Acne lesions can be of several types.
Comedones – blocked pores, black heads, white heads.
Papules – painful, red, raised bumps.
Pustules – small pus-filled boils.
Nodules – painful, hard, red lumps inside the skin.
Cysts – large, painful, boils that ooze blood and pus.
Grades of acne
Grade 1 – Comedonal acne
When acne is in the form of whiteheads and blackheads it is called ‘comedonal acne’.
These comedones or blocked pores may eventually get infected by Cutibacterium Acnes and turn into inflammatory papules and pustules.
Grade 2 – Papulo-pustular acne
When acne is dominated by painful, red bumps called papules and pus-filled small boils called pustules, it is called ‘papulo-pustular acne’. Black heads and whiteheads may also be present but are fewer in number.
Grade 3 – Nodulo-cystic acne
This type of acne has large, hard, extremely painful lumps under the skin called ‘nodules. These nodules may eventually turn into large, painful, soft boils that ooze pus and blood called cysts.
Grade 4 – Acne conglobata
This is the most severe form of acne. Here, several pus oozing boils seem to join and form large, painful areas. Most common areas involved are the cheek or chin.
Mild acne can be minimized with proper skin care.
But moderate/severe acne require medical treatment.
Scars might occur if acne is not treated and can be concerning as they affect the psychology of the patient.
Various treatment options available for acne scars include treatments like creams, chemical peels, MNRF, Laser etc.
Treatment for acne includes life style modifications, healthy diet, disciplined skin care routine and medical treatments depending upon the stages of the acne.
Acne Treatment Creams / Topical treatment:
Topicals include creams/gels/ointments such as benzoyl peroxide, Salicylic acid (exfoliant) , antibiotic creams to reduce bacterial growth (clindamycin, dapsone, nadifloxacin), retinoids, salicylic acid, azelaic acid etc.
These help in controlling the breakouts and decrease sebum production.
Usually given in conjunction with other treatments.
Retinol cream and gels
Retinoids are Vitamin A like substances which remove dead cells and reduce inflammation.
Use creams and gels containing this ingredient.
Some of the popular ingredients are Adapelene and Retinol.
But these products have few side effects also.
The most common side effects of these acne creams are redness, irritation, rashes and pigmentation.
Hence you need a short application time along with lots of sunscreen and moisturizer.
Antibiotic creams and gels
Cutibacterium acnes is the most common bacteria causing acne.
Antibiotic creams, gels and lotions are used to stop this bacteria from growing.
Ingredients such as Clindamycin, Dapsone and Nadifloxacin are used in the treatment of grade 2 and grade 3 acne.
The main drawback of these gels is that the bacteria can rapidly develop resistance to antibiotic creams.
Exfoliating creams
Exfoliating creams rapidly remove dead skin cells and speed up skin recovery.
Exfoliating ingredients such as Salicylic acid, Benzoyl peroxide and Alpha hydroxy acid along with antibiotic creams are recommended.
Important: One important thing to remember is that you should never combine exfoliating creams with retinoids. This is because it can cause severe irritation and burns of the skin.
Oral:
Oral antibiotics are prescribed for treating moderate to severe acne.
Medications used are doxycycline, azithromycin, minocycline etc.
Oral Retinoids are used in treatment of moderate to severe, resistant and nodular cases.
Hormonal therapy is generally advised for women with hormonal acne and who need oral contraception.
Advanced Acne Treatments:
Chemical peels:
Chemical Peels are used in combination with other treatment modalities.
Many different types of peels such as BHA, TCA etc are used to treat various types of acne.
Know more about chemical peel treatment here https://drshreyadas.blogspot.com/2023/10/chemical-peel.html
Light and Laser based therapy:
Laser therapies are used to target cutibacterium acnes, leading to production of free radicals which destroy the sebaceous glands.
Non ablative laser like Q Switch Nd:Yag laser are used. This treatment is also popularly called Carbon Facial. It clears your pores and reduces blackheads and whiteheads. It also kills acne causing bacteria and reduces excess oil. This gives you a clearer and brighter skin tone.
Red light (inflammation) or Blue light (C.acnes) or blue-red low level laser therapy is used for a short duration to control acne.
LED Light Therapy
Blue LED light is a part of mild to moderate acne treatment. Blue light reduces the activity of sebaceous glands without any skin irritation. So they produce less oil.
Besides this, blue light may also kill the acne-causing bacteria or P. acnes.
HOW TO REMOVE PIMPLE MARKS/DARK SPOTS?
Pimple marks are caused by popping of pimples or direct pressure, which leads to bleeding, red spots or dark spots.
Skin lightening creams like retinoids, glycolic acid, azelaic acid, kojic acid etc are used to remove dark spots which takes around 4-6 months.
Combination with chemical peels or lasers gives desired results in short time.
WHAT IS USED FOR ACNE TREATMENT?
Depending on the stage of the acne, the treatment used varies from maintaining good skin care with face cleansers, moisturizers and medical treatments such as anti-acne topical and oral tablets.
Acne scars need procedures such as chemical peels, TCA CROSS, MNRF, laser etc.
WHAT IS COMEDONAL ACNE?
Comedones are the primary stage of acne, caused by blockage of oil producing gland.
When the pore is clogged with sebum secretions it is called as white head/open pore/white acne (comedone).
The white head oxidizes on exposure to air, forms black head/black acne/closed pore.
Seen on forehead, cheeks and chin.
The best treatment for comedonal acne is daily application of retinoid in night.
WHAT IS THE BEST AND SAFE TREATMENT FOR ACNE?
Acne is treated by combination of topical such as retinoids, Benzoyl Peroxide cream, antibiotics along with oral treatment depending on the stage of acne.
This is the best and safe treatment when followed by good skin care plan.
DOES PCOD/PCOS CAUSE ACNE?
Yes. PCOD or PCOS aggravates acne due to underlying hormonal imbalance.
The acne lesions are commonly seen in jaw line and chin.
WHAT ARE THE CHEMICAL PEELS USED FOR ACNE?
Chemical peels used for acne are BHA like salicylic acid, mandelic acid peel, azelaic acid peel etc.