What causes acne? Acne is a difficult problem to treat because it has several underlying causes. Some are genetic, some hormonal, others involve external factors.
There is no 'cure' for acne, but management is possible.
The problem with acne really begins within our skin as it naturally produces oil in our sebaceous gland. Acne-causing bacteria metabolize this oil and that metabolized oil is irritating to our skin. As the skin becomes increasingly irritated by this oil our hair follicles will become plugged, thereby collecting debris. This debris then erupts down into the deeper layer of our skin, the dermis. This debris is an intruder in the dermis, a foreign body, which doesn't belong there. As a result our body attempts to get rid of this foreign body with an inflammatory response.
Initially we have to deal with the acne itself, then it adds to the problem by leaving scars on our skin, forever reminding us of our bad skin.
Acne scars are similar to other scars in that they are the result of a wound which has healed, leaving collagen behind. The difference is that the scars generally occur in the skin's deeper, dermis layer.
Types of Acne
Whiteheads : Also called closed comedones, they typically appear on your skin as small, whitish bumps. When the pores of your skin accumulate oils or sebum, you get whiteheads. This plugs your skin’s follicles and the clogged areas are not exposed to air. (With blackheads, air causes oxidation, and that oxidation darkens the tips of clogged areas.)
Blackhead :A blackhead is created when a follicle in your skin becomes plugged and pushes through the surface. Technically called open comedones, they are typically caused by your skin producing too much oil. This oil, when exposed to air, turns black in color because of a buildup of melanin, skin’s dark pigment.
Therefore blackheads are not caused by dirt as a lot of people think.
Papules :Papules are small, firm cone-shaped bumps that are pink in color. It’s basically an inflamed whitehead. That’s why they’re tender to touch unlike other forms of acne.
They contain no pus. Since they don’t contain pus you should never pop or poke them. If you do you might seriously irritate your skin and aggravate your existing pimples – and possibly end up with a permanent scar – with zero effect on the papules themselves.
Like papules, pustules are small, round lesions. You’ll notice they’re red in color with yellowish or whitish centers (caused by visible pus).
While it may be tempting to pop a pustule – don’t do it. You could end up with a permanent scar.
Nodular Acne : Nodular Acne are severely inflamed, painful , hard lesions lodged deep within the skin.
Cysts : Cysts are softer, pus-filled lesions, also deep under the skin. They develop when the contents of your comedones (a medical term for whiteheads or blackheads) have spilled into the surrounding areas. Your body’s local immune system responds to this ‘attack’ by producing pus.
Unlike other forms of acne, nodules may persist for weeks or even months, the result of their contents hardening into deep (and stubborn) cysts. Cystic acne is the most serious type of skin acne,although nodules do not always develop into cysts.
There are no overnight ‘cures,’ and acne doesn’t just ‘go away.’
Your body, your skin and your acne are all unique to you. That means you need to find acne treatments that works best for your situation.
There are a variety of options available today - from benzoyl peroxide to laser treatments to herbal remedies. We might all be familiar with the brand names of products , what’s really important is the active ingredients in those products and how they work against the acne, whether it’s targeting acne bacteria, keeping pores clear of blockages, or reducing inflammation.
Skin is the largest organ of the body. It is made up of two layers, the upper 'epidermis' and the lower 'dermis'. The epidermis and the dermis are further divided into other layers.
The lower most layer of the epidermis is known as the basal layer and it contains organelles called 'melanosomes'. These melanosomes contain cells called melanocytes which produce a pigment called 'melanin'. The color of skin depends mainly on thiand thes melanin amount of melanin present in the other layers of the epidermis.
What are the causes of hyper pigmentation (increase in skin pigmentation) ?
Hyper pigmentation may either be due to increased melanin deposition in the epidermis or dermis.
Epidermal pigmentary disorders respond well to treatment while dermal pigmentation may take a long time to lighten.
Melasma : Seen as brown patches on the face, it is more commonly seen in females after pregnancy. It occurs due to hormonal changes in the body. The pigmentation increases on sun exposure.
Peri-orbital melanosis : Also known as 'dark circles' may be heriditary, due to stress or eye strain
Freckles and Lentigenes : These are tiny black / brown spots on the face and are genetic in origin.
Photomelanosis : This is increased pigmentation due to sun exposure. The pigmentation occurs on exposed skin, commonly on the face, neck and the back.
Sun burn : A condition commonly encountered in fair skinned people due to excessive sun exposure.
Post inflammatory hyper pigmentation : It may be seen in the following cases
- Seen after healing has occured, like in acne, eczemas, contact dermatitis etc.
- Drug induced pigmentation.
- Pigmentation due to cosmetics especially those containing fragrance.
Nevus or 'Birth mark' : Usually seen at birth but may also appear at a later age.
Tattoo : Tattoos are pigments inserted into the skin for decorative purpose . Usually these artificial pigments are inserted deep into the dermis which makes them permanent and stubborn.
What is the treatment for hyper pigmented disorders ?
Melasma, Photomelanosis and post inflammatory hyper pigmentation can be treated with topical creams such as hydroxy quinone,Kojic acid, tretinoin, topical steroids ,alpha hydroxy acid creams or azelic acid. If the patient does not improve with these medicines other modalities should be used, which may be ;
- Chemical peeling with tri-chloro acetic acid or glycolic acid.
- Intense pulse light treatment
- Peri-orbital melanosis : Spot glycolic acid peel or electrical stimulation of the skin may be done. One may also try intense
pulse light therapy. Iron supplements and anti oxidants help when taken orally.
- Freckles and Lentigens : we have the following modalities
- Spot peel with TCA or glycolic acid
- Fulguration with Radiofrequency
- Nevus can be removed by pigmented laser- Q switched Nd-Yag
- Tattoo may be removed by dermabrasion or laser surgery
With the passage of time the face and lips tends to lose volume, which causes the skin to look less full and less tight. Fillers are synthetic materials that are injected into the face to increase lip, cheek, or chin volume. Fillers can also be used to reduce the nasolabial fold and to fill in creases in the skin. In some cases, filler can be used to treat the hollows beneath the eyes.
More and more consumers are opting for non-surgical techniques of preserving beauty as these techniques have ‘less downtime - without going thru the pains of healing from surgery
BOTOX is a toxin produced by the bacteria Clostridium botulinum that is injected into muscles and used as a paralyzing agent for the muscles of expression. This weakens the fine muscles in the forehead, around the eyes and the glabella areas as a result forehead creases , crows feet andfrown lines are reduced or eliminated.
It is injected directly into the muscles . It works by blocking nerve impulses to the injected muscles and reduces the muscle activity.
BOTOX is also being used to reduce sweating in the axilla, palms of hand and feet.
How is injection given ?
Treatment is in the form of multiple injections made using very fine needles with ice or local anesthetic cream to numb the area. The injections are not painful. The effects start to appear in a couple of days and the best result is seen in a week. The results generally last about 4-6 months and then the injection has to be repeated. The injections done multiple times may give a longer lasting result.
What are side effects?
BOTOX injections appear to be very safe. Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, bleeding / bruising.
The most serious side effect is drooping of the upper lid due to paralysis of the lid muscle or double vision caused by paralysis of small muscles of the eye. This complication is temporary and will disappear once the effect of botox wears off. This is avoided by keeping the injection away from the lid and not lying down for 4 hours after the injection.
No systemic side effect has been reported to date.
There may be some minor bruising which can be covered up with makeup.
Is treatment with BOTOX® Cosmetic painful?
Discomfort is usually minimal and brief. Prior to injection, your physician may choose to numb the area with a cold pack or anesthetic cream. The entire procedure takes approximately 10 minutes.
The head should be held elevated for 4 hours or more (no lying down). Ice application to the injected area will help in reduction of bruising and swelling. Makeup can be used within a hour.
Dermabrasion is a surgery performed most commonly to improve scars due to acne, chicken pox, small pox etc. As the word implies it involves abrading the skin by various means so as to create a wound which is superficial enough to re-grow normally and deep enough to eliminate a pathology like tattoo or acne scar.
Dermabrasion can be done using one of the following equipments:
"Chemical peel" is a general classification for a number of chemical treatments used to exfoliate and rejuvenate the skin. Typically during a chemical peel nothing actually "peels" off. A chemical solution is applied to the skin, and works by dissolving the upper layers of the skin. As the tissue is dissolved it causes new tissue to emerge.
The depth and strength of the 'peel' varies based upon the :
Strength of the chemicals used and length of time the solution is applied.
Number of coats applied.
Lip Augmentation: Lip augmentation procedure is to increase the size of thin lips. The upper or lower lip may be treated alone, or both may be enlarged at the same time.
Gore-Tex is synthetic options with permanent results. They do not shrink and are never absorbed. Synthetic implants are foreign substances and may become infected or be rejected by the body. If this occurs, the implants can be removed.
Fat Grafting This procedure has permanent results . Although it is possible that the body will reabsorb it, many people choose fat grafting because they are most comfortable with using the fat from their own body. The fat is harvested from another area of the body, often the abdomen.
Mesotherapy is a specialty that involves penetrating microscopic quantities of natural extracts, pharmaceuticals agents and vitamins into the skin. It can be used to eliminate cellulite, promote weight loss, treat aging skin and redundant (sagging) skin, and rejuvenate the hands and neck. It is also useful for hair loss clients.
Results vary depending on your body type and the condition being treated. On average, patients notice visible improvement in three to five sessions.
The results do last, especially when combined with exercise and proper nutrition. However, one cannot stop the natural aging that affects your appearance. For this reason, doctor recommended regular maintenance visits.