As a teenager, I suffered from terrible acne. I understand how it can create a terrible cycle of self-consciousness and poor self-image. Fortunately, my mother, who had also been an acne sufferer, quickly got me on to medical treatment for the problem and within a year it had cleared up completely. However, this was not without some side effects: nose bleeds, low mood, etc. It was all worth it though, because I have rarely had a blemish since and I was very lucky to avoid the residual scarring sometimes sometime left behind.
What is acne?
Acne is a skin disease where the hair follicle opening becomes blocked by a plug of skin cells from the follicular lining. This prevents oil from the sebaceous gland that attaches to the root of the hair from escaping, leading to a build-up of oil, bacterial growth and inflammation. This manifests as black heads, whiteheads, red bumps, pimples and most severely, cystic acne.
These can occur on the face, neck, chest, back, shoulders, and even the upper arms. Onset is usually during adolescence with increased sex hormones, that stimulate and enlarge the oil (sebaceous) glands of the skin. Acne is experienced by both teenagers and adults all the way through their 40’s.
How can we fix this?
There is a lot of misunderstanding about how to treat acne. I know of many teenagers who are told to simply stop eating so much chocolate and it will go away. How ridiculous! Whilst a good diet will improve general skin quality, it is not enough to control this disease. At Concept Cosmetic Medicine our goal is to clear your skin, stop future breakouts, reduce existing scars and prevent future scarring.
Skin care at home:
Wash face twice a day with a wash that contains alpha hydroxy acids (eg. Glycolic acid) or beta hydroxy acids (eg. Salicylic acid). Some people find the latter more effective.
At night use a cream that contains one of the above.
If this doesn’t improve the situation after 2 months, speak to your GP about adding a prescription cream containing adaptalene and benzoyl peroxide combination; or a retinoic acid cream.
If Step 1 fails, there are two good options next:
Your GP may be able to prescribe oral antibiotics. These are usually a tetracycline antibiotic which are a broad spectrum antibiotic however very effective and commonly used in the treatment of acne. Improvement is usually seen after 2-3 months. It is relatively cheap however, having antibiotics in your system for extended periods can quite often be accompanied with the possible side effects.
Blue light therapy is a good alternative for those who can’t or don’t want to take antibiotics. Like the antibiotics, the blue light destroys the acne causing bacteria on the skin and can significantly improve the appearance of moderate acne in around 6-10 treatments. It is quick (under 15 mins), efficient and painless and there’s no downtime.
It is however, more expensive than oral antibiotics.
Treatment Resistant Severe Acne:
Photodynamic therapy (PDT) is effective treatment and involves the application of a photosensitising agent to your skin and then going under an Omnilux light to activate the agent. This targets acne causing cells deep in the sebaceous glands, so its’ very effective for cystic acne. PDT treatment requires up to a week of down time. The discomfort could be likened to “sun burn” for the first few days and it gradually improves over the rest of the week. 1-2 treatments are usually adequate for most people, who will see significant reduction of acne lesions and an improved appearance in scarring and skin quality. This is a great option for people who want to avoid the nasty side effects of taking oral retinoic acid for several months.
Oral retinoic acid is a Prescription only medication that’s an extremely effective treatment, but it does have some bad side effects that vary between patients. You will need to be closely monitored by your GP and dermatologist whilst on this medication to minimise any harmful side effects.
If you are interested in Blue-light therapy, PDT for acne or even just want further information about problem skin then please, we love talking about it and we’re only too happy to have a no obligation chat - Simply phone us.
by Dr Phoebe Jones