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Medical Management Of Acne

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Acne Vulgaris, Pimples, Blackheads, Pustules, Rosacea, Whiteheads, Zits, Backne, Bacne, Comedone

Acne is a very common skin condi­tion that origin­ates in the oil gland appar­atus that is present in the skin. The natural purpose of this oil gland is to produce a natural mois­tur­ising and protective barrier oil that coats the surface of the skin.

If this process of the oil spilling out to the surface of the skin is blocked you will get an Acne, a pimple or a Zit. Please under­stand that this is a very simplistic explan­a­tion. There are gener­ally 4 condi­tions that act indi­vidu­ally or together to give you an Acne. There could be a block at the opening or skin pore (blockage with dried up oil, dead skin, makeup, sunscreen), there could be an over produc­tion of oil in the skin, there could be a bacterial infec­tion (there are bacteria called P Acne that are most commonly implic­ated in Acne) or you could have a skin type which mounts an excess­ively aggressive inflam­matory response to a small blockage in your oil glands.

Whatever the process the blockage, bacteria or the skin’s defence (inflam­matory response) you will get a pimple or acne of some type.

Frequently Asked Questions

What causes Acne – is it a disease?

Acne is an extremely common and relat­ively harm­less skin condi­tion. In some patients it can be quite aggressive and leave behind actual and emotional scar­ring. It can have many different causes as high­lighted above.

What are the different types of acne?

All the different types of acne can be under­stood if you follow the explan­a­tion of the cause of acne above. If the oil gets clogged and dried up at the opening of the skin pore, then it gets oxid­ised to a black coloured plug often called a Comedone or Comedogenic Acne. If the plug does not get oxid­ised it appears white and is there­fore called a Whitehead. When the blocked gland and skin tissue around it get inflamed, raised, red and painful and are felt like a solid bump inside your skin, you have Nodular Acne. If you have a blocked gland, that is infected, inflamed and has a point of pus at the tip on the skin you have a Pustular Acne. Finally if you have a large lump under­neath your skin that is full of pus you have a Cystic Acne which some­times is combined with Nodular Acne a condi­tion which is described as Nodulo-Cystic Acne.

Do I have Severe Cystic Acne?

While an accurate diagnosis can be made in the clinic, if you have large acne pustules that heal with severe scar­ring, there is a high chance you have nodulo-cystic or cystic acne and will need a course of Oral treat­ment with Isotretinoin.

Why do I have acne on my back, is this not supposed to be on the face?

Given that acne is a disorder related to the sebaceous oil glands, it can occur where ever the density of these glands is high in the skin. It can there­fore occur on the face, upper chest, upper back and the shoulders

What can I do for my backne or bacne, is there a cure for back acne?

The treat­ment of backne or bacne or back acne is determ­ined on the basis of the severity of the disease. Most patients will benefit with pre shower 5% Benzoyl Peroxide applic­a­tion, while a subset will need oral anti­bi­otics or Isotretinoin treatments.

Do fast food or chocolate cause acne?

All food which has a high Glycemic Index (the ease with which the body can extract sugar from a food; so chocolate would be really easy, so High Glycemic; a piece of Brocolli wold be low glycemic) can predis­pose you or worsen your Acne Condition. Fast Food, Refined Carbohydrates, Sugar, Chocolate are certainly to be avoided or indulged in extreme moder­a­tion if you want to reduce your Pimples/Acne. Milk Products can also worsen acne, but this seems to be due in part to the intol­er­ance or inab­ility to digest milk that is quite prev­elant in the population.

Why do teenagers get acne?

During puberty, the balance of female and male hormones rises and falls at different times till the levels stabilize to adult levels in the mid 20 years of age, in both sexes. Whenever the andro­gens (male hormone, which is also present in females) component is predom­inant there is a stim­ulus for over­pro­duc­tion of oil, which predis­poses you to Acne.

Why do I get acne around my periods?

As mentioned above the cause of acne relates to an imbal­ance between the andro­gens and oestrogen/progesterone (female hormones), the fluc­tu­ating hormonal levels are respons­ible for the menstrual cycle, consequently in patients with a bigger hormonal influ­ence, the acne happen just before the periods start. Hormonal Acne are typic­ally located around the lower jaw and chin.

Do women in their 30’s and 40’s get Acne?

Yes, there is a subset of women in whom the acne problem starts in the late 20s and continues into their 40’s. The acne in this group is gener­ally hormon­ally influ­enced. Rosacea can often present like acne in this age group and needs to be diagnosed.

Do I have acne or rosacea?

While in the younger age group up to 30 years of age, it is gener­ally Acne that is the problem, Rosacea which is a very common skin condi­tion can also have a present­a­tion similar to Acne in the older age group of women. The distinc­tion between the two condi­tions is that in Rosacea, trig­gers like spicy food, alcohol, heat, stress, or exer­cise can cause an intense redness or flushing of the skin around the nose and cheeks, it can also be asso­ci­ated with thread veins in these regions. When you have your consulta­tion with Dr Prashant at his Reforme Medical Clinic in Cardiff, he will be able to help you with the diagnosis.

Will I have Acne if my mother had it when she was young?

There is definite hered­itary connec­tion of acne and the chances that you will have acne if your parents had them growing up are high. Other familial condi­tions like Polycystic Ovary Syndrome or Metabolic Syndrome also show hered­itary tendencies.

What will get rid of my acne?

There are many extremely effective treat­ments for acne. But the first thing that will help is in your hands (it liter­ally is). Touching your face either with your fingers or cell phone worsens blockage of the skin pores and should be avoided. Cut your nails short as sharp nails will cause micro injury to the skin when you touch your face and transmit aggressive bacteria into the area of the acne, worsening it.

Treatments of acne consist of :

Skin applic­a­tion of products that reduce the oili­ness, reduce dead skin build up, have an anti-inflammatory (skin calming) effect these are :Vitamin A deriv­ative creams like Tretinoin, Adapalene (Differin), Benzoyl Peroxide, combined Adapalene and Benzyl Peroxide (Epiduo), Azelaic Acid, Tazarotene.

Skin applic­a­tion of products that kill the bacteria that cause Acne: Benzoyl Peroxide, combined Adapalene and Benzyl Peroxide (Epiduo), Azelaic Acid, Clindamycin, Dapsone.

Oral medic­a­tion that reduces the oil produc­tion: Isotretinoin (Roaccutane), Combination Oral Contraceptive pills, Spironolactone.

Oral medic­a­tion that kills the bacteria: Minocycline, Doxycycline.

In Clinic Treatments: Incision and Drainage of Acne Pus, Chemical Peels, Steroid Injections, Scar Management with Peels and Lasers.

When you come to see Dr Prashant at Reforme Medical Clinic in Cardiff, we will go through with all your prob­lems and give you a short and long-term solu­tion that should start working within a 4–6 week period.

Can I treat my acne at home?

Home skin care is the bedrock of successful acne treat­ment. Wash your face just twice a day with a sali­cylic acid cleanser (if you have an oily skin) or a gentle non soapy cleanser (if you have dry sens­itive skin). More frequent washing, scrub­bing, exfo­li­ating devices, exfo­li­ating mask, scrubs will only make the problem worse. Use a non comedo­genic spf 30 sunscreen and avoid sun exposure. Cut your nails, stop touching your face with your hands. Don’t pick at your acne, even if it is tempting, as trying to do this will only leave you with a scar. Please visit our clinic Reforme Medical in Cardiff, where we will you get rid of the acne without leaving you with scars.

Why do I get acne on my forehead?

Most patients who suffer from fore­head acne have Dandruff and when the Dandruff is managed they see a dramatic relief of their fore­head acne.

What can I do for my blackheads and whiteheads?

There are some very effective cleansers and creams that Dr Prashant can prescribe that will reduce both Blackheads and Whiteheads within a 4–6 week period.

Approximate Costs

An accurate estimate of the costs is only possible after an in-clinic consulta­tion with Dr Prashant. We charge a £50 deposit to secure your consulta­tion with Dr Prashant, this amount will be deducted from the costs of the treat­ment you go on to have at our clinic.

Please contact us to find out more.