Acne Care Tips

Acne is generally attributed to the use of cosmetics, especially oils and other greasy applications on the skin. Use of oils even on the scalp hair has been noticed to aggravate acne, especially on the forehead. Inflammatory acne has a strong component of infection in the sebaceous glands, while the cystic lesions are caused by a combination of blockage and infection and inflammation.

Since acne shows a strong correlation with the onset of adolescence, the sex hormones are considered to playa basic role in their causation. Testosterone and other male sex hormones increase the size of the sebaceous glands and aggravate acne, while oestrogen and other female sex hormones decrease the size of the oil glands and improve acne. Theoretically, therefore, acne should occur only in males and not in the females. However, the hormonal pattern in both the sexes is very complex-females also have a certain component of the male hormones and the oil glands in the skin have certain receptors which respond in an exaggerated manner to the normal levels of male sex hormones. Certain females, who have abnormally high levels of the male sex hormones, develop severe acne and continue to do so even beyond the age of 25 years. Patients who are treated with male sex hormones for some other diseases have also been observed to develop acne as a side effect. Certain other drugs, such as corticosteroids used locally as well as orally, Isonex used for tuberculosis, iodides used in tonics, bromides used for psychiatric problems and contraceptive pills which also contain sex hormones may also produce acne.

Emotional stress is another factor which has been noticed to aggravate acne. Undoubtedly acne tends to spoil the appearance of an individual at a time when she/he wants to look her /his best. It often leads to severe emotional stress in some individuals. On the other hand, a period of emotional stress due to any other cause also often aggravates acne. Thus the very desire to look her /his best actually leads to worsening of the situation.

Some neurotic patients tend to scratch off the acne lesions and produce dark pigmentation in the area. This is a bad practice because it actually leads to worsening of the appearance. Pigmentation generally takes longer than the time taken by the original acne lesions to disappear. Squeezing the acne lesion to express the pus out of the pustule is another bad practice because this can lead to scarring and pigmentation, besides causing a serious risk of the infection spreading to the brain, which can be fatal.

Every patient having arne should know that arne is a selflimiting disease and it will disappear by the time the patient attains the age of 25 years or so. She/he should however, also be aware that the tendency to develop acne will continue till it ultimately disappears by the age of 25 years. The best way to manage acne is to prevent acne, because, if not prevented, the patient is likely to be left with permanent scars for the rest of his /her life. Prevention will also help to keep the face clear. We therefore, recommend that as soon as a child attains puberty, he/ she should start observing the following precautions and schedules for preventing arne.

Cleaning the Face is commonly recommended that arne patients should wash their face frequently. Washing the face properly and thoroughly is more important than washing the face frequently. Washing the face once or twice a day is as a rule sufficient, provided it has been washed properly. Proper washing includes applying an adequate quantity of soap and massaging it thoroughly into all parts of the face, taking special care to clean the folds around the nose, between the lower lip and the chin, behind the ears and the under-surface of the chin and the neck, which are likely to be left out from proper cleaning. The tip of the nose is another area which usually gets ignored while cleaning the face.

Proper cleaning does not require more than one extra minute of bathing time. Bathing should therefore, be undertaken in a relaxed manner and not in a hurry.

Soaps are the best agents for cleaning the skin. The common belief that soaps harm the skin is erroneous. The main action of the soap is to emulsify the oil on the skin and release the dust, dirt and bacteria sticking to the oil. One should therefore, apply an adequate quantity of soap which can emulsify and remove all the oil present on the skin. If all the oil is not removed, the process of cleaning will be incomplete. For this reason, use of soaps having greasy components like fats, oils, cream, milk, etc. or the use of so-called mild soaps is an illogical and scientifically incorrect concept.

The selection of a proper soap is important. An ordinary soap is as a rule adequate. The so-called herbal soaps, or those with anti-bacterial agents or sunscreens can be positively harmful. Some of the antiseptics used in foreign soaps contain sun-sensitising chemicals which can lead to an increased sensitivity to the sun and produce pigmentation or severe dermatitis on the exposed parts of the body. Some antiseptics indiscriminately kill a large variety of diseaseproducing as well as harmless bacteria but spare the dangerous disease-producing bacteria. Constant use of soaps containing such antiseptics can actually lead to serious skin infections. Several herbal products can lead to pigmentation or other types of reactions in the skin when used on a regular basis.

The main precaution to be observed is that cream or oil should not be applied to the face or the hair, or on any part of the body at all. It has been observed that patients who use cream or other greasy cosmetics on the face experience aggravations in their acne. Similarly, applications of oil to the hair lead to aggravation of acne on the face, especially the forehead. Even if the oil is applied elsewhere on the body, it can easily get transferred to the acne-prone areas by hand. It is a wrong belief that oil is necessary for maintaining a good growth of hair on the scalp. This however, is not true because people who use plenty of oil on their hair are as bald as the people who do not. It has also to be understood that no oil can penetrate the intact skin; otherwise, an oil massage on the skin should be equal to eating the same quantity of oil.

Oil applied to the skin soaks only the most superficial layer of the skin; it cannot penetrate deeper than that. The oil remains in the superficial skin layer till it gets washed off or mopped up into the clothes. None of the claims that a particular oil can prevent hair loss or lead to a luxuriant growth of hair has ever been confirmed by scientific evaluation. Most of the oils marketed by the various commercial groups, have been evaluated by their own people who do not understand the fundamentals of hair growth and hair loss. Such enterpreneurs have always shied away when the scientific community has challenged them to prove their claims.

The only function of oil is to keep the hair matted together so that they do not fly off, but, the oil interferes with cleaning and forms a film where the dust from the atmosphere accumulates just as a patch of oil applied to a shirt would act as a spot where the dust would get stuck compared to the adjoining areas of the cloth. Most beauticians advise their clients to apply oil onto their hair at night so that it gets soaked into the hair and then wash the excess with shampoo next morning. This practice is as foolish as going in for vomiting after a hearty meal. The fact is that excess of oil requires extra shampoo to wash it off completely and this means wastage of oil as well as shampoo for complete cleaning; otherwise, the cleaning is incomplete.

Topical therapy : As already explained, the best approach for the management of ame is to prevent ame. This means that the patient must keep on using some medication on a regular basis even when he/she is not having acne. This medication should be started at the time of puberty (preferably, even before the individual starts developing ame) and continued till the age of 25 years when the person is no more prone to develop ame.. Moreover, the medication must be applied on all the acne-prone areas and the application repeated whenever the face or other areas are washed. It is to be used more like a cosmetic rather than a medication.

With these considerations in mind, we have formulated a medication which could be used as a cosmetic. It contains lactic acid/ sodium lactate and is thus based on the ingredients produced by the skin itself as a part of the natural mechanism for protection against infections. It was theorised that an individual who develops more severe acne possibly produces lesser quantities of these natural chemicals, and augmenting this natural mechanism should be the most logical approach for preventing acne. This formulation is a colourless liquid which disappears into the skin and can therefore, be used even during the day like a cosmetic. Since it contains the body’s own constituents, there is no question of an allergic or a toxic reaction. It is to be applied with the finger-tips and massaged into the skin till it disappears into the skin. Application of larger quantities with a cotton swab leads to unnecessary wastage and should be avoided.

After the lesions disappear completely, the oral treatment can be stopped while the topical treatment should be continued to prevent further recurrences. When however, the next severe recurrence does occur, another course of the oral antibiotic can be instituted again. Thus, a few courses of the antibiotic therapy for a year or so, along with the regular use of the preventive topical treatment, can keep the skin almost clear of the acne lesions.

There are several so-called ayurvedic preparations advertised which promise to purify the blood. Most such preparations presumably contain antibiotic/antiseptic agents, the dosages ofwhich have never been standardised, and their toxicity/safety never confirmed/investigated on scientific criteria.The term blood-purifier is a misnomer. The manufacturers do not know even the impurity in the blood which is being removed by the so-called blood-purifier.

The medicine is applied to the face and the other acneprone areas twice a day-in the morning after the bath and then again at night. If the face is washed again during the day, it is useful to apply the formulation again. Ideally, the applications should be started at puberty and continued till the age of at least 25 years.

Acne is a skin problem that usually happens in your teens. Acne develops as a result of blockages in follicles. Pimples form when hair follicles under your skin clog up. It is shows up as different types of bumps. They include whiteheads, blackheads, red bumps (pimples), and bumps that are filled with pus (cysts).  Most pimples form on the face, neck, back, chest and shoulders.  Hyperkeratinization and formation of a plug of keratin and sebum (a microcomedo) is the earliest change. Enlargement of sebaceous glands and an increase in sebum production occur with increased androgen (DHEA-S) production at adrenarche. Increased sebum production provides an environment for the overgrowth of Propionibacterium acnes. Bacterial overgrowth of Propionibacterium acnes can cause inflammation.  Some adult women experience mild to moderate acne due to hormonal changes associated with pregnancy, their menstrual cycles, or starting or stopping birth control pills. More than four out of five people between the ages of 12 and 24 develop acne at least once.

Acne condition is most common during adolescence, affecting more than 85% of teenagers, but frequently continues into adulthood. Acne most common form   acne is  “acne vulgaris.  Many teenagers get this type of acne. Beneath the skin, in your pores, is where the acne forms. The mix of your natural oils and dead skin cells cause the formation of acne. Sebum (oil) which normally drains to the surface gets blocked and bacteria begins to grow. Both whiteheads and blackheads start out as a microcomedone.  There are many misconceptions and rumours about acne. Any medication containing halogens (iodides, chlorides, bromides), lithium, barbiturates, or androgens. Exposure to high levels of chlorine compounds, particularly chlorinated dioxins, can cause severe, long-lasting acne, known as Chloracne. Common myths state that masturbation causes acne and, conversely, that celibacy or sexual intercourse can cure it. Seafood often contains relatively high levels of iodine. Iodine is known to make existing acne worse but there is probably not enough to cause an acne outbreak.

Hormonal changes in your body can provoke or aggravate acne. Friction or pressure on your skin caused by items such as telephones or cell phones, helmets, tight collars and backpacks. Benzoyl peroxide can cause redness and peeling. Externally applied antibiotics such as erythromycin, clindamycin, Stiemycin or tetracycline aim to kill the bacteria that are harbored in the blocked follicles. Oral antibiotics used to treat acne include erythromycin or one of the tetracycline antibiotics (tetracycline, the better absorbed oxytetracycline, or one of the once daily doxycycline, minocycline or lymecycline). Trimethoprim is also sometimes used. Topical antibiotic such as erythromycin (Benzamycin gel), or clindamycin (Duac once daily gel), or treat the outbreak with a topical antibiotic alone, eg clindamycin (Dalacin T), erythromycin (Eryacne gel), tetracycline (Topicycline). Azelaic acid lotion or gel, which is put on twice a day. Long-term treatment with oral antibiotics such as tetracycline or minocycline (eg Minocin), combined with one of the medications mentioned above may be helpful.

Topical Treatments for Acne Tips

1. Acne lotions may dry up the oil, kill bacteria and promote sloughing of dead skin cells.

2. Oral contraceptives, including a combination of norgestimate and ethinyl estradiol , have been shown to improve acne in women.

3. Externally applied antibiotics such as erythromycin, clindamycin, Stiemycin or tetracycline aim to kill the bacteria that are harbored in the blocked follicles.

4. Topical antibiotic such as erythromycin (Benzamycin gel), or clindamycin.

5. Azelaic acid lotion or gel, which is put on twice a day.

6. Long-term treatment with oral antibiotics such as tetracycline or minocycline (eg Minocin).

7. Trimethoprim is also sometimes used.