ACNE (Pimples): OVERVIEW

Acne is the medical term for pimples and it is the most common skin concern. It may develop once or more than once between age of 13-14 years to 30 years. Acne develops due to blockage of hair follicle opening by dead cells of skin and excess oil secretion by oil glands under hormonal influence. Acne symptoms may range from simple comedones to painful nodule and cysts. Simple and fewer acne can be treated by home remedies for acne and acne creams but for severe acne patient may need combination of acne creams, antibiotics and oral isotretinoin. Though this is a common disease, there are many myths due to lack of the right information accessible to patients. Because of misbeliefs and myths sometimes it becomes difficult for people to get clear skin. So, Dr Sunil Kothiwala dermatologist in Jaipur has put together all the basic and advanced information on this page that can help you to take care of acne (pimples).

Why do I need treatment of acne (pimples) ?

Most common myth is that you should let acne run its course, there is no need of treatment and it will subside on its own. We strongly advise you against this because when acne left untreated, can leave undesirable pigmented marks (dark spots) and permanent acne scars on your face. These changes often lead to psychological impacts, such as poor self-image, depression, and anxiety. Early treatment of acne is recommended to avoid post inflammatory pigmentation and post acne scars.

ACNE: CAUSES

How does acne develop? Why does acne occurs?

There are four basic mechanism involved in the development of acne.

• Shedding of normal skin or hair cells
• Excess sebum (an oily secretion of sebaceous gland that lubricates the hair and skin) by sebaceous gland
• Inflammation occurs as a result of bacterial over growth
• Hormonal changes

How do hormones affect acne?

Sebaceous glands are highly sensitive to the hormones. Hormonal changes during adolescence cause the sebaceous glands to become enlarged, and sebum production increases. Less often, women’s hormone levels are affected by an underlying medical problem known as polycystic ovary syndrome (PCOS). Hormonal acne more common in women. Pre menses flares of acne (menstrual acne) also common in women older than 30 years.

What are other factors which influence acne?

• Diet- Food that causes acne are dairy products specially skimmed milk, food with high glycemic index like sweets, some chocolates, whey protein supplement. Diet which you should avoid in continuous and excess consumption are carbohydrate rich or fat rich goods like pizza, burger and french fries. One common query by indian patients that does pani-puri worsen acne? Answer is alone pani-puri and its masala pani do not cause acne but use of potato may aggravate acne. For more details watch our video about effect of diet on acne and anti acne diet on youtube. https://youtu.be/ZScCsNkz8OY
• External factors- Oil-based creams, make-ups, cosmetics, excess use of soap or facewash can worsen acne.
• Life styles which worsen acne- Stress, Sedenetary lifestyle and lack of proper sleep.
• Family history

How does pimple form ?

Normal skin or hair cells and excess sebum leads to development of plug that occlude the opening of hair follicle. It is called comedone. Overgrowth of normal bacterial flora specifically Cutibacterium acnes happens due to excess sebum production which results in inflammation. Due to inflammation there is formation of papule (red bumps), pustule (yellow bumps) which further may evolve into nodule and cysts.

ACNE Symptoms

What are the symptoms of Acne ?

• Blackheads, whiteheads, red/yellow bumps, painful nodule or cysts.
• Itching & pain in acne, headache & fever due to acne.
• Red-brown spots on the skin: After acne heals, it usually leaves behind dark spots that may take some months to clear off.
• Post acne scars: Acne cysts and nodules which leave scars are common with people who have had acne. The scars tend to show after the acne has cleared.
• Low self-esteem and depression:Acne makes some people feel bad and can lead to low self-esteem and depression.

What are the types of acne?

• Whiteheads (closed plugged pores)
• Blackheads (open plugged pores)
• Small red, tender bumps (papules)
• Pimples (pustules), which are papules with pus at their tips
• Large, solid, painful lumps beneath the surface of the skin (nodules)
• Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

What are common sites of acne?

• Face – most common. Teenagers have acne specially in T zone of face (forehead, nose and sides of nose). Cheeks and forehead are commonly involved. Hormonal acne develops on lower face around jaw line.
• Back acne- shoulders and upper back commonly involved. Sometimes whole back may have acne.
• Chest & arms
• Buttocks

ACNE: TREATMENT

How Is Acne Diagnosed?

Acne can be diagnosed by face assessment only. There are some other skin diseases which can look like acne so it is important to differentiate acne from other causes of acne form eruption. With the diagnosis, it is also equally important to assess severity of acne to decide nature and course of treatment. There are four grades of acne which can be assessed by dermatologist on basis of type of acne lesions.

What are grades of acne ?

Severity of acne (grade 1-4) can be assessed by observing number of acne lesions.

• Grade 1- Comedones (black heads, white heads), very few papules
• Grade 2- Comedones, Many Papules (Red bumps), Pustules (Yellow bumps), few nodules
• Grade 3- comedones, papules, pustules, many nodules, few cysts
• Grade 4- Nodulocystic acne

How is acne cured or removed?

Yes, acne can be cured but there is no single treatment that can resolve acne completely. Acne removal  treatment involves a combination of Medical therapy (Topical and oral medications), Clean-ups, Chemical peeling, and scar treatment. Acne treatment in every patient is customized based on the severity of your condition, skin analysis, and history.

Topical medicines (Treatments that will be applied on the skin)

Acne creams

The commonest form of acne medicine is acne creams. Best acne creams are retinoids (tretinoin,adaplene), benzoyl peroxide or antibiotics (clindamycin) and they act by reducing the oil while the others work by killing the bacteria. Alone topical antibiotics like clindamycin should not be used because it may leads to antibiotic resistance. Acne removal creams are useful in grade I acne or in combination of other acne treatment in severe acne.

Anti Acne soaps & anti acne facewash

Soaps with ph of 5.5 and face washes containing benzoyl peroxide, salysylic acid, azaelic acid, tea tree oil and zinc are usually helpful in supporting acne treatment. However, excess facewash should be avoided as it may worsen acne.

Treatments that work in the body: In grade 2, 3 or 4 acne any or combination of the following may be prescribed to you by your dermatologist:

• Oral antibiotics
• Oral retinoid
• Birth control pills and other hormonal drugs

Procedural Acne removal treatments: Some procedures may be performed by your dermatologist when you visit to help you get rid of the acne. They are:

• Professional Comedone extraction and clean-up: Clean up,involves the extraction of comedones by vacuum & suction and thorough cleaning of your skin. At our centre we give importance to professional extraction of blackhead and whiteheads by sterilized extractor tools because it helps in complete evacuation of content without causing infection and post procedure mark. After extraction of comedones new pimples decrease significantly and shorten the treatment duration. Our signature clean-ups are customized to soothe, pamper and heal skin without aggravation of acne. Clean-ups aim at reducing skin oils content, preventing dead cells from clogging the pores and finally killing bacteria to prevent further acne outbreaks. Traditional facials may aggravate acne. Instead opt for regular clean-ups which will leave your skin nourished, polished and glowing, healing acne at the same time.
• Chemical peels for acne: There are two major indication of using peel in acne treatment. Peel helps in reducing inflammatory lesions little faster than conventional treatment and at later stage peels can be used for treating pigmented spots of acne. During a peel procedure, the peeling agent exfoliates the top layers of skin. This is extremely helpful in lightening the pigmentation which is caused by acne. Peeling hastens the skin cell turnover and prevents pores from clogging up helping to control sebum production thereby aiding in healing and drying of existing acne. Commonly used chemical peels for acne are salysylic acid peel, tca peels, glycolic acid peel, mandelic acid peel and black peel.
• Laser for acne removal treatment in Jaipur: This treatment used to reduce the acne-causing bacteria P. acnes and clear your acne. We use intense pulse light (IPL), Q switch nd:yag Laser (Alma Q) in micro pulse mode and blue light.

What about the acne scars treatment ?

Acne treatment is incomplete without dealing with the scars it leaves behind. Collagen induction is the best way to treat scars. We recommend CO2Pixel laser treatment combined with PRP treatment for rejuvenation of acne scars.

Course and Result of Acne Treatment

In grade 1 acne with help of comedone extraction and acne removal creamsgood results can be achieved in 4-6 weeks. Acne requiring oral retinoids takes 6-9 months for complete clearance. Dr Kothiwala’s SkinEva Clinic provides all anti acne treatments with best results under guidance of Dr Sunil Kothiwala, best acne specialist doctor in Jaipur located in Vaishali Nagar & Sitabadi, Main Tonk Road. Regular treatment and follow up with Dr Sunil Kothiwala dermatologist can help in getting rid of acne without having to wait forever and you will no longer be suffering from dark spots, permanent scars and from being uncomfortable in your own skin.

ACNE: TIPS

DAILY SKIN CARE ROUTINE IN ACNE

The following are tips related to daily skin care routine which can help you reduce acne:

1. Have good personal hygiene, yoga and daily exercise in daily routine.
2. Use a gentle non-abrasive alcohol-free cleanser on your skin with your fingertips.
3. Avoid scrubbing or aggressive your skin; it worsens acne and can lead to frictional pigmentation.
4. If skin is oily, salicyclic acid, tea tree oil based face wash can be used but avoid frequent facewash.
5. If you do workouts, don’t rub sweat on face while cleaning face.
6. Be regular with washing your hair, especially if you have oily hair.
7. Do not pick or squeeze your acne; this will make them take a longer period to heal and can leave pigmented spot also. Let them heal naturally.
8. Avoid repetitive touching your face with your hands to prevent the spread of germs.
9. Consult a dermatologist if you feel that conservative treatment and daily care tips are not helping you in clearing acne.
10. During use of retinoid gels, you may feel dryness that can be managed with correct use of topical retinoids. You have to take small amount (pea size or less) then spread it on finger tips then apply gently on affected area only. Don’t rub or use excess quantity.
11. During treatment of post acne pigmentation avoid excess sun exposure.

ACNE:FAQS

• Q.Why Should I choose Dr.Kothiwala’s SkinEva Clinic?
• A. At our clinic, Acne treatment is always conducted by well-trained medical doctors under strict guidelines and protocols to ensure your safety.

• Q.Why does acne occur?
• A. Acne develops due to blockage of opening of hair by mixture of dead skin cells and excell oil. This leads to development of comedone which can be inflammed to form papule, pustule, nodules and cysts. This process is mainy driven by hormonal changes.

• Q.What are other factors involved in acne?
• A. Other than hormones, some diets, stress, sedentary life, oily cosmetics and daily skin care products can start or worsen acne.

• Q.what are the foods which cause acne?
• A. Most common is dairy products specially skimmed milk, food with high glycemic index and whey protein supplement.

• Q.Can vitamins or medicines cause acne?
• A. Yes, Vit B12 in higher doses may cause acne or acniform eruption. There are some medicines like anti tubercular, phenytoin which can cause acne.

• Q.is poor facial hygeine reason of acne?
• A. No, there is no connection of hygeine level of face and acne. But sometimes improper cleaning of dead cells of skin may results in formation of comedones.

• Q.is acne develop due to digestion problem ?
• A. No, acne is not directly related to digestive system. But consistent indigestion may alter microbiota of gut which may result in changes in skin health which indirectly may affect acne too.

• Q.I have taken pimples treatment once, can I have pimples again?
• A. If you have taken treatment regularly as per your dermatologist there is minimal chances of recurrence. After taking full course of oral retinoids it decreases the chances of recurrence by 70%. Recurrence may depend on other factors like food habbits, life style and skin care products.

• Q.I am having pimples since my age of 13-14 years and they are not stopping inspite of multiple treatments?
• A. Dermatologist checks type of acne lesions, hormonal status, diets if patient is having pimples regularly. Sometimes it may need long regular combined treatment to get rid of acne.

• Q.I suddenly developed pimples and next week I have some programme in my family. Is there any treatment for quick relief?
• A. Yes, there are chemical peels, laser and IPL treatments which help in quick settling of pimples.

For more information on Acne Treatment in Vaishali Nagar,  Jaipur or to inquire about other services please contact us on 7726938335.