• What is acne?
• Acne treatments
• Frequently asked questions

• It appears to be hereditary,  affecting 95-100% teenage boys, 83-85% teenage girls however,  acne lesions affect the adult female population predominately.
• It typically begins during adolescence, when hormonal changes cause enlargement of sebaceous glands.  Acne may present as both open (whiteheads) and closed comedones (blackheads),  inflammatory lesions such as red pimples, pus filled or cystic .  The condition often results in scarring and pigmented marks (post inflammatory hyperpigmentation).

• It is a multifactorial disease

• Acne occurs in skin that has densest population of sebaceous follicles: facial and upper body areas. In fact, the facial, neck and chest areas have approx. 900 sebaceous glands per cm2 as opposed to less than 100/cm2 over the rest of the body areas. The amount of sebum produced and acne grade are strongly related.

Classification

Grade I : comedones only (blackheads)
Grade II: comedones plus papules (blackheads and red pimples)
Grade III: comedones, papules plus pustules (blackheads, red pimples and infected pimples)

Grade IV: comedones, papules, pustules and cysts   (blackheads, red pimples, infected pimples and deep seated infection, often painful )
                                                             
Each category may be further divided into mild, moderate or severe cases.

(Therapeutic Guidelines: Dermatology 1999 Version 1,Therapeutic Guidelines Limited)

• The over production of dead skin cells in the follicles causes obstruction.
• A usually friendly skin bacteria called Propionibacterium acnes (P. acnes) is involved in the pathogenesis of inflammatory acne converting non inflammatory acne to an inflammatory one. P. acnes bacteria incites the wall breach and is involved in the pro inflammatory cascade that follows.
• Acne Inflammation: the process involves lymphocytes and neutrophils (white blood cells) affecting the wall of the closed comedone,  if breached the extrusion of irritants into the deeper skin (dermis) leads to a variety of lesions The inflammatory acne lesions often result in permanent scars
• Acne is often painful, disfiguring and permanent scarring is common. (Farrar & Ingham, 2004) For this reason, its effects are not only physical but also social and psychological.  Acne negatively affects quality of life and increases the risk of anxiety and depression. (Yazici, et. al. 2004)

There are several drugs which are regularly prescribed for acne. These include anti-biotics, contraceptives, hormone therapies and isotretinoin (Ro-Accutane). There is a growing concern with the use of some of these therapies particularly due to potential problems and adverse side effects that they may cause.

Anti-biotics are commonly prescribed. Unfortunately the use of anti-biotics can lead to the development of antibiotic resistance.  The incidence of bacterial resistance has increased dramatically over recent years and the necessary long-term use of these drugs is likely to contribute to the pool of resistant bacteria.

Teenagers are the main population who suffer from acne and thus may be adversely affected by hormone based drugs and isotretinoin due to their emotional volatility. In fact, acne by itself can be associated with depression, so the combined effect may be amplified due to teenage vulnerability and these drugs which may elicit strong emotions.  Despite their effectiveness, these drugs carry common side effects as well as risks of severe side effects including birth defects and depression.

In recent years, advancements in light therapy and clinical treatments have given acne sufferers alternative treatment options. Concomitant use of light therapy or clinical treatments and topical use of vitamin A reduces the sebaceous secretion, inflammation and reduces post inflammatory hyper pigmentation associated with acne scarring.

Our clinicians at Melbourne Laser & Aesthetic Centre target acne and acne scarring using several modalities.  A multifactorial disease such as acne needs a multifaceted approach. Various methods are used to address inflammatory lesions, sterilize the skin, reduce the obstruction of the follicles, control sebum production and to encourage systemic balance through use of wholistic remedies. Specific combinations of vitamins and other oral supplementation are recommended to improve clearance of acne lesions and to improve skin healing.

Our clinicians will develop a clinical treatment program to address your acne condition and any specific concerns you may have.  A homecare program will also be required to further enhance and maintain results. Various modalities may be included in such a program; Laser/ IPL therapy, peeling, medical microdermabrasion, advanced penetration of  corrective remedies by iontophoresis/sonophoresis infusion are combined to achieve outstanding results.  Post acne scarring is also targeted simultaneously.  Deeper scars will require scar revision once acne has resolved.

A consultation is time spent speaking with you about your skin concerns.  It is an important time when we can assess the grade of acne, scarring, any medical history, offer advice and develop a program that suits your particular needs.

Recent advancements in cosmetic science have resulted in more effective skincare. Cosmeceutical ingredients which have been scientifically verified are used in various strengths to treat skin efficiently. The skincare products used and recommended in our clinic are medical strength.  In order to obtain results quickly, it is advisable to use products recommended as they provide daily application of essential cosmeceuticals.  Our clinicians will develop a program of acne treatments and products which will suit your budget.

A treatment program will address your type of acne condition. We aim primarily to clear acne lesions, reduce inflammation and enhance the healing process. This initial stage may take 4-6 weeks depending on type and frequency of treatments required. Homecare topical treatments, supplements and monthly maintenance treatments will continue to keep the skin clear.