All About Acne: An Informative Guide to Handling Acne

What is Acne?

Acne is a skin condition that can manifest in many forms including blackheads, whiteheads and pimples that can vary from small red bumps to large cysts.

The various forms of acne are formed in a 4 stage process:

  1. Dead skin forming a keratin plug that blocks the opening of the hair follicles (pores).
  2. Overproduction of sebum by the oil glands in the skin
  3. Infection by cutibacterium acnes (bacteria that is associated with acne)
  4. Subsequent inflammation

Non inflamed acne typically manifest as blackheads (open comedones) and whiteheads (closed comedones) whereas inflamed acne manifests as papules, pustules, nodules or cysts.

Causes of Acne

There are 4 main causes of acne, namely:

  1. Genetic Predisposition is the most important cause
  2. Cosmetics can clog pores
  3. Medications such as steroids, anti-epileptics and hormonal drugs
  4. Endocrine disorders such as polycystic ovarian syndrome and congenital adrenal hyperplasia

What Can We Do When We Have Acne?

  1. Control and monitor your diet.
    When we have acne, it is important to watch what we eat and to avoid certain foods that will only worsen the acne. Having a healthy diet helps to reduce obesity as well, which increases the risk of acne. Food that should be avoided when one has acne includes Chocolate and Milk.

    It is also recommended to have a low GI (Glycemic) and high fiber diet. Having a low GI diet helps to eliminate spikes in your blood sugar levels, and these spikes produce sebum, an oily substance that causes acne to form.

  2. Using cosmeceuticals that are non-comedogenic.
    It is important to use non-comedogenic cleansers, moisturisers and sunscreens as they are unlikely to cause pore blockages and breakouts, which is the cause of acne.

Treatment Options for Acne

  1. Topical medication – benzoyl peroxide, retinoids eg. Differin and topical antibiotics
  2. Oral medication – antibiotics, isotretinoin
  3. Chemical peels eg. Glyclolic acid and salicylic acid peels
  4. Laser therapies.

    At Cove Aesthetic Clinic, we offer the following laser therapies:
    • Q switched Nd:Yag laser – helps with oil control, pore cleansing, kills acne bacteria and lightens acne marks

    • Fotona long pulse laser – a combination of long pulse laser settings to produce optimal effect on reducing acne swelling and inflammation. Also controls oil and reduces pore size.

Acne Scarring- Types of Acne Scarring

1. Post-Inflammatory Hyperpigmentation

Commonly seen as dark marks left behind by acne, it occurs when acne related inflammation causes discolouration of the surrounding skin. The marks can be of varying colours, most commonly black/brown or red.

2. Hypotrophic Scarring

These are scars that result from loss of tissue due to damage from the acne inflammatory process. Common types of hypotrophic scars include icepick, boxcar and rolling scars depending on the shape of the scar.

3. Hypertrophic Scarring/Keloids

Scars that grow above the surface of the skin and are a result of excessive formation of scar tissue after acne inflammation

Treatment of Acne Scars at Cove Aesthetic Clinic

Hypotrophic scarring:

  1. Fractional laser resurfacing
    A combination of erbium and carbon dioxide laser resurfacing. Fractional laser beams are broken up into smaller units, so they ablate between 25% and 40% of the skin’s surface, leaving the rest intact. The surrounding intact skin helps jump-start healing, stimulating the production of new collagen and the turnover of new cells. This over time causes scars to become shallower and less noticeable.

  2. Targeted filler injection
    Hyaluronic acid fillers can be directly injected into deep scars eg boxcar/icepick scars with significant reduction in depth of the scar

Hypertrophic/keloid scarring:

  1. Long pulse laser: helps to stimulate collagen remodelling and reduction in size of scar. Also reduces redness and vascularity of keloids.

  2. Intralesional steroid injection: Can rapidly cause reduction in scar size and height

AUTHOR: Dr. Ng Hong Yi, Aesthetic Doctor, Cove Aesthetic Clinic