There are only three things you really need to remember.
Acne is due to the mess-up of the piliosebaeous gland. This gland is like a bag that produces oil (you may call it sebum if you like to be medical sounding). So acne occurs when there is too much oil being produced, the opening of this bag or the pore gets clogged for whatever reasons. At this stage you can get small acne, known as a comedone. To add to this event, the small number of bacteria, known as P acnes, feeds on this oil and goes into a bunny frenzy and reproduces by a thousand times./ multiply. The body now realizes that there is a whole colony of bacteria in the skin in this gland. It thus sends all its excellent fighting cells to destroy the bacteria, at this stage, the comedone evolves to an ever enlarging pustule. The bacteria, the white cells, the casualties all form the white pus that you like to squeeze out so much. The fighter cells are capable to produce lots of powerful enzymes to kill the bacteria, these act really like bombs and burn down all the houses, which in this case would be the collagen fibers,
leaving a huge hole in the skin. The fighter cells wins almost everytime that’s without question, the question is how long it takes and how much damage it takes to bring the P acnes colonies down. You can imagine, where your acne scars come from.
Anyways how do we treat it.
1 st : and foremost, we need to reduce the amount of oil being produced by these glands. The most effective way would be to use some form of vitamin A, oral or topical. We can also use laser treatments to reduce oil production. So roaccutine, nimegen, retin A creams all work to reduce sedum production. This is the root cause and thus also the most effective and fundamental of treatment.
2 nd : Next, lets target the sky rocketing growth of the P acnes. These are bacteria and thus will be killed much more efficiently by antibiotics then the enzymes of the fighter cells. You can choose from oral to topical antibiotics. You can also add on blue LED light that also targets these bacteria.
3 rd : Lastly, remember the pores get clogged up. Here we can use chemical peels or topical creams that peel the skin gently. We also have an option of carbon laser peel. Other than that, you need to remember what your mums tells you about washing your face after using make-up, after going out, especially when working in polluted environment. I used to have some stage actors / actress who use lots of heavy make- up. These people did not used to have acne, it all started only after going on stage. I also need to add a little more things to this simple concept for you to have the complete picture. Stress is a huge factor in the starting of many acne breakout, if there is anyway you can relieve your stress including lashing out on the poor doc, please go ahead, as long as it treats your acne and our mission is accomplished.
The other thing would be hormones.
Some ladies have high raves of hormones running through their body whenever they are going to have or having the menses. Guys learn to be patient and totally blur about the visual and audio effects of PMS. If your acne is very cyclical, getting bad for no other possible reason every month, think about your partner and your acne. Get your self onto a good contraceptive for your own good. We recommend Diane 35. It will regulate the raves of hormones and help both your behaviour and the acne.
So all that been said what treatments do we reccomend for Acne scars,
We call acne scars acne scars when you see visible depressions on the skin. You can think of it as small chunks of skin tissue being damaged and being lost so that you get holes in the skin. We have all types of holes as like the human beings. There are various form of hole formation in the skin that varies in shapes and sizes.
We have tall and thin holes and flat and short but large holes. Tall and thin we also call them pits – they look like large deep pores. Short, flat but large holes – can be called box scars. If the scars are even larges and more shallow, we can call them rolling scars.
From my point of view, we respect two types of scars mainly, pits and box scars. They are permanent and unless treated will not change. These are scars can be pits or boxes but have very sharp edges and have angular shapes. When they occur, they usually come in a large company that covers almost the entire surface of the face.
There is only one common history with all patients that have such scars: they have been extensively treated by an enthusiastic beauty therapist. There is an irony in this. Every time I see these scars and such faces, the close-up image of the curved, smooth nail squeezing the daylights of the acne comes to mind. Yes, these are the work of human fingers. The shape of the scar is also characteristically similar to the shape of nails. Be warned. Back to the treatment of acne scars, first things first, its heavy stuff, and will not be treated by small stuff. Don’t be tricked to believe that diamond microdermabrasion or light fruity peels will do the trick. They do not go anywhere near to having any effect at all. The problem of scars is that it penetrate deeper than the surface while these treatments are rather superficial. These scars go v deeply into the skin structure and unless you can do something deep, anything superficial is just not sufficient. Chemical peels done in our region, consist mainly of light peels using glycolic acid. Even TCA peels are done lightly locally. To get any results, you need a medium to deep peel and that means 3-6 weeks out of action. No one in the tropics does this any more. Our climate, our skin type and our work lifestyle just do not allow us to do such deep peels. Basically I am sick of hearing patients telling me how effective simple chemical peels are for their scars while still seeing the scars deep as before maybe. It just doesn’t work. You need to go deep. Even if you are using a laser to do micro peeling, its not going to give you much help.
To go deep, we have to use fractional laser that makes small holes in the skin, these holes can go deep and transform the scar structure. In between the holes are healthy tissues that allow the healing to be fast and downtime to be corresponding lesser, even then it is still about 3-4 days of have slightly dull and peeling skin.