WHAT IS ACNE?

The best way to treat acne is to first understand why it occurs. The skin consists of a top layer of skin cells known as the epidermis and a secondary layer known as the dermis where we produce elastin and collagen. Collagen is also the basis of scar tissue. The epidermis periodically dips into the dermis to create a gland. It is these glands that produce the oils that keep our skin moist. It is also these glands which are part of the problem in acne. In teenage years, and with some types of medications, these glands become overactive producing excess amounts of oil. At the same time the epidermis makes new skin cells every 7 to 10 days. If these skin cells are not sloughed off in daily wear and tear, they block the glands as they try to excrete their oil. The result is a cyst, or white head. If the is bacteria on the skin, this cyst becomes infected and a pimple is formed. Pimples are like pressure cookers and must release their contents. If they can not do this the inflamed area pushes further down into the skin forming a blind pimple, if this continues the pimple bursts in the dermis layer and the resulting inflammation causes scarring. This is the worse scenario as once acne scarring occurs it is virtually impossible to fix. It is even worse if the acne occurs on Asian and African skins where the inflammation process can lead to permanent pigmentation changes and deep scarring.
Hence the aim of acne treatment to;

1. Reduce oil production

2. Improve skin exfoliation

3. Prevent infection

REDUCING OIL PRODUCTION

Reducing oil production can be done medically or cosmetically. When acne is severe and causing scarring, it becomes necessary to use a vitamin A based medicine. This must be prescribed and monitored by a dermatologist. Up until this point the medical options for girls include the oral contraceptive pill. For boys and girls, the vitamin A cream also helps to dry up the gland. Cosmetically, the use of vitamin A based cosmetics will have a similar action to vitamin A creams. The effect of cosmetic creams may however, be faster as the amounts of vitamin A can be gradually increased. Girls should also ensure that they remove all traces of makeup daily and if possible switch to mineral makeup, which does not interfere with the skins natural oil production or clog pores.

IMPROVING SKIN EXFOLIATION

This is crucial to fighting acne. There are a number of cosmetic options. The fine sandblasting known as microdermabrasion can be very effective but for a few can worsen their acne. Another option is chemically peeling the skin. This is best done as a series of superficial peels which causes minimal impact on daily life. In addition the use of skin care which has natural exfoliating agents in them such as the alpha and beta hydroxyacids, is a must. Many of the over the counter acne treatments act to dry out this skin. This only results in worsening acne as the body tries to compensate by increasing its production of new skin cells leading to further blocking of the pores. The aim is not to dry out the skin, but only to gently remove the build up of dead skin cells. The moisture balance must be maintained.

PREVENTING INFECTION

The prevention of infection involves ensuring that the skin stays at the appropriate pH to allow its natural defence mechanisms to work efficiently. This is why choosing the correct skin care is essential. Peeling has the secondary effect of also stripping bacteria from the surface of the skin. Medically, oral or topical antibiotics can be prescribed.

Choosing the correct treatment for acne requires a good knowledge of skin as well as experience with multiple treatment options. A visit to a cosmetic physician can be a worthwhile experience if unsure of where to start with good skin care or to treat an existing problem.