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Acne A Nightmare No More.

Byline: Dr. Armeela Javaid

Acne, a skin disorder that mostly affects about eight out of ten teenagers at some point of adolescence, is a long-term skin condition that occurs when hair follicles become clogged with dead skin cells and oil from the skin. It can occur at any age, affecting virtually everyone at some point in their lives. Many people think that acne is just pimples, but a person who has acne can have any of these blemishes: blackheads, whiteheads, papules, pustules (what many people call pimples), cysts and nodules.

Understanding Normal Skin and Age Related Changes

Small sebaceous (fatty) glands lie just under the skin surface. These glands make oil (sebum) that keeps the skin supple and smooth. Tiny pores on the skin allow the sebum to come on the skin surface. These pores also allow the hair to grow through them.

During teenage the body makes much more sebum due to hormonal changes of puberty which stimulate the sebaceous glands. As a result, the more sebum you make, the more greasy your skin would be and hence acne at its worst.

Acne can appear on the back, chest, neck, shoulders, upper arms and buttocks. Studies have shown that people with bad acne can have negative psycho-social impact such as low self-esteem, depression and self-doubting.

Acne and Permanent Scars

Sometimes people get dark spots or scars when the acne clears. One can prevent these scars by getting it treated by a dermatologist. Treating acne before cysts and nodules appear can prevent scars from forming.

Many effective treatments are available - not just oral but many skin treatments can cure, control and prevent permanent damage to the skin.

Grades of Acne

Mild-to-Moderate Acne

Acne appears when a pore in our skin clogs. This clog begins with skin becoming thicker along with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. But in case of acne the cells become trapped inside the pore and we see them as the blackheads and whiteheads (comedones). In many cases, acne does not progress beyond this mild to moderate stage.

Moderate-to-Severe Acne

Sometimes bacteria that live on our skin, (p. acnes,) also make their way inside the clogged pore. Inside the pore, with a lot of oil and dead skin cells, the bacteria find perfect environment for multiplying very quickly. As a result, the pore becomes inflamed (red and swollen). With inflammation, the spots become larger and filled with pus (pustules). If the inflammation goes deep into the skin, an acne cyst or nodule appears.

Adult Onset Acne

A growing number of women after the age of thirty experience different form of acne like Perioral Dermatitis, Rosacea etc.

What Makes Acne Worse?

The progestogen-only contraceptive pill may make acne worse.

- In women, the hormonal changes around the monthly cycle may cause a flare-up of spots.

- Thick or greasy make-up may possibly make acne worse. However, most make-up products do not affect acne. One can use make-up to cover some mild spots. Non-comedogenic or oil-free products are most helpful for acne-prone skin types.

- Picking and squeezing the spots may cause further inflammation and scarring.

- Sweating heavily or humidity may make acne worse. Direct exposure to heat may contribute to blocking of pores.

- Some medicines can make acne worse. For example, phenytoin (which some people take for epilepsy) and steroid creams and ointments that are used for eczema. Do not stop a prescribed medicine if you suspect it is making your acne worse but do consult your doctor. An alternative may be an option.

- Anabolic steroids (which some body builders take illegally) can make acne worse.

Some Myths About Acne

It is a misconception that diets high in sugar and milk products make acne worse but research only supports that food with low glycemic index may worsen acne in few patients.

- Acne is not caused by poor hygiene. In fact, excessive washing may make it worse.

- Stress does not cause acne. But may aggravate it.

- Acne is not just a simple skin infection. The cause is a complex interaction of changing hormones, sebum, overgrowth of normally harmless germs (bacteria), inflammation, etc. You cannot catch acne - it is not contagious.

- Acne cannot be cured by drinking lots of water.

- Some people believe that acne cannot be helped by medical treatment. This is not true. Treatments usually work well if followed correctly.

Skin Care for People with Acne

You can reduce your acne by following these skin care tips from dermatologists:

- Do not wash more than normal. Twice a day is normal for most people. Use a mild soap and lukewarm water (very hot or cold water may worsen acne.) Do not scrub hard when washing acne-affected skin. Do not use abrasive soaps, cleansing granules, astringents, or exfoliating agents. Use a soft washcloth and fingers instead. Excess washing and scrubbing may cause more inflammation and possibly make acne worse.

- Antiseptic washes may be beneficial but not essentially needed.

- You cannot clean off blackheads. The black tip of a blackhead is actually skin pigment (melanin) and cannot be removed by cleaning or scrubbing.

- Some topical acne treatments (described below) may result in dry skin. If this occurs, use a fragrance-free, water-based moisturising cream. Do not use ointments or oil-rich creams, as these may clog the pores of the skin.

- Wash twice a day and after sweating. Perspiration, especially when wearing a scarf, veil, hat or helmet, can make acne worse, so wash your skin as soon as possible after sweating.

- Use your fingertips to apply a gentle, non-abrasive cleanser. Using a washcloth, mesh sponge or anything else can irritate the skin.

- Be gentle with your skin. Use gentle products, such as those that are alcohol-free. Do not use products that irritate your skin, which may include astringents, toners and exfoliants. Dry, red skin makes acne appear worse.

- Scrubbing your skin can make acne worse. Avoid the temptation to scrub your skin. Visiting a Dermatologist's office to get a gentle Hydrafacial is a better idea.

- Rinse with lukewarm water.

- Shampoo regularly. If you have oily hair, shampoo daily to prevent acne on forehead. This helps specially in acne on forehead.

- Let your skin heal naturally. If you pick, pop or squeeze your acne, your skin will take longer to clear and you increase the risk of getting acne scars.

- Keep your hands off your face. Touching your skin throughout the day can cause flare-ups.

- Stay out of the sun and tanning beds. Tanning damages your skin. In addition, some acne medications make the skin very sensitive to ultraviolet (UV) light, which you get from both the sun and indoor tanning devices.

Will Acne Return After Treatment?

Once the spots have cleared, acne commonly reappears if the treatment is stopped. Therefore, after the spots have gone or are visibly reduced, it is advised to carry on with a maintenance treatment to prevent acne from flaring up again.

Maintenance treatment is usually with either topical acne creams as prescribed by your dermatologist or with the procedures like Microdermabrassion and HydraFacial and Blue and Red Light therapy.

How Do Dermatologists Treat Acne?

Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be treated.

When to See a Dermatologist

If you have a lot of acne, cysts, or nodules, the mild medicines mentioned above may not work. If you want to have clearer skin, you should see a dermatologist. Dermatologists offer the following types of treatment:

- HydraFacial: It cleans the skin, removes the dead skin, takes out the black and whiteheads and remove excessive oil and skin debris clogged in the pores

- Laser and Other Light Therapies: These devices reduce the p. acnes bacteria. Your dermatologist can determine whether this type of treatment can be helpful.

- Chemical Peels: You cannot buy the chemical peels that dermatologists use. Dermatologists use chemical peels with great caution to treat two types of acne - blackheads and papules.

- Acne Removal: Your dermatologist may perform a procedure called "drainage and extraction" to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine.

- Comedo Extraction: It may temporarily help those with comedones that do not improve with standard treatment.

Dermatologists can help treat existing acne, prevent new breakouts and reduce your chance of developing scars. Today, virtually every case of acne can be successfully treated.
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Date:Jun 30, 2016
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