Download ACNE-PIMPLES:

ACNE-PIMPLES:
Dr.K.Srinivasa Murthy, M.D., D.V.D, Fellow of American Academy of Dermatology,
Skin & Cosmetology Centre, # 32/4, 1st floor, Alsa Glenridge Apts, Langford road, Shantinagar, Banagalore-25
Ph: 22210913, 22210015 email: [email protected]
What is Acne: Pimples or Acne is a disorder of the oil producing glands of the skin, mostly affecting the
teenagers. This disorder affects men & women all over the world. It is more severe in men.
Why do you get it? : This is a hormonal problem. After puberty the male sex hormone (Androgen)
stimulates the oil producing glands (Sebaceous glands), which are abundant over the skin of the face, chest,
back, & shoulders. This leads to more oil production in the skin (oily skin) over these areas. At the same
time there is a blockage of the skin pores (due to hormones), leading to a small pimple (black or white head).
Later this might get infected with the bacteria residing in the skin, leading to red boil or pustule.
How does it appear? : Pimples appear as black or white heads, reddish boil, or pustules particularly over
the face, upper chest & back, shoulders. Pimples if not taken care properly can leave black marks, or pitted
scars or large thick scar. Sometimes pimples appear as big boil-Cyst (filled with watery fluid) or Nodule
(painful-deep boil).
People with acne frequently have a variety of lesions, the basic acne lesion, called the comedo (kom´-e-do)
or comedone, is simply an enlarged hair follicle plugged with oil and bacteria.
If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo or whitehead.
Whiteheads usually appear on the skin surface as small, whitish bumps.
A comedo that reaches the surface of the skin and opens up is called a blackhead because it looks black on
the skin’s surface. This black discoloration is not due to dirt. Both whiteheads and blackheads may stay in
the skin for a long time.
How long will it continue? : Pimples appear after puberty, last for years together, waxing & waning up to
late twenties or sometimes it persists up to 30-35 yrs of age.
In late onset-adult acne: Pimple appears during late 20’s & continues till 30-40 yrs of age.
What are the types of Acne? : Adult acne- appearing late 20’s, premenstrual acne-occurring before
menses, steroid induced acne-appearing either due ingestion or applying steroids, nodulo-cystic acnepainful, deep pus filled boils appearing as big lumps.
Some Facts about Pimples:
Moderate to severe acne is seen in the same families.
It is not a contagious disease.
It does not cause any health problems except it causes physical & psychological scars -mental agony.
Food like oily food, chocolates, ice cream or any other food has no role in causing pimples. The oily skin of
the face is due to oil produced by the oily glands under the influence of the male sex hormone.
What are the aggravating factors for pimples? :
Pimples increase during winter, decreases in summer or vice-versa. Mental stress aggravates pimples.
Pimples increase few days before the menstruation in some females.
Oil massaging of the hairs & applying lot of oil & greasy materials to the hairs leads, to pimples over
forehead & back.
Pimples increases due to application of oily based creams, cosmetics, facials, beauty packs & home
remedies, as these products block the pores of the skin.
Pimples increases due to application of steroid creams over the face, or consuming steroid tablets/injections,
oral contraceptives, cod liver oil capsules, & certain Anti-Psychotic, Anti-epileptic, Anti-Tuberculosis drugs.
Pimples appear over arms/thighs/abdomen in people working with oil & greases (Mechanics, cook etc)
In middle aged women, pimples increases due to internal hormonal problems-Adult Acne.
Treatment:
Often pimples improve within several years without treatment. Pimples disfigure the skin & upset the
patients mentally. Untreated pimples can lead to scars & marks. To avoid pimples scars & marks, treating
pimples early is important. No single treatment will give permanent cure. Treatment should be taken
whenever pimples appear. Dermatologist can improve pimples scars, either medically or surgically.
General Measures:
Avoid the aggravating factors.
Wash the face with any ordinary soap (or face wash or cleanser) & water 3-4 times per day, as this will help
in removing the facial oil, & there by unblock the pores reduce the pimples.
Do not use basin powder for washing the face, as does not remove the oil. It is used for dry skin.
To use minimal cosmetics-only water based cosmetics-oil free cosmetics. Wash the cosmetics before going
to bed with mild cleanser.
Regular shampooing the scalp hairs with any ordinary shampoo will reduce the dandruff & they’re by helps
in reducing the pimples.
Avoid squeezing the pimples as it can lead to scars & marks.
Regular steaming the face will help in opening the pores, there by reduces the pimples.
Any kind of food can be consumed (nothing in excess). Obese patients should avoid high glycemic index
food (like maida items, chocolates, sweets etc ) in excess. Well balanced, healthy, nutritious diet, (more of
vegetables & fruits) definitely gives a good glowing skin.
Specific Treatment:
There are various creams & gels available to apply on skin, to reduce pimples.
Peeling agents such as Tretinoin, Adapalene gel, Benzyl Peroxide will remove the upper layers of the skin,
unblock the pores, and there by reduce black, white heads, & pustules. Your dermatologist will advise you
about correct usage and how to handle side effects.
Antibiotic creams such Clindamycin, Clarithromycin will reduce the bacteria & there by reduce the red
boils & pustules.
Before starting any medication, even topical medications, inform your doctor if you are pregnant or
nursing, or if you are trying to get pregnant.
Oral Antibiotics (Tetracycline, Doxycycline, Minocycline), Dapsone are given for moderate to severe
pimples.
In cases of unresponsive or severe acne, isotretinoin may be used. Patients using isotretinoin must
understand the side effects of this drug. Monitoring with frequent follow-up visits is necessary.
In women with moderate to severe pimples, anti-male Hormone tablets, oral contraceptive tablets can be
used to control pimples.
In women while taking any medications for pimples, pregnancy must be prevented up to the period as
advised by your dermatologist.
All medications are to be taken under strict supervision of the doctor.
Treatments available to reduce pimples faster are:
Comedo extraction to remove black & white heads.
Cryoslush & light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the
blackheads and whiteheads, and stimulate new skin growth.
Surgical Treatment for Pimple scars:
For all depressed scars we prime the skin with topical glycolic acid cream & tretinoin cream initially for few
weeks as it will help to prime the scars for further surgeries & also elevate the depressed scar at least 2030%.
For Depressed shallow scars:
Subcision surgery under local anaesthesia to elevate the depressed scar. Followed by Co2 Fractional Laser,
RF Microneedling or Dermapen (4-6 sittings)
For Depressed deeper or Punched out or Ice pick scars:
Punch Flotation or Punch Excison under local anaesthesia, or TCA Cross followed by Co2 Fractional Laser,
RF Microneedling or Dermapen (4-6 sittings)
Combination of these surgeries will improve the pimple scars.
Pimples are not curable, but it is controllable; proper treatment helps you to look better and may prevent
scars. Proper skin care by the patient is important to prevent pimples.