Severe Acne will be controlled effectively with the help of a professional dermatologist

Health

Sat 14 Aug, 2021

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acne acne forehead

By Dr. Ronald Katureebe

Acne is a common skin condition that usually manifests with black heads, whiteheads or pus filled spots on the skin known as pustules. It mostly occurs during the puberty stage and most people will be affected by this condition in their teenage years.

In most cases, Acne disappears for most people while they go through their early twenties however in some cases it may persist beyond that.

It may also occurs for the first time in one's late twenties and beyond while in some cases children may also develop blackheads or pustules on their cheeks and beck.

Acne spots usually cover the neck, face, back and chest and in severe cases may lead to scarring and loss of self confidence.

What Causes Acne?

The sebaceous (oil producing) glands of people with acne are usually more sensitive than those of other people.

As a result of this, these glands produce excess oil which when combined with dead skin that is not shed properly because of the thickened lining of skin pores leads to clogging of the skin pores forming white heads and black heads.

Acne bacteria known as Cutibacterium acnes lives normally on the skin of every one but an ideal environment in those with acne is created by the build up of excess oil causing this bacteria to multiply.

As a result of its multiplication coupled with inflammation, red spots some times swollen with pus manifest on the skin.

In some cases acne can be caused by medication given for other health conditions including particular types of pills and injectables for birth control.

A high glycaemic index diet can also lead to or exacerbate acne. This diet includes foods like sugar, white rice, sugary foods, potatoes consumed frequently.

While many acne sufferers have normal hormone levels, hormonal problems can also cause acne and the most common here polycystic ovarian syndrome in females.

Females having irregular periods, excessive hair growth or loss are therefore advised to make this known to their Dermatologist when suffering from acne.

Genetic predisposition can increase the chances of one getting acne but this goes hand in hand with one’s diet and life style.

Signs and Symptoms of Acne

It usually shows with oily skin, red spots, black heads, white heads and pus filled pimples.

Occasionally it manifests with nodules (deeper bumps) which may develop into cysts which resemble boils. Affected skin may feel hot, painful and tender to touch.

Some of the effects of acne on the skin include scarring around the nodules and cysts. These may be raised and lumpy or indented.

Acne in some cases leads to discolouration which may be red, hyperpigmentation (darker than normal) or hypopigmentation (lighter than normal) for affected areas of the skin.

Studies have also shown that acne has negative psychological effects in severe cases leading to depression and suicidal tendencies. It is advisable to seek medical attention fast as soon as one develops such tendencies.

Treatment of Acne

It should be noted that there is no definitive cure for acne at the moment however treatment can be given to prevent scarring and occurrence of new spots.

Over the counter treatments may work for mild acne but may not be effective in combating moderate or severe acne due to a number of factors and it is for this reason, it is recommended that you visit a Dermatologist for proper diagnosis and treatment.

The key forms of treatment given for acne include topical treatment for those with mild to moderate acne and this is applied directly to the skin. It’s usually the first line of treatment in most cases.

The common ones include antibiotics, benzoyl peroxide, retinoids, azelaic acid and nicotinamide. It is advisable to apply it onto small areas to gauge if one’s skin reacts and then it can be applied to the entire affected area if there is no reaction.

Oral antibiotics may also be recommended by your dermatologist, usually erythromycin or tetracycline and may be taken alongside topical treatment. These should be taken for a minimum of two months or until there is no further improvement, however recommended usage is 3 to 6 months.

Some antibiotics shouldn’t be taken along with food as they may make the skin more sensitive to the Sun. A number of these antibiotics are not advisable to take when pregnant therefore you need to discuss with your dermatologist if you are planning to get pregnant during treatment.

Some oral contraceptives can also be used as treatment for acne. These ones contain a hormone blocker for example cyproterone acetate which reduces the amount of oil the skin produces.

These are also used in prevention of pregnancy but carry an increased risk of blood clot therefore before using them one should consult with their doctor especially if they have a history of blood clots.

Isotretinoin is another effective treatment used to treat severe and persistent acne. This medication is usually taken for 6 months with results not being immediate but progressive and it is very effective in the long-term. In some cases acne may increase in the short term when this medication is started but it later clears out giving a long lasting improvement.

However this medication is not given to pregnant women as it affects the unborn child. Women going to start on it are advised as a result to start on pregnancy prevention pills weeks before starting on this medication and to continue taking them for at least 4 weeks after.

Among other side effects Isotretinoin has also been associated with increased mood swings, depression and suicidal behaviour which are all already linked to severe acne.

It is therefore only prescribed under the guidance of a dermatologist having considered all factors including one's medical history.

The scarring from acne can also be removed or reduced using light and laser treatment through a procedure called laser resurfacing mainly for facial skin . However studies have shown this may not be 100% effective.

This also requires an experienced laser surgeon and should only be done at least a year after completing prescribed acne treatment.

Subcision, microneedling, steroid injections and skin camouflage for disguising Pigmentation changes can also be used to deal with the effects of acne scars.

Self care tips for acne

Use recommended cleansers and soaps for your skin type

In case you are to use make up it should be labelled non comedogenic i.e doesn’t leave white or blackheads behind and also non acne genic.

Avoid squeezing the acne spots as they may lead to inflammation, infection and scarring.

Seek social and medical support if you feel moody and depressed.