Acne! That dreaded word that I absolutely hated in high school. I had it, and I had it bad. I spent hours trying to wash my pimples off with all sorts of products recommended to me by my pharmacist cousin, but nothing seemed to work. I eventually grew out of my pimple problem after leaving high school, but the damage was done.

Timonthy Stuurman elaborates…

In hindsight, I would have given an arm and a leg for some expert advice. So, in foresight, here is some advice for you from the founder of Cape-based Derma Clinic, Dr Ilsa Orrey, who says that ‘Acne vulgaris is a condition that can be treated successfully if approached correctly. Scarring and pigmentation can be avoided. It is not necessary to battle through teenage years with pimples/acne, but it is important that you get the proper advice and treatment.”

So, how do you get rid of it? Firstly it’s important to bust the myths surrounding acne.

Have you ever been given any of the following advice?

“Washing your face regularly prevents/cures acne.”
“Acne in the centre of the face or around the mouth is “hormonal.””
“Stress causes acne.”
“Smoking doesn’t affect acne.”
“Eating chocolates causes acne”
“Eating greasy foods causes acne”
“Tanning ones face makes acne better”
“Applying Sunscreen causes acne”
“Everyone will outgrow their acne, it is ‘normal’ to have pimples as a teen”
“A few pimples are not acne” (See table below. Mild acne can progress to more severe acne.

These little tidbits of advice are all fiction, even though many of them are widely believed to be true.

The truth about acne is that:

Acne is a disease of the pilosebaceous unit (hair follicle and sebaceous (oil producing) gland)) which leads to
Excessive sebum (oil) production as a result of increased sensitivity of the sebaceous glands to hormonal influences. This starts in teenage years but can persist into adulthood. There is often a genetic predisposition.
Skin cells sticking together causes plugging of pores (keratinization disorder). This causes the formation of comedones – blackheads or whiteheads.
Bacterial overgrowth within the comedone, and finally
Inflammation which causes pimples and pus pimples (pustules) as well as cysts.

Diagram Showing the Pilosebaceous Unit

Simplified Acne Grading

Dr Orrey states that it is correct that your lifestyle can affect your skin and it’s susceptibility to acne. Factors such as eating foods high in sugar, eating or drinking too much dairy, excessive scrubbing and cleansing, applying occlusive ointments such as Vaseline, and squeezing pimples (who doesn’t love a good pimple squeezing session?) can all worsen your acne which will inevitably cause scarring, pigmentation, and often psychological damage/self –esteem issues.

How Is Acne Treated?

Now that you have a little bit more information on exactly what acne is and how it works, let’s help you get rid of it. Dr Orrey highlights five great products that will help you treat acne.

Keratolytic agents:

Using washes that contain salicylic acid, resorcinol, benzoyl peroxide, and glycolic acid (just to name a few) will aid in unblocking your pores and help your skin retain its moisture by stimulating your sebaceous glands to produce more oil.

Antibacterial/anti-inflammatory agents:

Using Benzoyl peroxide (Benzac, Brevoxyl), Azelaic acid (Skinoren), and topical antibiotics (such as Zineryt, Clindoxyl, Dalacin T), will help to kill the bacteria that causes acne and reduce inflammation.

Retinoids:

Using retinoids help unblock pores, reduce overproduction of sebum (the food source for bacteria), inflammation, and thereby scarring and pigmentation too. Retinoids can be applied topically (in the form of Retin A, Isotrex, Differin,) and can cure acne if given orally at the correct dosage (in the form of Roaccutane/Acnetane/Oratane).

Antiandrogens:

Antiandrogens block the effect of androgens on the sebaceous gland to stop overproduction of oil, and blocked pores. Oral contraceptives (Yaz, Yasmin, Dianne 35, Minerva, Ginette) with or without androgen blockers (Androcur/Cyproterone acetate/spironolactone) are used in females.

Acleara:

New vacuum technology called Acleara is used to unblock and clear out pores followed by an LED light pulse to heat and shock the sebaceous glands to stop overproducing oil, and to kill bacteria. Immediate improvement after treatment is noted, and is sustained with ongoing treatment. Acleara technology is only available in a few centres in South Africa.

So What Are The Do’s And Don’ts of Acne Treatment?

Do’s:

Go get professional help early. Start off with your GP who will refer you to a dermatologist if necessary. Acne scarring is irreversible and can be prevented.
Eat a healthy diet, avoid sugar especially sugar containing cool drinks such as COKE and FANTA, and manage your stress
Clean the skin with a gentle cleanser and not scrubs
Apply an oil free moisturizer
Apply sunscreen when out in the sun. There are many oil free preparations available
Use a foundation to cover up the pimples if necessary. There are many acne friendly cosmetic preparations available

Don’t:

Leave your skin and hope it will clear on its own
Squeeze pimples. Squeezing and ‘picking’ can lead to scarring and pigmentation. This can damage the skin permanently.
Tan your face hoping acne will go away. The sun damage can cause premature aging and also skin cancer later in life.
Use abrasive cleansers and scrubs.

Dr Orrey, founder of Derma clinic, has been a practicing dermatologist for more than 20 years and has dealt with patients from all age groups and walks of life. She understands the damage that acne can cause both physically and psychologically, and has therefore made the treatment of this condition one of her main areas of focus.

For more information on managing acne and other medical skin conditions, have a look at www.dermaclinic.co.za

Written by Timothy Stuurman