Acne is a skin problem that affects almost all teenagers. The condition results from the action of hormones on the skin’s oil glands (sebaceous glands). The sebaceous glands make an oily substance called sebum that empties onto the skin surface through the hair follicle opening (pore). The mixture of oil and cells allows bacteria that normally live on the skin to grow in the follicle openings. When this happens, pores become clogged and pimples develop.

Pimples can be one of the following kinds:

Comedones: Non-inflammatory papules that can be open (blackheads) or closed (whiteheads).
Papules: Lesions that are inflamed and can be tender to the touch. These usually appear as small, pink bumps on the skin.
Pustules (pimples): Lesions that are inflamed and filled with pus. They may be red at the base.
Nodules: Solid lesions that are large, painful, and lodged deep within the skin.
Cysts: Pus-filled lesions deep under the skin. These may cause scarring and pain.
In most cases, pimples occur on the face, neck, back, chest, and shoulders. Acne does not present a serious health risk, but severe acne can result in permanent scarring. In addition, acne can have significant physical and psychological consequences, such as causing a poor self-image, social inhibition, and anxiety.

Some People Get Acne and Some Don’t

It is not clear why some people are more prone to acne than others. The exact cause of acne is not known, but one important factor is an increase in male sex hormones called androgens. Androgens increase in both boys and girls during puberty. Androgens cause the sebaceous glands (oil glands) to get larger and produce more sebum. Androgens also can increase because of hormonal changes related to pregnancy or starting or stopping birth control pills.

Another factor in the cause of acne is genetics. Researchers believe that the tendency to develop acne can be inherited from parents. In addition, some drugs (for example, anti-epilepsy medication, prednisone, androgens and lithium) are known to cause acne. Cosmetics that have a greasy consistency may change the cells of the follicles, causing them to stick together and resulting in a plugged pore. Water-based products are less likely to cause acne.

Things that can make acne worse include:

• Friction caused by leaning on or rubbing the skin; harsh scrubbing
• Picking or squeezing blemishes
• Pressure from bike helmets, backpacks, or tight collars
• Changing hormone levels in adolescent girls and adult women two to seven days before the start of the menstrual period
• Stress

Other factors that were previously thought to make acne worse do not seem to have an effect on the development of acne. These factors include chocolate, greasy foods, and dirty skin.

How Is Acne Treated?

Dermatologists often treat acne, particularly in severe cases. Family or general practitioners, pediatricians or internists may treat milder forms of acne.

Treatments may include:

OTC topical drug treatments: Over-the-counter (OTC) medications include salicylic acid, benzoyl peroxide, and sulfur. These treatments are available in many forms including gel, lotion, cream, soap, or pads. When these products are used regularly, they are moderately effective in the treatment of acne. It may take 4-8 weeks for an improvement to occur in the skin.

Prescription topical drug treatments: The prescription topical drug treatments that are used to treat acne include benzoyl peroxide, antibiotics, tretinoin, adapalene, and azelaic acid.

Prescription and OTC benzoyl peroxide work the same way. Doctors often prescribe benzoyl peroxide so that they can make sure that their patients get the most desirable formulation (for example, cream, lotion or gel).

Prescription oral drug treatments: For patients with moderate to severe acne, doctors often prescribe oral antibiotics (taken by mouth) in addition to topical medication. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and decreasing inflammation. They are usually taken daily for a period of four to six months and then tapered and discontinued as acne improves.

The most potent oral drug, isotretinoin (Accutane), is usually taken once or twice a day for 16 to 20 weeks. It is believed to markedly reduce the size of the oil glands so that much less oil is produced. As a result, the growth of acne-causing bacteria is decreased. However, isotretinoin can cause birth defects in the developing fetuses of women who are pregnant while taking the drug. Women of childbearing age must not be pregnant and must not become pregnant while taking isotretinoin.

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Acne Prevention Tips

• Don’t over wash or use harsh scrubs. Remember, acne is not caused by dirt. Two gentle washings a day is sufficient. Too much cleaning can leave skin irritated and dry, triggering glands to produce more oil, increasing the likelihood of pimples.
• Use oil-free or non-comedogenic products (those that won’t clog pores) on your face.
• Don’t squeeze or pick blemishes. Popping pimples can drive acne bacteria deeper into the skin. Picking can lead to more inflammation and permanent scarring.
• Don’t let acne define who you are. Do the things you can to improve your skin, and then get back to doing the things you enjoy.
• Review this slide show to get more tips.

LaserOffers.com

Talk to your dermatologist or aesthetic physician about using Nd:YAG 1064 nm laser for the treatment of active acne. 2-4 sessions will help in a vast majority of cases. And stay away from Accutane.

A valuable input has been provided by a group of physicians from Korea, which published the results of their study in May issue of the Journal of the American Academy of Dermatology.

The group did a very interesting split-face clinical study of 18 Korean patients with facial acne scars. They treated on cheek with a 585-nm pulsed dye laser (PDL) and the other with a 1064-nm Nd:YAG laser to compare the efficacies of these two lasers in the treatment of acne scars.

Each patient received 4 sessions of PDL or Nd:YAG laser at 2-week intervals in a randomized split-face manner.

Results

“Both lasers induced notable and comparable improvement in the appearance of acne scars, particularly superficial scars, with significant reductions in the scores associated with the clinical evaluation scale for acne scarring (ECCA). Histologic evaluations revealed significant increases in collagen production and deposition following both lasers. Patient satisfaction scores concurred with these improvements. Ice-pick scars and boxcar scars tended to respond better to PDL and Nd:YAG lasers, respectively”.

Atrophic acne scars of representative patients showed notable improvement at 8 weeks after completion of laser treatment. A and B is PDL-treated side versus; C and D – Nd:YAG laser–treated side. Left column A and C) is the baseline (before treatment). Right column (B and D) – 8 weeks after completing 4 laser treatment sessions. Ice-pick and deep scars (C and D) as well as superficial scars (A and B) showed noteworthy improvement after laser treatments.

The study group concluded that both lasers are effective modalities for the treatment of acne scars. Results appear to be very comparable in efficacy.

LaserOffers.com Comment

This is a notable study, which conclusively shows that both lasers work well on Asian skin type, and the skin type is a very important factor in choosing one laser over the other. Nd:YAG laser should clearly be the laser of choice for a darker skin type. The 1064 nm wavelength is a much safer modality for the skin of color and tanned skin.

The study did not address the pain level for patients. Again, 1064nm with a short pulse width would be preferable as the patients with darker skin would experience less pain during the treatment.

An experienced aesthetic medical professional should determine the choice of laser for a specific skin color, skin condition and the scar type to achieve optimal results for the individual patient.

Pulsed dye laser-mediated photodynamic therapy for acne inversa is not successful. Results of a study in France just came out in Journal of Dermatological Treatment.

Acne Inversa is sometimes recognized as Hidradenitis Suppurativa (HS). Acne Inversa is not contagious. It’s a recurrent disease impacting inverse parts of the body such as breasts, armpits, and groin, and places hair follicles and apocrine glands are located. It usually develops early on as one boil-resembling, pus-laden abscesses, solid sebaceous lumps, to deep-seated, painful, frequently inflamed groups of lesions with extreme seepage resulting in major scarring.

See pictures of acne inversa

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The relapses and the chronicity of acne inversa cause a significant impact on the quality of life of the affected patients and urge for a search of more effective treatments. The authors report the treatment of four consecutive acne inversa patients with pulse dye laser-mediated photodynamic therapy (PDL-PDT). Three months after the end of the treatment there was no improvement in comparison with opposite control sites. Intense pain during treatment was reported by all the patients. These cases do not support the use of PDL-PDT for treating acne inversa.