Causes of severe acne and treatment options

There are many misconceptions when it comes to the cause and treatment of acne. Acne is the leading cause for visits to a dermatologist.¹ Although most acne cases develop in adolescence, the condition can frequently continue into adulthood.² 

Acne can affect any age group, in one study almost 18% of women were found to have true late-onset of symptoms, with an onset after the age of 25 years.³ Interestingly, the number of adults with acne appears to be increasing and unfortunately the reasons why aren’t known. Despite the apparent aesthetic nature of acne, the effects can be far worse than its physical impact, many can experience psychological difficulties associated with their acne such as a low self-esteem.

What causes acne?

There are many factors that can cause or contribute to acne:

• Hormonal imbalance/change
• Diets high in sugar, dairy, carbs and fast food
• Food intolerances
• Stress
• Poor digestion
• Poor sleep
• Inflammation
• Lack of skin care routine
• Some hair removal treatments
• Non-Mineral Makeup

How does acne form?

1. Hormone levels become unbalanced and an over-production of the male hormone (androgen) stimulates oil production.
2. The stimulation of the oil production increases and the oil type changes from a thin liquid to a thicker sticky substance.
3. Whilst we have the oil being produced our skin is shedding dead skin cells constantly. Skin cells that do not fall off our bodies get trapped in our pores.
4. The combination of thick sticky oil and dead skin cells create the perfect environment with little, to no oxygen for bacteria to live.
5. Now with the combination of sticky oil, dead skin cells, bacteria and little oxygen. The pore becomes inflamed as it tries to fight the bacteria, we are left with small bumps, nodules and cysts.

Varying severity of acne:

Grades I and II are often treatable with specific peels and home care routines. However if you have grades III and IV, you are within the more severe category of acne and medical intervention is generally recommended for effective treatment

Grade:	Diagram
Grade I (open & closed comedones)
Grade II (inflammatory, papules & minor pustules)
Grade III (inflammatory, mainly pustules)
Grade IV<br/ >(cystic/nodules)

Acne treatment by an experienced dermatologist:

At Specialist Clinics of Australia more severe cases of acne are assessed by our expert dermatologist so that medication that is unobtainable over the counter can be provided. This will incur an additional cost that can be claimed on Medicare. In some cases we will need to refer you to a gynaecologist for a female health check and possible hormone testing, as acne can be a sign of a more serious condition such as PCOS.

For less severe acne patients, treatment options vary from laser treatments, Phototherapy and chemical peels. A strict home skincare routine is often prescribed as this can speed up results and in many cases protects your skin whilst we are treating it.

Skin care products commonly used for acne:

1. Vitamin A (Retinoids) Its main role in treating acne is to:
   • Reduce the amount of excess oil being produced
   • Speed up skin cell production in sluggish skins so that dead skin cells don’t sit on the surface longer than they should
   • Refine skin texture
   • Builds collagen
2. Vitamin B (Niacinamide) Its main role in treating acne is:
   • Brightening of the skin texture
   • Anti-bacterial
   • Builds collagen
   • Balances oil flow
   • Helps with general hydration of the skin and helps regulate skin function.
3. Alpha hydroxy acids (AHAs) and Beta hydroxy acids (BHAs) – Lactic acid, citric acid, malic acid, salicylic acid, retinol, glycolic acid:
   • These acids help to loosen up dead skin cells to allow them to be shifted from the skin and not clog the pores.
4. Pigment Inhibitor:
   • This product differs from brand to brand and your clinician will advise on the best one for your skin type. Its main role in treating acne is to protect the skin from becoming more pigmented or get post-inflammatory pigmentation whilst undergoing treatment with laser and peels.
   • It will help to reduce the amount of excess pigment (melanin) your skin produces and help to give the skin a clearer appearance
5. Sun Protection:
   • We strongly suggest that a SPF 50+ is used on a daily basis no matter the weather or if you are indoors all day. This will aid in healing and decrease inflammation within the skin.

1,2,3 //www.the-dermatologist.com/content/acne-vulgaristhe-psychosocial-and-psychological-burden-illness