Acne & Acne Scarring
Acne is a chronic inflammatory disease of the pilosebaceous unit (hair follicle plus its sebaceous glands).
Therefore it typically affects areas with the highest density of sebaceous follicles (face, upper chest and back).
It results from increased sebum production by sebaceous glands, altered keratinisation, inflammation, and bacterial colonisation of hair follicles.
The excessive production of sebum combines with dead skin cells and clogs up the hair follicles.
Acne patients typically present with:
comedones (clogged follicles) subdivided in 2 types:
black heads or open comedones: the pore at the surface of the skin is open and exposing its content to the air. The black color is dead skin cells, bacteria and oil stuck down in the pore.
white heads or closed comedones: clogged follicles without an opening.
papules: small red bumps
pustules: similar to papules but inflamed, with a white tip in the centre (pus).
Twenty per cent progress to more severe acne, with nodules and cysts (larger painful lumps beneath the surface of the skin).
Pruritus, pain, erythema and tenderness are frequently described.
The onset of acne typically correlates with the onset of puberty, when sebum production increases, and its incidence is maximal in teenagers. However Acne can persist into adulthood.
Acne can lead to permanent scarring and dyspigmentation, and the psychological impact of this very common condition can be important and disabling.
Therefore we always encourage each patient to see a dermatologist who can propose different treatments like retinoids, benzoyl peroxyde, antibiotics, hormonal therapies, spironolactone or isotretoin.
However, pharmacological treatment of acne can be a challenge for dermatologists. Furthermore the potential side effects and microbiome disruption of these treatments, and the development of resistance to antibiotics explain the growing interest for adjunctive acne therapy.
Cosmetic interventions have been shown to be effective and improve quality of life of patients with Acne.
A randomized investigator-blind trial of different passes of microdermabrasion therapy and their effects on skin biophysical characteristics. Davari P, Gorouhi F, Jafarian S, Dowlati Y, Firooz A.Int J Dermatol. 2008 May;47(5):508-13.