Acne treatment involves a combination of several therapies and it is never the same for all patients. Treatment depends primarily on the type of pimples and skin sensitivity.
Most young people face the problem of acne or pimples for the first time during puberty, and as many as 80% of the population has acne at least in some period between 11 and 30 years of age.
During puberty, under the influence of hormones and increased function of the gonads and sebaceous glands, the skin becomes more oily. In individuals who are genetically predisposed, increased fat also means increased production of blackheads followed by pustules. In case of hormonal imbalance, male hormones, which have the function of increasing skin oiliness, prevail.
Depending on the type and severity, pimples can be grouped into blackheads or comedonal acne. Pimples that have pustules in addition to blackheads are common acne (acne vulgaris). If nodules and deep inflammatory processes appear along with blackheads and pustules, this type is called nodulocystic acne.
The most severe form of pimples involves pustules and nodules, with merged painful purulent collections that sometimes cover a significant area of the face and/or back.
In boys, the appearance of acne is exclusively genetically determined, while in girls, hormonal imbalance can have a large impact on the appearance of pimples. After the onset of regular menstrual cycle, acne disappear in a high percentage.
Although genetics plays a big role, acne in teenagers is unpredictable, so parents can have a very mild form, and the child a significantly more severe form of acne.
Also, other factors can have an impact on the worsening of acne and pimples, primarily improper diet and stress.
Although it is believed that food cannot be the cause of acne, fast food, sweets and industrially prepared meals can make acne worse in individuals who are prone to them.
This diet increases the amount of insulin in the blood, which acts as a male hormone that makes the skin oily and prone to pustules. It should be noted that fruits and other natural sugars do not cause pimples. Also, according to recent research, large amounts of milk or yogurt can worsen the form and amount of acne. The problem is the high percentage of hormones found in milk, so more than three glasses of milk a day is not recommended for people prone to pimples.
Stress is a factor that can affect skin changes and even their occurrence. Adrenal hormones are increasingly produced when the body is exposed to stress and they have the effect of male hormones on the body, which consequently leads to acne.
Acne treatments
Acne treatment is usually necessary to prevent the scarring which is later difficult to remove. That is why it is important to start the treatment as soon as possible.
There is no single, universal therapy for acne, but the treatment depends on several factors: the cause of acne, the type and sensitivity of the patient’s skin, and the type of pimples. When the condition is caused by a hormonal imbalance, in addition to treating skin changes, it is necessary to treat the hormonal imbalance.
Depending on the type or severity of pimples, the treatment can be local and systemic.
Local treatment of acne involves the application of creams, peels, lasers. Creams usually contain benzoyl peroxide, retinoids, azelaic acid, antibiotics, salicylic acid, glycolic acid. In more severe forms, antibiotics, isotretinoin, and contraceptives may be included in the therapy.
Laser treatments and chemical peels significantly speed up the healing process but cannot cure acne permanently, as sometimes advertised. Chemical peels dissolve blackheads, while lasers can replace the mode of action of antibiotics and speed up the healing of pustules and purple spots.
Following the local therapy, patients must use preparations intended for maintaining the good condition of the face, whose role is to keep the further functioning of the sebaceous glands under control. If they do not adhere to this rule, the process will start again in 3 to 6 months.
Severe forms of pimples require systemic therapy with antibiotics or isotretinoin tablets for several months. Isotretinoin also known as Roaccutane is the medication of choice for all forms of pimples that remain scarred after the inflammation subsides. It is used for 4 to 6 months and it is the only medicine that can permanently cure this condition. There is a great misconception about Roaccutane therapy among people who are not professionals, believing that this medication leaves lasting consequences. Everything should be discussed in detail with your dermatologist.
Acne scar removal
If there are residual scars on the skin after the acute condition is healed, there are various treatments that can significantly reduce these scars.
Acne scars can be treated using chemical peels, laser treatments, dermapen or they can be filled with hyaluronic acid.
Vbaem laser treatment is recommended for red-bluish acne spots that have formed at the site of strong inflammatory process with dilated blood vessels and long-lasting purple discoloration. Pockmarks can be treated with fractional CO2 laser or radio wave abrasion with TCA peel.
Dermapen can also be used during the period when it is sunny, however, it takes a slightly longer time to see the results of this treatment compared to all previous methods.
References:
- A review of diagnosis and treatment of acne in adult female patients
- Acne clinical guideline
- Guidelines of care for the management of acne vulgaris
- Systematic review of the epidemiology of acne vulgaris
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