Successfully treating acne

COMMON SYMPTOMS

• Blackheads (Open Comedones): Blackheads form when oil, dead skin cells, and pollutants oxidise, turning dark. They primarily appear on the nose, chin, and forehead, contributing to skin congestion rather than inflammatory acne.
• Whiteheads (Closed Comedones): These small, flesh-colored bumps have a white or yellowish centre and appear mainly on the T-zone (nose, chin, and forehead). Although they cause minimal inflammation, untreated whiteheads may develop into acne lesions.
• Papules: These tiny red bumps result from inflammation due to excess sebum. They indicate chronic inflammation, a weakened skin barrier, loss of hydration, and increased bacterial presence.
• Pustules: Pustules resemble papules but contain pus, giving them a whitish-yellow centre. Their red base and surrounding inflammation signal the presence of P. Acnes.
• Cysts: Large, painful lesions form deep in the skin and fill with pus. If left untreated, cysts can cause permanent damage and often require medical intervention.

Extraction Manual or suction-based extraction removes blackheads and prevents clogged pores from worsening.Clay masks detoxify the skin and reduce sebum production. Combining them with an enzymatic peel enhances their effectiveness.

Topical cream Pore-exfoliating and sebum-reducing creams help manage severe acne when included in a skincare routine.

Warm compresses soften the skin, promote pus drainage, and accelerate healing. They increase blood circulation to the affected area, reducing inflammation. Applying ice also helps with pain and swelling.

LED therapy promotes collagen production, reduces inflammation, and kills bacteria in active acne stages.

DIODE and IPL treatments address vascular and pigmented skin issues while promoting healthy tissue regeneration.

Topical retinoids These treat moderate to severe acne by drying out sebum-producing glands. They unclog pores by exfoliating and preventing dead skin cell buildup. Tretinoin directly improves scarring and, when combined with hydroquinone, reduces the risk of hyperpigmentation.

Azelaic acid, available in peels or creams, works well as part of a home or clinic-based peel routine. This naturally occurring acid has antibacterial and anti-inflammatory properties.

Isotretinoin tablets (Accutane) significantly reduces sebum production. It is prescribed for cystic acne but requires careful monitoring due to potential side effects such as elevated blood cholesterol, liver enzyme issues, colitis, depression, and other systemic reactions. (It cannot be taken six months before or during pregnancy/breast feeding and must undergo monthly pregnancy tests.)

Topical and oral antibiotics target P. Acnes and treat pustular eruptions and inflammation. Doxycycline is commonly prescribed at 100mg per day.

Benzoyl peroxide eliminates P. Acnes, reduces inflammation and swelling, and speeds up recovery. It may be used with antifungal treatments and topical antibiotics but should not be used continuously.

Microneedling breaks up tightly scarred tissue and stimulates growth factors to generate new skin. Combining it with targeted serums and peels enhances results.

Laser treatments (CO2, Er:YAG, RF) help reorganize scar tissue and promote new, healthy skin growth.

Biostimulator Injections (Profhilo, Poly Nucleotides, SuneKOS) help reorganize scar tissue and stimulate elastin and collagen, lifting depressed scars. SuneKOS specifically helps remodel scarred collagen to produce healthier skin, while poly nucleotides reduce inflammation.

Hyaluronic Acid (HA) Filler Injections lift depressed scars, preventing their attachment to underlying tissue. For best results, these injections should follow microneedling, TCA Cross, ablative laser treatment, or subcision. Otherwise, the filler disperses sideways. This treatment is best suited for rolling and boxcar scars but requires repeated sessions.

PLLA (Sculptra or RICH) Injections provide a long-lasting collagen lift for rolling and boxcar scars. PLLA must be injected into the deep dermis or subcutaneous layer to be safe. Though results last longer than HA fillers, PLLA does not offer as much lift and can form nodules if injected too superficially. Massaging treated areas is difficult, so multiple treatments are necessary.

Botulinum Toxin Injections reduce scar tension and sebum production.
TCA Cross involves applying a strong TCA peel to depressed scars, chemically restructuring scar collagen and promoting new, healthy collagen growth, similar to ablative laser treatment.

Subcision and Incision/Drainage release scarred areas from the upper skin layer, reducing depressions and encouraging new collagen production. Combining subcision with botulinum toxin, tretinoin, or poly nucleotides can improve outcomes. Larger cysts may require incision and drainage.