ACNE, PORES & SCARRING

WHAT IS ACNE?

No matter what your age, skin type, or skin colour, at some point, you are bound to get a pimple. It’s not surprising that acne is the most frequently diagnosed condition at dermatologists’ offices and the most common skin disease that exists today.

Whether it’s an occasional breakout, blackheads on your nose and chin, a full Class IV case of teenage acne, or embarrassing pimples on your back or chest, it’s all acne in one form or another. A comprehensive plan of attack to clear your skin involves interrupting the processes that create the visible acne breakouts.

Acne vulgaris, the technical medical term, includes everything from blackheads, whiteheads, and inflamed pimples to deeper, more painful cysts, pustules and nodules. Acne is an inflammatory condition of the skin that occurs inside a pore. The bump that appears on your face is actually the final step in a silent process that begins deep inside a pore one to two weeks before the pimple is ever visible. Here is a simplified look at the acne process:

  1. CLOGGED PORES: During the normal process of skin renewal, dead skin cells combine with skin’s natural oil and instead of shedding, clump together inside the pore. A hard, firm plug called a comedo is then formed and acne has begun.
  2. BLOCKED OIL: Your hormones stimulate oil production in the sebaceous glands, which are attached to the pores. The plug (comedo) impedes the oil from traveling up to the skin's surface and instead, is trapped providing a perfect environment for bacteria to flourish. Keep in mind that this can also happen even if you have dry skin.
  3. BACTERIAL ATTACK: Once your pores are clogged, an airtight environment is created and a bacteria called Propion ibacterium acnes (P. acnes for short) “feeds and breeds” on the abundant oil, releasing inflammatory toxins.
  4. INFLAMMATION: The body’s natural response to these toxins is to contain the infection. The end result is intense swelling, inflammation, and pain in the form of a pimple, pustule, or, in more severe cases, a cyst or nodule. Unfortunately, some acne sufferers form of a pink/brown discoloration (post-inflammatory hyperpigmentation) at the site of the healed blemish that lasts long after the acne has cleared. 

PRODUCTS THAT HELP WITH ACNE

We cannot stress enough that although acne is not curable, it is treatable and controllable. Today there are lots of options to treat, control, and prevent future acne breakouts, but keep in mind that there are no quick fixes. Once you get your acne under control, it is recommended to continue with ongoing preventative treatment to keep your breakouts from resurfacing. Below we outline the treatments to attack each of the factors that contribute to the formation of an acne breakout. The basic principles of treatment are: unclog the pores, kill the bacteria, and calm the inflammation.

  1. UNCLOGGING PORES: To prevent dead cells from clogging pores, they must be kept from clumping together. This requires delivering the right ingredients deep into pores. Salicylic acid, alpha hydroxy acids, retinoids, and sulphur are ingredients capable of seeing your pores clear. Using a clay mask as a cleanser or spot treatment is extremely beneficial in drawing out impurities.
  2. KILLING BACTERIA: Benzoyl peroxide is an excellent antibacterial agent for long-term control of acne. We recommend using benzoyl peroxide at 2.5%, the lowest clinically effective concentration.
  3. TREATING INFLAMMATION: While unclogging the pores and killing bacteria will keep new bacteria from forming, the most immediate improvement in acne comes from treating the swelling or inflammation. This will help reduce redness as well. Sulphur is commonly used for its anti-inflammatory benefits. 

SKINCARE ROUTINE

Below is the recommended skincare routine for acne, blemishes and enlarged pores:

CLEANSE: A creamy, kaolin clay or sulphur based cleansing mask to draw impurities from pores without robbing skin of essential moisture. 

PORE MINIMIZING & CLARIFYING TONER: A toner containing clarifying ingredients; alpha-hydroxy acids, salicylic acid and poly-hydroxy acids to minimise pores but primarily to exfoliate pore-clogging dead skin cells.

TREATMENT DAY CREAM WITH SPF: A moisturising treatment cream with SPF protection containing a concentration of powerful peptides. Optical brighteners can minimise the appearance of skin flaws while skin conditioning ingredients, Dimethicone and Sodium Hyaluronate, provide moisturisation and calm inflammation.

VITAMIN A: Gold standard treatment in the care of ageing and acne prone skin. Best used in the evening to increase skin renewal, refine pores, normalise skin cells and visibly improve skin texture and appearance. 

SCARRING

A true acne scar, like all scars, occurs as a natural part of the body’s wound-healing process. In terms of acne, scarring can take the form of depressed pits, broad indentations, or raised, thickened, round, or linear bumps called keloids.

Who gets acne scars?
Generally speaking, the more advanced cases of cystic and nodular acne are the most likely to cause scarring, so it is especially critical to take all possible measures to manage this condition. “Severe” inflammation in some people may not result in scarring, while in others, a small pimple may leave permanent damage. And if you’re inclined to pick, consider this: you’re creating a wound on your skin, and nature is going to do what it must to quickly repair it.

How do you treat acne scars?
Unfortunately there is no universally effective treatment to remove scars. However, micro exfoliation, micro dermabrasion and skin resurfacing are effective treatments which can significantly lessen the appearance a scar.

Various substances and techniques can be used to peel or resurface the skin, including acids, minerals, plants, and crystal like granules. The value of these treatments is rapid exfoliation at varying depths, depending upon how deep the treatment must be for a desired benefit. The most common methods of superficial skin resurfacing today are microdermabrasion and hydroxy acid peels, which improve skin texture and tone. In some cases, more aggressive micro exfoliation or skin needling procedures may be performed to treat surgical or traumatic scars. 

RESURFACING

SUPERFICIAL RESURFACING

Hydroxy Acid Peel: Light peel, most commonly with salicylic or glycolic acid. Exfoliates, enhances cell renewal, and increases penetration and potency of other topical agents. Acidic solution is applied evenly to the entire face and left on for several minutes. Helps clear acne, refine pores, improve texture, and diminish signs of sun damage.

Microdermabrasion: Abrasion of superficial layers of the skin to remove dead surface cells and enhance cell turnover. There are two primary methods:

  1. Fine crystals of aluminum or sodium bicarbonate are sprayed onto the skin at a precise pressure and then concurrently vacuumed off with adjustable intensity of suction.
  2. A rough-textured handheld instrument is applied to the skin for abrasion. This is followed immediately with suction to remove exfoliated cells.

Superficial resurfacing smooths the skin’s surface, refines pores, brightens skin, and stimulates collagen and elastin growth, helping diminish the appearance of superficial marks.

Micro-Needling: An alternative procedure for skin rejuvenation and an effective treatment of acne scars is micro-needling. This procedure is performed by rolling a device with approximately two hundred tiny needles (0.2mm in length) across the area of skin to be treated. This procedure triggers the wound healing processes to produce new collagen fibres with results comparable to ablative techniques such as deeper peels, dermabrasion, and IPL lasers, but with less injury to the skin. By incorporating just a minute per day of rolling into a non-prescription skincare regimen, we can achieve impressive results for line and wrinkle reduction, pore tightening, and skin firming, all pain-free and without an appointment.