What is Acne?
Acne is an inflammatory skin condition caused by the clogging of pores by excessive sebum and acne-causing bacteria on the skin, with the actual root cause remaining unknown. Although the majority of those who suffer from acne are adolescents going through puberty, there is a fair number of adults who suffer from adult acne. In addition, there are many different types of acneiform skin lesions and various factors leading to its development. Being a difficult skin condition to eliminate forever, many suffering from acne might feel that there are not many treatment options for acne. However, in actuality, there are many effective short-term and long-term treatments for acne.
When Should I Seek Treatment?
If you feel that you have persistent and stubborn acne on your skin, it is advisable to consult a dermatologist or doctor. These health professionals will be able to advise an appropriate treatment plan for you depending on your lifestyle and skin health. Some examples of treatment they will be able to advise you are topical, non-invasive, invasive treatments and medication.
Schedule a consultation today and start your acne recovery journey today.
Treatments for Comedonal and Mild Acne
Some over-the-counter treatments that can help with mild to moderate acne include:
Retinol is obtained from vitamin A, an essential vitamin for skin elasticity and overall immunity of the body. When applied topically, retinol helps with unclogging pores and treating acne on the skin. An additional perk of using retinol is that it has anti-ageing properties when used consistently, giving the skin a youthful appearance.
However, it should be noted that the concentration of retinol that can be bought over-the-counter is mostly low and more suitable for people with mild to moderate acne. Thus, if you suffer from severe acne, it is advisable to look at other treatment options as advised by a dermatologist or doctor.
2. Benzoyl Peroxide:
When looking for products for acne treatment, do look out for products containing benzoyl peroxide. Benzoyl peroxide helps to reduce the appearance of acne on the face due to its antibacterial properties decreasing the amount of harmful bacteria on the surface of the skin. Most products that contain benzoyl peroxide are in the form of a face wash or gel.
Similar to retinol, the concentration of benzoyl peroxide that can be found in over-the-counter products is mostly low and is therefore more suitable for those with mild to moderate acne. If you believe that you would benefit from a stronger acne medication or higher concentration of benzoyl peroxide, do consult your doctor or dermatologist!
3. Salicylic acid
Skincare products containing salicylic acid can aid with inflamed acne on the skin due to the compound’s anti-inflammatory properties. Salicylic acid has been seen to be more effective than benzoyl peroxide in some studies, therefore if you feel that benzoyl peroxide has not been working for your acne, you could try salicylic acid instead. Salicylic acid can appear in the form of serums, cleansers and even used in chemical peels for increased effectiveness.
If you feel that the above topical treatments have not been working for your skin and your acne is stubborn, invasive or non-invasive procedures might be for you! Invasive procedures tackle problem acne on the spot using surgical equipment and techniques, directly addressing stubborn acne. On the other hand, non-invasive procedures use equipment that is gentle on the skin and require a few appointments to see significant results. Here are some of the popular invasive procedures for comedonal and mild acne:
1. Blemish extraction
This acne surgery consists of removing blackheads and whiteheads using appropriate comedone extractors that put pressure on problem acne areas. Similar to the incision and drainage procedure, this technique uses sterilised surgical equipment to properly remove clogged pores.
The main difference between invasive and non-invasive procedures is mainly their downtime. If you are uncomfortable with surgical procedures and prefer procedures that are gentler on the skin, non-invasive procedures might just be for you! Non-invasive procedures have a significantly lower downtime, with many popular treatments allowing you to continue your daily routines immediately after the treatment. Some of the more popular non-invasive treatments offered for acne include:
1. Chemical Peels
Chemical peels are one of the most common acne treatments recommended by dermatologists and aestheticians for acne. There are three different types of chemical peels categorised based on their depth of penetration of the skin. However, those that are used the most for acne include the light and medium chemical peels. Some of the common chemicals used for these peels include salicylic acid and glycolic acid. These peels help with decreasing the amount of inflammatory and non-inflammatory acne on the skin, depending on the type of chemical used in the peel. For instance, the salicylic acid peel is more effective in reducing comedonal acne, such as blackheads and whiteheads. Your aesthetician or dermatologist will be able to recommend the most suitable chemical peel that you should try, determined by your skin type, condition and aesthetic goals.
Hydrafacials are an effective, quick and hassle-free way to cleanse your clogged pores, reduce sebum-production and increase hydration in the face, making it ideal for acne-prone individuals. This treatment works by first having a water-based fluid move throughout the skin, removing any dead skin cells, debris and oil on the top layer of the skin. Next, this treatment involves creating small suctions over the skin that allows for the extraction of dirt and oils from the pores of the skin. Apart from cleansing the skin, the hydrafacial also includes hydrating and pampering the skin with various serums that help to improve skin health and decrease the chances of acne recurring on the face.
3. Pro Yellow Laser (Pulsed Dye Laser)
As the name suggests, this laser treatment makes use of yellow lasers to get rid of acne, acne scars and other skin conditions such as melasma by targeting deep layers of the skin with next to no side effects. Not only that, this yellow laser is able to eradicate specific bacteria that cause acne, namely the P. acnes bacteria (Propionibacterium acnes), and also reduce the sebum production in problem areas. These effects of yellow light help to decrease the chances of recurring acne on the skin.
In addition to helping with acne, this pro yellow laser aids in collagen growth in the skin, aiding with the issue of ageing skin.
4. Carbon Laser Peel
This treatment makes use of both a carbon mask and a laser. The carbon mask is first applied to the face, after which a Q-Switched laser is used to remove this mask, along with the various debris on the skin. This technique helps to decrease the excess sebum produced by the skin, refining pores and improving skin texture.
Treatments for Moderate to Severe Acne
If you suffer from moderate to severe acne, it is advisable that you consult a doctor or dermatologist to reduce your active acne, before going for surgical and non-invasive treatment. They might offer you one or more of the following treatments:
Isotretinoin, commonly known by the brand Accutane, is typically prescribed when a patient has been suffering from stubborn severe acne. It belongs to a class of drugs called retinoids and is highly effective in addressing stubborn acne that has not responded well to other treatments. Isotretinoin works by reducing the size of sebaceous glands, which are responsible for producing excess oil that can clog pores and lead to acne. Isotretinoin also has anti-inflammatory properties.
2. Oral Antibiotics
Some common antibiotics prescribed for acne include doxycycline, minocycline and tetracycline. These medications have been shown to be effective for the treatment of acne lesions. These antibiotics work by targeting the bacteria that contribute to acne development, such as Propionibacterium acnes. By reducing the population of these bacteria, oral antibiotics help alleviate inflammation and control the occurrence of new acne lesions. Additionally, they possess anti-inflammatory properties that further aid in the treatment process. While the precise mechanism of action is not fully understood, these antibiotics are believed to inhibit the production of inflammatory substances involved in acne formation.
1. Incision and drainage
This procedure can help with existing severe acne on the skin such as cystic or nodular acne. This invasive procedure is conducted by making a small incision directly on the problem acne, after which the dermatologist or aesthetician empties the contents of the pimples with some pressure. After this procedure is done, the patient will experience a decrease in inflammation and pain the acne had been previously causing.
Although this procedure might seem similar to popping a pimple, it should not be attempted on your own. This is because when conducting this procedure surgeons or aestheticians make use of sterilised surgical equipment and contents are expressed via a controlled small incision. This then prevents scarring and bacteria from spreading across the skin which decreases the chances of the formation of more acne on the skin.
1. Cortisone Injections
If you have stubborn cystic acne, you can try out cortisone injections. These steroidal injections are known to reduce inflammation and pain of severe acne quickly. Some studies have also recommended steroid injections as a short-term treatment while waiting for long-term acne treatment, such as oral medication, to start. All in all, cortisone or steroid injections for acne can provide quick relief for patients with severe painful acne.
In order for moderate to severe active acne to receive other non-invasive treatment, they need to be treated with medication first. This medicinal treatment will allow the acne to become milder and treatable, after which your doctor or dermatologist will be able to recommend treatments most suited to your skin type and condition.
Treatments for Acne Scars
1. V-beam laser
V-beam laser, also known as pulsed dye laser, is a popular treatment option for addressing redness caused by acne. This laser technology specifically targets oxyhemoglobin, the red pigment found in blood vessels, to reduce their size and minimise redness. The laser emits a focused beam of light that is absorbed by the oxyhemoglobin, leading to its selective destruction of blood vessels responsible for redness associated with acne, without damaging the surrounding skin.
The procedure is generally well-tolerated by the skin and requires minimal downtime. Multiple treatment sessions may be necessary to achieve optimal results, depending on the severity of the redness.
It is important to consult with a dermatologist or skin care professional to determine if this treatment is suitable for individual needs and skin conditions.
For Crater Scars:
1. CO2 Fractional Laser
CO2 fractional laser is an effective treatment option for crater scars caused by acne. This laser technology works by delivering targeted beams of light that create microscopic channels in the skin. The fractional nature of the laser means that only a fraction of the skin's surface is treated, leaving surrounding tissues intact. The controlled injury from the laser stimulates the production of new collagen and promotes skin remodelling, which can help fill in the depressions of crater scars and improve the overall texture of the skin. CO2 fractional laser treatment can effectively smoothen the skin, reducing the depth and visibility of the scars. The procedure is usually performed under local anaesthesia or with the use of a topical numbing cream to minimise discomfort. Downtime is typically required after the treatment, as the skin undergoes a healing process and may appear red, swollen, or flaky. Multiple treatment sessions may be necessary to achieve optimal results, depending on the severity of the crater scars. It's crucial to consult with a dermatologist or skincare professional experienced in CO2 fractional laser treatments to assess the suitability of the procedure for individual needs and scar characteristics.
2. Hyaluronic acid injectables
Hyaluronic acid injectables are a popular treatment option for addressing crater scars caused by acne. Crater scars, also known as atrophic scars, are characterised by depressed or sunken areas in the skin. Hyaluronic acid is a naturally occurring substance found in the body that provides hydration, volume, and structure to the skin. When used as an injectable filler, hyaluronic acid can help plump up and elevate the depressed areas of the skin, effectively filling in the craters and making the skin surface more even. The injectable procedure is typically performed in a clinical setting, where a dermatologist or aesthetic healthcare professional carefully administers the hyaluronic acid into the targeted areas using fine needles.
The results are immediate, with improved skin texture and a reduction in the appearance of the crater scars. The effects of hyaluronic acid fillers are temporary, lasting several months to a year, depending on the specific product used and individual factors. Repeat treatments may be necessary to maintain the desired results. It's important to consult with a qualified professional to determine the most suitable hyaluronic acid injectable and treatment plan for individual needs and scar
1. Pico Laser
Pico laser is a laser treatment that can effectively help with hyperpigmentation caused by acne scars. This advanced laser technology works by delivering ultra-short pulses of laser energy to the skin in picoseconds (trillionths of a second). By emitting such rapid and intense bursts of energy, pico laser breaks down pigmented cells responsible for the hyperpigmentation, such as melanin, into smaller particles. These smaller particles are then naturally eliminated by the body's immune system, leading to a reduction in hyperpigmentation. Pico laser not only targets the surface layers of the skin but also reaches deeper layers, stimulating collagen production and promoting skin rejuvenation. This helps in gradually fading the appearance of acne scars and achieving a smoother, more even complexion.
Pico laser treatments are typically performed in a series of sessions, depending on the severity of the hyperpigmentation, with minimal discomfort and downtime. However, it's important to consult with a dermatologist or skin care professional to determine if pico laser treatment is suitable for individual needs and skin conditions.
2. Q Switch Laser
Q-switched laser is a widely used treatment option for addressing hyperpigmentation caused by acne scars. This type of laser delivers high-intensity, short pulses of laser energy to the targeted areas of the skin. The laser energy selectively targets and breaks down the excess melanin, which is responsible for the dark pigmentation in acne scars. As the excess melanin is fragmented, the body's natural healing processes gradually eliminate the pigmented particles, leading to a reduction in hyperpigmentation. Q-switched lasers are capable of reaching deeper layers of the skin, effectively treating even stubborn and deep-set acne scars.
The treatment is generally well-tolerated, with minimal discomfort and downtime. However, multiple treatment sessions may be required, spaced several weeks apart, to achieve optimal results. It's important to note that q-switched laser treatments should be performed by experienced dermatologists or skincare professionals to ensure safe and effective outcomes. Consulting with a medical professional will help determine if q-switched laser treatment is suitable for individual needs and skin conditions.
This blog post was medically reviewed by Dr Summer Zhang.
3. D. Castillo, J. Keri. (2018). Chemical peels in the treatment of acne: patient selection and perspectives. DOI: 10.2147/CCID.S137788