What are the probable causes of Acne vulgaris (Pimples/zits), acne scars & what is the best treatment for Acne?
a) Acne can be manifested in the form of small bumps over the skin of the face, back, chest, thighs, buttocks, arms, and the scalp. These bumps may be white called s whiteheads or may be black known as blackheads, pus filled, red or pink in colour or in hard and big nodular form. When these bumps have healed, they leave behind dark coloured marks and at times pitting acne scars on the skin which can result in bad disfigurement of the skin.
b) Zits/pimples are most commonly observed in teenagers; however they can go on until late twenties and thirties. They may suddenly show up at the time of pregnancy and refuse to go there after. Some people may get these when they reach middle age whereas in case of women they may get it at around menopause.
c) Why do acne occur? Acne vulgaris is usually associated with hormonal changes impacting the skin in teenage. Pregnancy, heredity, hormonal abnormalities, polycystic ovarian syndrome (PCOS), high levels of P. Acne bacteria in the skin, certain medications, etc. Are some of the factors responsible to cause acne. The role of food resulting in acne is a matter of controversy; although, if anybody observes that a particular food item is causing your acne to increase, you should avoid it.
d) It is very important to get your skin examined by a skin doctor/ cosmetic dermatologist when required, particularly in case of severe and persistent acne, so as to find the underlying cause if any and prevent discolouration and scarring.
e) Your Skin Specialist/ Dermatologist may prescribe lotions, creams, face washes or tablets as a treatment. Skin pigmentation and scars need to be treated with chemical peels, microdermabrasion, dermarollers etc. Based on the intensity of the problem, with the most recent being the Fractional Laser technology which is available at some centres.
f) Chemical peels may prove to be useful in case of mild acne scars and for pigmentation post acne. Multiple sessions of treatment are required. A wide range of peels are available ranging from TCA, glycolic, salicylic, lactic, retinoid, arginine, yellow peel, green peel, blue peel, etc.
g) Microdermabrasion also referred to as skin polishing, is beneficial for mild acne scars. It can be carried out with diamond crystals or powder crystals. Multiple sessions are needed. Just recently, advanced microdermabrasion followed by serum infusion (Hydrafacial) is available at few of the skin centres.
h) Dermarollers are small hand held instruments having very fine needles attached to them, which trigger production of collagen when applied to the skin. This treatment requires multiple sessions and can be used to treat mild to moderate acne scars.
i) Fractional lasers are available in 2 varieties: ablative and non – ablative. Certain studies in the western world report better results with the ablative variety. Nevertheless, there are not many studies done yet on the comparison between the two on Indian skin. Though, if you ask me, I agree with the world literature.
The ablative type has 2 varieties – the Fractional CO2 laser treatment and the fractional erbium YAG laser. In case of laser treatment for acne scars, the Carbon Dioxide Laser (CO2 laser) may be used for intense and deep acne scars whereas the Erbium Yag Laser is used for shallower acne scars. Both the carbon dioxide lasers (CO2 laser) as well as the Erbium Yag lasers, need multiple sessions, the Erbium YAG laser more so than the CO2 laser. Darker Indian skin types do pose a risk of post laser hyperpigmentation. Hence, appropriate selection of the patient, the practitioner’s experience with lasers and appropriate skin care after the laser treatment are the key to have the best and successful results. However, when moderate to severe scarring is involved, the results cannot be 100%, but they can be satisfactory and improve the skin to a great extent.
j) It is always advisable to seek an expert/ top / best dermatologist / laser skin expert’s opinion and get your skin treated in time, rather than experimenting on your skin with your own or peer recommended therapies and then seek advice after the damage has been done. Every individual’s skin is different and requires personalized care.