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Acne

Acne is a common skin condition that occurs most often during the hormonal changes that accompany adolescence, but it can occur at any age. It is so common among teenagers that it is considered a natural part of growing up.

Acne occurs in adolescence because various hormones – mainly androgen circulates in higher levels in the blood, increasing the amount of skin oil produced. It can also occur or become worse with other conditions that involve hormonal changes, including menstruation, pregnancy, or use of birth control pills, and sometimes during early menopause.

The severity of acne varies. Some people have only mild, sporadic outbreaks of a few annoying whiteheads or blackheads. Others have severe eruption of pimples and cysts that can leave permanent scars. Acne usually clears up on its own by late teens or early 20s in men, and somewhat later in women.

Acne occurs in sebaceous glands and the hair follicles to which they are attached. The sebaceous glands make oil called sebum. Normally, this oil, along with dead skin cells, moves up from the bottom of the gland through the pore (opening) on the surface of the skin, spreading across the skin, where it is washed away.

In acne, the sebum and dead cells plug up the opening of the sebaceous gland and its hair follicle. This plug is called a comedo. Sometimes the opening of the comedo is not visible; there is just a bump underneath the skin. This is called a closed comedo. Other times the opening at the top of the plug is visible (open comedo).

When the plug of sebum and cells is white, it is called a whitehead. Sometimes the pigment melanin in the dead cells makes the plug dark (which is sometimes mistaken for dirt); this is called a blackhead. Generally the plug in closed comedos is not dark, while open comedos usually have a dark plug.

The bacteria Propionibacterium acnes live inside the hair follicles. They use sebum for nutrition. When the bacteria digest the sebum, they produce waste material (fatty acids) that can be very irritating to the skin. Most of the time these fatty acids are pushed up to the surface of the skin and washed away. However, when the glands get plugged and filled with sebum, these fatty acids accumulate inside the sebaceous gland, causing inflammation.

Symptoms

Acne falls into two categories: inflammatory and non-inflammatory. Both types usually occur on the face, but may also appear on the upper chest, back, neck, and buttocks. Most people have non-inflammatory acne, which consists of comedos that have no surrounding redness or tenderness. Inflammatory acne occurs when fatty acids cause plugged follicles to become inflamed, forming pimples and pus-filled nodules. Severe inflammatory acne may create deep, pitted scars that can be disfiguring.

Preventing Complications

It is difficult to prevent acne, but you can take steps to prevent its complications. Wash your face twice a day with ordinary soap and water; this is the only cleanliness measure that is necessary.

Using cosmetic creams or oils on your face can plug pores and make you susceptible to acne; choose products labeled “oil free”. Taking oral contraceptives or illegal “muscle building” steroids can also bring on acne.

Do not scratch or squeeze pimples or cysts; this can lead to scarring that is often permanent. There is no evidence that any foods or sexual activity have any effect on acne.

Treatment Options

There are three general approaches to treatment: preventing the pores from getting plugged with sebum; causing the whiteheads and blackheads to dry up more rapidly; and using antibiotics that kill the P acnes bacteria. It usually takes time for acne to improve. In some people the condition worsens before it gets better.

A cream often treats mild inflammatory acne with relatively few open comedos or lotion that contains benzoyl peroxide, which helps keep pores open. If you have many whiteheads and blackheads, the medicine tretinoin (which comes as a cream, lotion or gel) can open them up and let the material drain onto the surface of the skin, where it can be washed away. Ask your physician which medication is best for your acne.

If your acne includes inflammation (redness and tenderness around the whiteheads or blackheads), your physician may recommend antibiotics. For milder degrees of inflammation, the antibiotics can be taken as creams, lotions, or gels to rub on the face.

For more severe inflammation, antibiotics in pill form such as tetracycline, doxycycline, minocycline, or erythromycin are used. Antibiotics mainly prevent the formation of new acne, and do not help very much with existing acne; thus, improvement takes several months. Antibiotics are often given for at least 6 months, although the dosage may be reduced with time.

For the most severe forms of acne in which there are cysts and great inflammation and when the treatments above have not been effective, two additional treatments are possible. Your doctor may inject anti-inflammatory corticosteroid medicines directly into the inflamed cysts.

Alternatively, the drug isotretinoin, taken as a tablet, is very effective against acne. However, a woman who is pregnant, because it can cause severe birth defects and miscarriage, should never take isotretinoin.

As is evident from above, traditional therapies have a variety of side effects and sometimes require months to work, if they work at all. Topical creams and lotions can cause redness and irritation. Oral antibiotics can cause stomach upset, light sensitivity and yeast infections in women, and studies indicate about 40% of skin bacteria have become resistant to antibiotics, making them a doubtful ally in the fight against skin breakouts.

The intense pulse light procedure that we use destroys the most common bacteria that cause acne — without drugs, without pain and without downtime:

-P. acnes bacteria are destroyed by intense pulse light of the appropriate frequency
-Each treatment lasts 15 to 20minutes. A total of approximately eight treatments will effectively make acne disappear
-No side effects, no pain and no downtime

Frequently Asked Questions:

What happens during a treatment?

A typical treatment session requires approximately 15-20 minutes. Clients lie comfortably on a bed. Protective eyewear is used during all treatments. A unique spectrum of light is utilized that causes the acne bacteria to self-destruct, while having no effect on the normal skin. The treatment is designed to treat mild to moderate inflammatory acne and is suitable to treat all areas of the body, including the back, chest and face. Clients return to normal activities immediately after treatment. During the procedure sometimes there is a slight warming sensation. The treatment is safe and painless.

How many treatments are required?

The number of required treatments will be determined during the consultation session based on individual needs. Typically, a total of eight treatments are given twice a week for four weeks.

Will skin be blemish-free at the end of the treatments?

Though the inflammation will be gone for a majority of clients, some may experience residual redness where the inflamed blemish was located. The redness will dissipate over time.

Are the results permanent?

The treatment usually helps control acne breakouts for four to eight months; after that, occasional touch ups may be necessary.

Are there any preparations needed for the skin before coming in for a treatment?

Yes. The affected area should be washed with a mild acne cleanser, then rinsed with water and dried. Women should remove makeup before treatment sessions, and should only wear oil-free make-up between appointments. Make-up can be re-applied immediately after a treatment session has been concluded.