5.1 ACNE (Pimples)

Oh, Pimples & Dimples ! You are Not Simple !! You make me miserable !!!

Now, wonder of lasers! You are far simple !! Lasers make me pleasurable !!!

Yes! Look Young Laser & Cosmetic Surgery Centre is special place where acne scars are vanished or reduced and skin is made beautiful or clear. We use laser facial skin rejuvenation treatment to reduce the pore size & oily nature of the skin and you get smooth texture, more fairness, & evenness of colour tone ! Dark spots disappear.

Life cycle of Acne : Small people/comedone (in the form of small elevation large papule white head pustule, blackhead bursted pustule or cyst or nodule or scar/thicker layer of dark spot.

Causes: Acne are due to hormonal changes, oiliness of the skin, defective life style, stress (e.g. examination), in adequate washing of the skin, starting and stopping of birth control pills, pregnancy, stress of menstrual cycle, junk food, etc.

Various types of appearances of acne:

Black heads, white heads (comedones), small papules (the pimples), larger papules, pustule, nodule, small cyst are various type of appearances of the acne.

Those who develop papule, pustule and nodulocystic lesions develop scarring and dark spots on the face.

Acne usually develop on face. But in more advanced stage acne my develop on back, chest and neck.

Is acne problem curable ?

When acne formation starts in the skin it completes its life cycle of 4 to 12 weeks. One cannot reduce this life cycle satisfactorily with medicine but can prevent complications caused by that acne So when you start taking treatment for acne it takes 6 to 12 weeks to achieve satisfactory response & 6 months to 10 years to control acne completely. Acne can recur at any stage of life.

Best treatment of acne is to prevent them & take early medical treatment during initial period of the disease & take maintenance cure of the skin. Depending upon severity & duration of treatment one needs intermittent preventive treatment in future at certain interval. Such repetition of preventive treatment may vary from two to multiple times.

Mismanagement of treatment:

It is most commonly mismanaged cosmetic disorder of the skin. This mismanagement of problem is often done in the form of non medical treatment, use of advertise products, reporting late for medical treatment, believing in suggestion of non medical people & friends, seeking cheaper technologies etc. Millions of people suffer from various forms of acne which terminate into scars, thickening of the skin, depressed area, pigmentation etc.

Effects of complications of acne tend to develop slowly: These complications are likely to last for whole life if left untreated or incompletely treated or wrongly treated. These effects affect body, mind, emotions & social life of the individual. Such affection may reduce interest in work, studies, personal /family life, social life & professional life. If person has ugly scar or pits of acne on the face, it irritates conscious & subconscious part of mind & person feels restless, depressed & socially inhibited.

Treatment policy is often cure, maintenance & prevention: Those who have more pimples need long period need better preventive treatment & follow up skin care. After cure all of the acne, there is no single specific follow up preventive treatment policy which is applicable to everybody. Follow up preventive treatment policy varies from person to person depending upon quality of the skin & degree of response, hormonal status & provoking factors in that case.

Most of the youths tend to suffer from cosmetic skin problems. Why?

Most of youths have beautiful & glowing skin. They take it for granted that beauty of their face will going to last forever. They are not aware that every aspect of beauty last for certain limited period unless medical maintenance care is taken under experts guidance. Most of they do not make care of the skin under medical supervision at certain regular interval. They need knowledge, scientific care and precautions to prevent the acne problem & the complications. To prolong beauty of the skin, one needs to follow proper scientific precautions. Most of the persons should be serious in taking treatment even if disease is mild we need long term medical cosmetic care when problem is advanced or reached in incurable state.

Always follow preventive care throughout the life as follows:

1. Avoid self handling of acne problem and self medication. Such improper handling provokes more acne, frequent recurrence & more complications.

2. Keep face clean. Wet the skin for few 10-60 seconds to emulsify and remove grease or any other material which is on the skin then rinse the skin. with simple warm water 4 times in a day. Wash face frequently to remove excess of oil and bacteria.

3. One may take mild steam bath or steam on the face.

4. In case of infected acne on the face. Use bactericidal skin soap to prevent infection. Avoid use of harsh soap & soap having alkaline pH. If the skin is more oily, use deodorant soap with antiseptic agent. After returning home, always wash off the cosmetic thoroughly with mild soap. Use non medicated soap only one in a day. If you want to used medicated soap consult your cosmetic physician or dermatologist.

Many popular brands or most advertised brands soaps are alkaline in nature. These soaps make our acidic skin dry & irritable for half an hour. So use soaps which have natural or acidic pH-between 5 to 7. After using alkaline soap use moisturizer.

5. Do light massage on the skin. Avoid massage on the spot where there is discomfort or pain.

6. Use light make up only when it is necessary. Wash it off as soon as one does not need it. Avoid heavy makeup and oily cosmetic procedures. For oily skin, use good powder foundation which provides coverage. Talk powder helps to absorb surface oils. Avoid facial & facial massage with oil based products in beauty parlour or home. For those who have bad quality of skin should avoid self use of cosmetics. Use cosmetic preparations sunder medical supervision to improve quality & health of the skin.

7. Use oil free moisturizer in lotion base once or twice in a day.

8. Take more green leafy vegetables & fruits. Avoid fast food, fried food, over processed food e.g. chocolate, sweets etc.

9. Avoid stress. Keep habit of working or studying with relaxed mind.

10. Keep regularity in routine life.

11. Improve positive element in attitude, in thinking & in activities. Keep one positively relaxed.

12. Acne tends to recur because of oily nature of the skin.

They may recur in any body at any time in future. Understand & learn to manage acne by discussing with cosmetic physician. So take care of the skin in such a way that in will have minimum oiliness.

13. Try to understand mistakes you have made or you tend to make in handling acne, management of acne and treatment of acne.

14. Start treatment at right time. Do not waste time in home medication, advertised medication or using medication prescribed to other. Keep proper follow up. Even if acne problem is solved later on one needs follow up maintenance of the skin care for long period. Even though your acne problem is completely solved consult your doctor at 4 to 6 months interval for maintenance cares of the skin.

When acne appears:

A. Never touch acne unnecessarily as it creates temptation to squeeze/ pinch and scratch. Avoid itching & pressing over acne. It further increases temptation to squeeze & scratch. Also avoid squeezing or scratching of acne or any lesion on the face. Our fingers are often contaminated. So frequent touching on the acne with finger increases possibility of infection.

B. If one has frequent infection of acne, use bactericidal soap to prevent infection. E.g. Neko soap, detol soap. Use soft soap having pH slightly acidic or near neutral. Do not use hard and alkaline soap.

C. Avoid oil based greasy cosmetic products. Use lotion based moisturizers & sunscreens.

D. Cosmetics: Use water based oil free cosmetic sparingly. Always wash off cosmetic thoroughly with mild soap after returning home.

E. Role of diet: Avoid certain food like fried food, chillies, chocolates, fast food, junk food etc. After the treatment one need to take preventive treatment & proper skin care excess oil etc. Increase percentage of given leafy vegetable & fruits in routine diet for certain period.

Skin Behavior during treatment : Skin behavior of the individual varies from person to person. Response to same treatment varies from person to person, so treatment regime individualization takes some time. Considering response to treatment titrate dose of the drugs. Some patients want earliest result because of pre marriage preparation or certain celebration. In such case they need intensive treatment for some period & frequent visit to clinic. They may need treatment of more than two varieties at a time. Those who want early improvement or this who have advanced acne problem may experience temporary side effects or treatment like redness, irritation, itching, dryness, temporary increase in acne etc. In such case be in touch with your doctor & make changes in treatment.

Any medical treatment for acne or for other cosmetic problem may cause dryness of the skin or peeling of white scale, redness, itching, stinging or burning sensation. It happen in some individuals. These changes are part of medical treatment in some individuals. If you are unable to tolerate these effect cosmetics your doctor & make necessary changes.

Self-treatment: This is common aggravating cause. Both adults & youths equally mismanage /self manage acne problem complication or sequence effects of acne problems. Although effective medicines are available, due to mismanagement, lack of long term follow up treatment & preventive treatment by most of people tend to develop long terms residual effects of disease. They tend to loose self confidence & faith in therapist. They continue to take insufficient treatment improper care of skin long period.

Knowledge of acne problem & its management: Most of us pay cost of ignorance!

Any medical treatment for acne or for other cosmetic problem may cause dryness of the skin or peeling of white scale, redness, itching, stinging or burning sensation. It happen in some individuals. These changes are part of medical treatment in some individuals. If you are unable to tolerate these effect cosmetics your doctor & make necessary changes.

1. Keep skin of the face wet:

Dryness in atmosphere & in the skin induces acne activities. In dry weather dryness of the skin should be prevented. To keep the skin wet, use emollient. Non comedogenic facial cleanser can be used in all types of treatment of acne. Use cleansing products that existing hard plug loose is mole of oxidized oil and adhered dead bacteria along with debris. Apply cleansing agent which has astringent property. One may use benzoyle peroxide. It is abrasive cleansing lotion.

2. Eliminate or reduce infection:

Infection by propionic bacteria produces inflammatory extracellular products inside the gland deeper in the pore. Free fatty acids are also produced by bacterial division. Antibiotics treat infection & also reduce production of inflammatory free fatty acid. If not treated with adequate doses & in required frequency, 60% patients develop resistant bacteria. Antibiotics are given in the form of oral medicine & local medicine.

In acute acne, laser light source near 400 nm is used to kill bacteria. It is used as adjuvant treatment.

3. Remove material that clogs the pores & duct of pilosebaceous unit:

Unplug blockage in the follicle:

The cause of acne is blockage of the caused follicle by accumulated plug of exfoliated keratinocytes. To unplug this blockage in follicle, comedolytic medicines are used such as salicylic acid, oral retinoids (like tretinoin, isotretinoin) etc. are used. This drug reduces positive & negative charges on the keratinocytes in follicle. So, cohesiveness among them reduces. After this unplugging, antibiotic can enter in follicle to treat the inflammation to eradicate existing comedones & to prevent the formation of new ones. So anybody having acne problem need regular extraction of comedones.

4. Reduce inflammatory response:

Use anti-inflammatory products.

5. Reduce level of the sebum:

Oral & topical retinoid can be used to reduce activities of sebaceous glands. In females, oral contraceptive helps to stabilize & to reduce secretion of sebum.

6. LASER Treatment (Laser Facial): To reduce inflammation, pigmentation, pore size, sebum production, oiliness, surface irregularities, recurrence of acne Laser facial skin rejuvenation is advised. To improve scar, thicker darks pots, surface irregularities Ultra Pulse CO2 laser resurfacing is most effective treatment. For overall improvement in cases of mild to excess acnes laser facial skin rejuvenation is most effective treatment for improving skin quality scars oiliness, dark spots, & other sequenale of acne. It is done once on a months for 6 to 10 months.

7. Take care of the skin as mentioned in chapter of skin care.

8. Remove comedones regularly under supervision of experts.

9. Use of Make-up & powder

Youths should avoid foundation. They may use day cream or compact powder. Removal of make up at right time is more important than application of make-up. It helps to maintain the skin.

10. Protect the skin from Sunlight:

Indian skin is more pigmented. So, it tends to absorb more sunlight but protects better. Avoid exposure to sunlight between 10 a.m. to 3 p.m. Apply sunscreen at least 3 times in a day during treatment period.

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