Acne is the most common skin disease and affects 80% of all people at some time between age 11-30 years. It begins from age 10-13 at a time when a child is undergoing puberty. It therefore can have far-reaching psychosocial consequences as well as result in permanent disfigurement.

 What causes Acne?

There are numerous factors that contribute to acne. One of which is an increase in androgens, male sex hormones. These hormones are typically found during puberty in both boys and girls, when there is an increase in hormonal activity. These hormones cause the sebaceous gland to enlarge and produce more sebum, promoting acne.

Acne is also common in pregnant and menstruating women due to hormonal changes in their body. Birth control pills may help control the level of hormonal activity.

Studies have shown that many teenagers with acne problems have a family history of acne. Additionally, drugs such as androgens and lithium are shown to increase acne. Some cosmetic products make the skin and hair follicles clump together, which create a skin plug, promoting acne in those areas.

There are four interrelated factors involved:

• Excess sebum (oil) production
• Blockage of the pilosebaceous gland
• Infection with a bacteria called Propionibacteriun Acnes
• Skin inflammation.

• Changing hormone levels in adolescents and adult women
• Oil from skin care products (moisturizers or cosmetics) or grease encountered in the work environment
• Friction and pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
• Squeezing or picking at blemishes
• Hard scrubbing of the skin
• Stress. (e.g. Less sleep, anxiety, schooling, tests, relationships etc)

Is acne Hereditary?
Yes, the activity of the pilosebaceous glands is inherited.

  Are there any differences in Acne between different skin colours?
There is a great deal of variation in the incidence of Acne throughout the world;

• Black-skinned patients are more likely to form whiteheads and white skinned patients more likely to have inflammatory Acne
• Patients with black skin may respond to inflammatory Acne by forming keloid scars which can result in gross disfigurement.
• A specific form of comedonal Acne that is very common in black patients is Pomade Acne, due to the application of waxes, greases and oils to the hair, resulting in pilosebaceous duct blockage and therefore comedogenesis. Ideally, the patient should cease from using such materials on the hair.

 What part of the body does Acne affect?
The distribution of Acne occurs where the density of sebaceous glands is the greatest, namely the forehead, cheeks, chin, upper chest and upper back.

 How is Acne treated?
We offer various treatments (depending on the severity of the acne) at Advanced skin clinic. Early treatment of Acne is essential for the prevention of lasting cosmetic disfigurement associated with scarring and treatment depends on what type of Acne is present.

Mild Acne (Comedonal acne)
This form of Acne is very common in pre-teenage or early teenage years. Treatment is very important at this stage to prevent further development of Acne complications such as scarring: topical tretinoin or adapalene used once daily at night. We prefer to use retinoids at night as they can photosensitize the skin and therefore are best washed off in the morning before going into sunshine. Topical retinoids are effective against whiteheads and blackheads and may also benefit patients with increased pigmentation. Salicylic acid up 2% in various formulations may be used as an anticomedone treatment and mild anti-inflammatory agent. Azelaic acid formulations can also be effective

 Moderate to Severe Acne
Several types of prescription topical medicines are used to treat moderate to Severe acne. They include:

• Antibiotics – Slow or stop the growth of bacteria and reduce inflammation (and may reduce the formation of comedones).
• Vitamin A derivatives (retinoids) – These vitamins are typically used to unclog existing comedones to allow other topical medications to enter the follicles
• Others – Included are Benzoyl Peroxide, sodium sulfacetamide/sulfur, Azelaic acid (Azelex), topical dapsone, and topical antibiotics such as  erythromycin or clindamycin.

Other Treatments for Acne

Our dermatologist (specializing in acne) can remove a patient’s comedones and other lesions during your visit. This is called acne surgery. The dermatologist may also inject corticosteroids directly into affected areas to help rapidly reduce the size and pain of inflamed cysts and nodules. This is helpful for brides or persons with upcoming parties, or special occasions for best results. Our dermatologist can also add a chemical peel or Blue-U light therapy to speed up resolution of acne.

For more information, please visit our offices today.