ACNE

ACNE:

Even if you sail through your teens with clear skin, acne may develop when you're an adult. Don't despair. An ever-widening variety of treatment options are now available, from powerful medications to surgical techniques to reduce scarring.

What is happening

Acne occurs when the oil (or sebaceous) glands under hair follicles, often on your face, neck, chest or back, get plugged up, inflamed or infected. Frequently the glands simply secrete too much of a thick

waxy lubricant called sebum that keeps your skin healthy. This blocks the pores and creates a perfect breeding ground for bacteria (especially Propinoibacterium acnes). Follicles then get red and inflamed.

  Hormonal imbalances can play a role as well. Sebum increases with the overproduction of tetosterone and other androgents in teenage boys, for instance, or with women's hormonal fluctuations, such as those associated with the menstrual cycle, pregnancy and menopause. In mild cases of acne (referred to as acne vulgaris). white-heads and blackheads appear, and may be some raised red blemishes. In more severe cases (called  cystic acne), pus-filled cysts and deep nodules, form around the inflamed follicles, causing unsightly bumps, tenderness and often pain.

LIKELY FIRST STEPS

• Daily cleansing routine to control oil and bacteria.
• For milder acne, try over-the-counter  antibacterial products (lotions, gels, pads).
• For more serious acne, try prescription medications (topical and oral)

QUESTIONS TO ASK

• What is the risk that my mild acne will turn into severe, cystic acne?
• Does it make sense to treat my scars now, as they occur, or should i wait?
• Could a hormonal imbalance be the cause of my premenopausal acne?
• Is it possible that at some point the anitbiotic  I'm taking won't work anymore? what will I do then?

Treatments

Acne doesn't really last forever (it just seems like it does) . It can, however, take time to clear up---anywhere from several days for a crop of pimples to months or years for some types of cystic acne preparations and keeping your skin clean can make a real difference.  For an extended outbreak,

you'll need to see a dermatologist for prescription medications. Certain office procedures--cyst removal, skin peels, steroid injections--can also be very effective in treating severe cases.

   Acne isn't life threating, but its ravages can be long term. The best way to prevent disfiguring scars is to treat any lesions promplty. And take heart: if you already have facial scars, cosmetic  laser treatments are now showing great success in reducing pitting.

Medications

If you have mild to moderate acne, home treatment should begin with antibacterial treatments--gels, creams, lotions and pads. Look for remedies with benzoyl peroxide (Oxy10, Acne Gel, Clearasil).

which fights he P.acnes bacteria. Other products, such as pads by Clearasil, feature salicylic acid, a derivative of aspirin. Salicylic acid products are a good choice for whiteheads or blackheads (medically known as comesdones) because they gently dry up and peel away the skin's top layer, unclogging pores.

                                          Treatment Options

MEDICATIONS      

------------------------------------------------------------------------------------------------------------------------------- Antibacterials                                 Benzoyl peroxide or sllicylic acid products.

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Oral contraceptives                        Maximum benefit seen in 4 to 6 months.

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Antibiotics                                      Topical: best if paired with antibacterials.

                                                        Oral: effective but promote drug resistance.

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Vitamin A derivatives                     Tretinoin (topical): benefits in 3 to 4 weeks. 

                                                         Isotretinoin (oral): needs doctor supervision.

PROCEDURES

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Comedone removal                          Must do regularly; lasting benefits arguable.

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Skin peel                                          Transitory effect but enhances drug absorption.

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Steroid injections                              Effective for severe lesions.

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Scar lessening                                   Collagen, dermabrasion, laser treatments.

LIFESTYLE CHANGES

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Cleansing regiments                          Keystone of home-care program.

NATURAL METHODS

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Herbal options                                    Tea-tree and camomile tea cleansers.

TAKING CONTROL

• Ask your general practitioner for a referral to a dermatologist, especially if you need a procedure done. Skin doctors are specially trained to do such treatments. 
• Choose acne products with care. There is no benefit in using harsh soaps and scrubbing the skin. It is best to use gentle, pH-balanced soap free cleansers.
• Try a blackhead extractor This pharmacy device may save you costly trips to the dermatologist. Before using this tool, soften the area with hot, wet compresses for about 10 minutes.
• Use water-based make-up. Look for products labelled 'noncomedogenic' or 'non-acnegenic'. Also, don't over-do the moisturising, and skip cosmetics completely if your acne is severe.

   If you think your acne flare-ups are related to your menstrual period, ask your doctor about the 

oral contraceptive pill. Oral contraceptive pills containing ethinyloestradiol (35 mcg) and the anti-

androgen cyproterone acetate (2 mg) (Diane 35, Brenda 35) reduce the production of sebum by about a third.

  If your acne doesn't improve, you may need to move on to prescription anitbiotics (topical or oral), which reduce skin bacteria  and have an anti-inflammatory effect. You may actually get the best results by combining top anitbacterials with topical anitbiotics, such as clindamycin or erythromycin. Oral antibiotics (tetracycline, minocycline, doxycyline) can be very effective at controlling acne when used long term. However, this practice is problematic because bacteria are becoming resistant to the drugs.