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Acne

21 December 2016

pimple

Acne

What is acne?

Acne is a common skin condition that is manifested by outbreaks of skin lesion commonly called pimples.

Acne lesions occur mostly on the face, neck, back, chest and shoulders.

People commonly affected with this condition are those within 14-19 years old age group, although people in their 20’s and 30’s may also experience acne, sometimes reappearing at menopause.

Acne is characterized by comedones which are formed when the openings of hair follicles become clogged with oil secretions and dead skin cells.

Although acne is not a serious health threat, severe acne can lead to pitting, permanent scarring and psychosocial impact.

Acne occurs mainly during puberty, when the sebaceous gland are stimulated by increased hormone levels, especially the androgens (example testosterone) , resulting in excessive sebum production. In a person early to mid 20’s, hormone production stabilizes and acne usually disappears.

How to know acne?

Patient presents with red spots or red bumps located on the face, neck, chest and/or back.

  • If the spots/bumbs inflamed and the bumbs appear with pus probably a nodule or cyst, the most severe form of acne which is more painful and is more likely to result in scarring.
  • If no bumbs appear, it probably a papule or an infected/inflamed comedone which appears as a small, hard, red bump on the skin.
  • If the inflamed bumps large and numerous, it probably a pustule which is characterized by a yellowish pus at the center.
  • If the spots not inflamed and there are a tiny dark spot at the center it probably a blackhead which is a small plug of oxidized material (black dot) sticking out from the bump.
  • If there are no spots at the center, it probably whitehead or a closed comedone which appears as a tiny, white bumps on the skin.

How to avoid from acne?

  1. One or twice daily washing with mild, non-drying soap or soap substitute (not an antiseptic) is sufficient. There is no need to wash the face frequently.
  2. Avoid using astringent, abrasive scrub or harsh soaps.
  3. Keep hair off the face. Hair especially if greasy can worsen the blocked pores.
  4. Application of oil, oil based product and grease can aggravate acne.
  5. Use water base cosmetics instead of cake make up.
  6. Remove make up with gentle make up remover before going to bed.
  7. Avoid touching the face with hands or fingers.
  8. Avoid squeezing or pricking pimples. This will increase the amount of secretions in the area, promote infection and cause scarring.
  9. Avoid wearing tight-fitting clothes that can trap heat and moisture and can irritate your skin.
  10. Take a shower after performing heavy activities. Dirt and bacteria can be trapped on skin when oil and sweat are present.

Treatment of acne

  1. Mild acne

The majority of people who get acne will develop mild acne. This can usually be treated with OTC medications that can be brought to pharmacy with or without doctor’s prescription. There are usually applied on the skin-topical medicines.

Most acne OTC product may contain the following ingredients;

  • Resorcinol
  • Helps break down blackhead and whitehead. It also used in treatment of dandruff, eczema and psoriasis.
  • Benzoyl peroxide
  1. Kills bacteria and slows down your gland production of oil. It works as a peeling agent, accelerating skin turnover and clearing pores which is reduces the bacterial count in the affected area.
  • Salicylic acid
  1. Helps break down blackhead and whitehead by reduces shedding of cells which line the follicles of the oil gland, effective in treating inflammation and swelling.
  2. It also prevents pores becomes block by shed the epidermis to shed skin more easily and the same time allowing room for new cell to grow.
  • Sulfur
  1. Helps break won blackhead and whitehead.
  2. It act as mild reducing and antibacterial agent
  • Retin-A
  1. Helps unplug blocked pores and act as chemical peel
  • Azelaic Acid
  1. Strengthens cell that line the follicles, stops oil eruption and reduce bacteria growth.

You can buy acne medications in the form of gels, soaps, pads, creams and lotion. If your skin sensitive, you may prefer a cream or lotion. Gels which are usually alcohol-based and tend to dry skin are better for oily skin.

You may experience skin irritation, redness or burning when you first try them. Usually it will go away after continued use. If do not, you should see your doctor.

  1. Severe acne

If your acne is severe, you should consider seeing a dermatologist. You may be prescribed an oral or topical antibiotic. Antibiotic can combat the growth of bacteria and educe inflammation. Most commonly Erythromycin, Tetracycline and Clindamycin are prescribed for the treatment. Antibiotic are not taken for more than six month cause can developed resistant to the antibiotic.

  1. Cyst treatment with corticosteroid injection

If the acne becomes severely inflamed, there is high risk of rupturing and can result in scarring. The corticosteroid injection can treat the inflamed cyst and to prevent scarring. It also will lower the inflammation and speed up healing and the cyst will melt within few days.

  1. Oral contraceptives

The majority of women with acne find taking certain oral contraceptive help clear the acne. Oral contraceptives suppress the overactive gland and are commonly used a long term treatment for acne in women

Summary

  • Acne does not mean that the patient is dirty or unhygienic, but dirt can make it worse.
  • Appropriateness and effectiveness of treatment varies from person to person depending on several factors e.g the cause of acne, the person skin type, age, lifestyle and the kind of acne lesions.
  • Eating balanced diet also contributes to a healthy skin
  • Relax every now and then as stress is also a factor in the development of acne

By Pharmacy Department, Sri Kota Specialist Medical Centre

References

  1. MIMS Pharmacy Malaysia 2013/2014
  2. http://www.medicalnewstoday.com/articles/107146.php
  3. http://patient.info/health/acne-leaflet