is the most common problem people face in there life specially in their teenage years. Acne respond well to the treatment but they reappear quickly in high number of people once you stop the treatment. And the worst part is that this pimple leave dark spots & scar on face which keep us hunted for long & doesn’t make our skin look clear. So to keep this in mind we at paradise skin & hair clinic works on root cause of disease (hormonal changes, digestion, diet & lifestyle) to keep your skin pimple free. & advise you proper care & routine to keep your skin clear & glowing. 

Acne/pimple is long term skin condition characterised by comedones (open & closed), papule, pustule, nodule, & cyst. Often leaving pigmentation & scar. Though disease is not life threatening but many patient are unhappy with its cosmetic appeal.

 Which led them to take treatment & many times patient also try some homemade remedies or hacks which sometimeas led to worsening of the condition.

So first one should understand that this is chronic skin condition which should be well managed. Initially with improving diet, lifestyle & skincare like face wash, moisturiser, sunscreen etc. Further with medical grade treatment under supervision of dermatologist. 

Causes :- 

Diet :- oily, spicy, fatty, fast food, alcohol

Lifestyle :- excessive use of cosmetic product (mainly comedogenic product), exertion immediately after meal

Psychological :- stress, anger, tension 

Genetic predisposition 

Drug :- steroid, some anti epileptic, lithium etc 

Disease :- polycystic ovarian syndrome (pcos), congenital adrenal hyperplasia. 

Pathophysiology :- 

Release of inflammatory mediators into the skin. 

Follicular hyperkeratinisation with subsequent occlusion of  Pilo-sebaceous orifice.

Bacteria colonisation mainly Propionibacterium spp. especially P. acnes., Malassezia furfur, Staph epidermidis. 

Increased sebum production. 

Clinical feature :- 

Eruption is polymorphic, characterised by comedones, papule, pustules, nodules, and cysts in sebaceous distribution e.g :- chest, back, face etc, Including localised pain tenderness & erythema. 

SCARS :- 

DEPRESSED SCAR :-

ice pick scar :- which are deep pits. 

 b) box car scar

2) HYPERTROPHIC SCAR :- e.g:- keloid.

TYPES :- 

ACNE CONGLOBATA :- 

It is  severe form of acne, characterised by intercommunicating abscesses, cysts, and sinuses loaded with  fluid or pus.

Comedones are typically multiporous.

Lesions take months to heal and on healing leave behind deep pitted or hypertrophic (sometimes keloidal) scars. 

OCCUPATIONAL ACNE :- 

Caused by exposure to industrial chemicals like tar, chlorinated hydrocarbons (when it is called chloracne), and cutting oils.

COSMETIC ACNE :-  

Eruption frequently seen in women using cosmetics, especially oil-based ones.

Almost always comedones.

DRUG INDUCED ACNE :- 

Steroids, androgens, anabolic steroids, oral contraceptives, antitubercular drugs, iodides, bromides, and anticonvulsants can cause an acneiform eruption.

Trunk especially back; face may be involved.

INFANTILE ACNE :- 

Due to presence of maternal hormones in the child.

May present at birth and may last for up to three years.

Lesions similar to those of adolescent acne.

LATE ONSET ACNE :- 

Acne with onset after 25 years of age.

Predominantly women.

Presents as deep seated, persistent lesions on lower half of face.

Exclude underlying androgen secreting pathology, especially polycystic ovarian syndrome.

ACNE EXCORIEE :- 

Seen in young girls, who obsessively pick their otherwise mild acne.

Results in discrete excoriations on the face, wile comedones and papules (primary lesions of acne) are few and far in between

ACNE FULMINAS :-  

Acute onset.  Presents as crusted, ulcerated lesions.

Associated with fever, myalgia, and arthralgia.

ACNE AFTER FACIAL MASSAGE :- 

Facial massage may be followed (3–6 weeks later) by an acneiform eruption in about 30% of patients.

Indolent deep seated nodules with very few (or no) comedones. Heal with hyperpigmentation after several weeks.

Treatment :- 

• Retinoids :- 
• Topical :- Tretinoin, adapelene
• oral :- Isotretinoin 
• Mode of action :- increase epidermal cell turnover, increase dehiscence of stratum corneum. 

2) benzyl peroxide :- 

• Antimicrobial, anti-inflammatory

3) topical anti-biotic :- 

• Clindamycin, nadifloxacin

4) oral anti-biotic :- 

• Tetracyclines, macrolides etc  
• Mode of action :- inhibit growth of P. Acnes, anti-inflammatory  

5) other agent :- salicylic acid, glycolic acid, azelaic acid etc 

6) hormones :- anti-androgens act by decreasing sebum secretion rate.   

7) Advance treatment option :-

• Chemical peeling :- controlled exfoliation of superficial layer (stratum corneum) of skin. Removing dead skin. 
• Helps in controlling pimple & also lightens spots. 

Light therapy :- 

• IPL :- intense pulse light helps in controlling acne & its spot. IPL used to constrict sebaceous gland so controlling sebum production & kill acne forming bacteria. 
• Intralesional injection :- injection of anti-inflammatory drug are used to control nodule-cystic acne.
• Red & blue light therapy :- with wave length 420-630 nm. Help increase blood circulation for better wound healing. Helps kill acne causing bacteria & reducing skin inflammation.