Acne vulgaris, or simply acne, affects 80-90% of the population, usually during adolescence. Genetic predispositions are usually a factor. During puberty, both sexes increase production of the androgen hormone, resulting in the formation of pimples. In adulthood, there can be several reasons for acne. Some cases require serious examination since some hyper-androgenic syndromes such as the most common PCO (Polycystic Ovary Syndrome) affect many young girls and older women without them even knowing it. The simple appearance of pimpled skin can call attention to the need to treat such a condition which, if left untreated in the long term, can cause infertility. It is the responsibility of the attending doctor to conduct a thorough examination of the possible background causes for such acne.
There is no need for such examinations in the vast majority of cases in adolescence. In the case of suspicious symptoms like abnormal weight gain, deepening of the voice, or abnormal hair growth or hair loss, endocrine controls are recommended even for adolescents.
In the case of unexpected symptoms or symptoms carrying over into adulthood, a thorough examination should always precede or accompany the treatment.
Such an examination includes: a search for foci of inflammation, which discovers any possible internal inflammation or infection; exploring for problems in digestion or gastroenterological problems; eliminating the possibility of food intolerance; an endochrinological examination which reveals any hormonal or metabolic abnormalities. Sometimes, periods of high stress can provoke symptoms. The role of nutrition is not entirely clear, but clinical studies appear to show that there is a correlation between consumption of foods with a high glycemic index and the appearance or worsening of acne. Consumption of dairy products can worsen symptoms of acne in certain cases.
A pimple is formed by a hair follicle being blocked by the accumulation of dead epithelial cells, and by the increased production of sebum which blocks the pores. In such cases, a bacterium called Propionibacterium acnes also grows, which is responsible for producing acne.
First a comedo appears which which can be closed (whitehead) or open (blackhead). In adulthood, this phase of acne often doesn’t occur. If the blackhead becomes inflamed then small red pimples appear which, in severe cases, can turn into deep lumps or painful, interconnected abscesses.
A serious complication of acne is the formation of scar tissue. One of the most important goals when treating pockmarked skin is preventing the formation of lasting scars. Such scars usually appear as pitted craters of varying shape on the skin. In rare cases, protruding, hypertrophic scars can appear following abnormal healing. Mild cases can be treated with topically applied skin cosmetics or prescription medicated creams and solutions. In stubborn cases, we can supplement home therapy with chemical peels in the dermatology clinic. If there is a risk of scarring, we always use internal medication therapy. We may use internal antibiotics or medication therapy that regulates the function of the sebaceous glands, depending on the severity of symptoms.
If scars have already formed, sometimes accompanied by brownish splotches, then we may choose from a number of treatment methods and sometimes even apply a combination of several treatments. It is always easier to completely eliminate fresh, superficial scars than to correct deep acne scars that have been neglected for years. It is never too late, but it doesn’t hurt to start early.
- fractional carbon dioxide laser treatment
- shortwave radio frequency
- derma roller
- chemical peels
- PRP, bio-filler treatments