Acne 101

Arm yourself against nasty eruptions and hideous scars By Annie Tan

puberty is a time of many dramatic changes. Our body fills out with beautiful curves, our face loses its thick pad of baby fats to reveal well-chiselled cheekbones, and the first nasty pimple rears its ugly head on our once faultless complexion. 
Yes, acne is arguably the greatest curse of puberty. Studies suggest that every teenager between the age of twelve and seventeen suffers from at least an occasional blemish. 
Don’t let yourself be fooled, however, into thinking acne is strictly an adolescent problem and a passing phase. In fact, a little carelessness on your part during this crucial period, and you may find that these nasty bumps and pits stick around for a lifetime. With that said, it is imperative to arm yourself with basic knowledge of the beauty crisis of our age. 

Beneath the bump
What is acne? Acne is a term used to describe plugged pores such as blackheads, whiteheads and pimples. As Dr Chee Yew Wen, CEO and Medical Director of Wen and Weng Medical Group explains, acne usually starts appearing at puberty when there is an increase in circulating sex hormones in the body. These hormones have an effect on the sebaceous (oil) glands, causing them to enlarge and produce more sebum. The blockage of the normal passage of sebum out of the gland causes acne.
While acne is primarily an adolescent problem, many adults suffer from occasional breakouts as well. Women, however, tip the scale in terms of severity and recurrence due to the hormonal cycle they go through each month and the use of unsuitable cosmetic products. Other equally important factors include genes, the sensitivity of sebaceous glands, lifestyle choices, climate and certain medical conditions. 

Bump off
Of course, this doesn’t mean you’re completely at the mercy of random eruptions. Dr Chee tells us that good skincare products and a little discipline may go a long way towards clearing out these unsightly bumps:
REGULAR CLEANSING This is first step and bare minimal of any skincare regime. Proper cleansing is important because it prevents pores from clogging. People with acne-prone skin should choose cleansers that contain AHA or salicylic acid.
CLAY MASK Applied once a week, a good clay mask will further help to cleanse the skin and extract impurities.
PIMPLE CREAM When applied directly to individual zits, off-the-counter benzoyl peroxide works to eliminate bacteria and dry out acne.

Off-the-counter creams and regular cleansing should suffice for mild cases of acne. But, remember that what works for one person may not work for another. Moreover, even with the best possible care, acne takes time to clear. So allow it to heal on its own and resist the temptation to burst it!
If through some unfortunate accident, you happened to burst a bump, however, make sure you don’t cause further infection and inflammation by constantly picking at it or touching it. Instead, apply an antibiotic cream or a cream prescribed by your doctor to prevent scarring.
If acne is not controlled or is causing scarring, Dr Chee urges immediate consultation with a doctor. Indeed, it cannot be stressed enough that professional help is crucial for moderate and severe acne as these are more likely to leave permanent scars. 
In such cases, a dermatologist will be able to assess your condition to determine if there are any underlying problems contributing to acne, institute prescription drugs, or offer topical treatments such as lasers. Some prescription drugs include Tretinoin-based products such as retin-A, antibiotics and roaccutane. 

Marked for life
Well, if all this advice came a little too late, and you already have scars to show for it, fret not. With the advancement in aesthetic medicine, all may not be lost.
But before tackling the disagreeable topic of scars, let’s set things straight first. Just because you notice an iffy red mark on your face doesn’t meal you have a scar. This may be, instead, a ‘pseudo-scar’. A ‘pseudo-scar’ is flat reddish spot that is, in fact, acne in its the final stage of healing. Though this marks may remain for up to six months, rest assured that it will eventually fade. So don’t scream blue murder if you spot one.
So what are scars? Scars are permanent marks formed at the site of a former injury. When skin tissue is damaged, the body sends its rescue team of white blood cells and inflammatory molecules to the site of injury to repair tissue and fight infection. But sometimes, after the wound has healed, a depressed area or a raised thickened tissue may be noticed at the site of injury. This blight on our skin is otherwise known as a scar.
There are generally two types of scars: depressed scars such as ice-pick scars and box-scars, and raised thickened tissue such as keloids. The latter usually occur along the jaw line.
“It is hard to tell (a scar from a ‘pseudo scar’). But if an acne burst and forms a scab, (this will probably) leave a depression,” says Dr Chee. “Colour scars such as the red marks of acne usually fade over time, but not depressed or ice-pick scars, which do not improve (without) treatment.”

Nip tuck
Treatment options vary based on the individual’s condition, and his or her comfort level with aesthetic procedures. However, according to Dr Chee, microdermabrasion, Intense Pulse Light (IPL), carbon laser peel, and chemical peels are some of the common procedures that address acne issues. Most dermatologists or aesthetic surgeons use a combination of procedures for the effective treatment of acne.
MICRODERMABRASION is good for (the) prevention of (acne) if done regularly as it prevents the formation of comedones (the first stage of acne). 
INTENSE PULSE LIGHT (IPL) reduces the amount of facial hair, and in doing so, reduces the production of sebum, and unblocks the passage of sebum out of the gland. It also helps reduce the red marks left by acne.
CARBON PEELS help even out depressed scars and shrink pores. They should be used in combination with subcision. During this procedure, individual depressed scars are freed from the fibrous tissues that hold them down.
CHEMICAL PEELS involve the use of a chemicals solution to remove the damaged outer layer of the skin and improve its texture. These vary in terms of invasiveness.

“Most procedures have little or no downtime, and are safe,” reassures Dr Chee. “(But), for significant reduction in the appearance of depressed scars, a series of treatments are usually needed – usually six sessions performed over in three weeks.
“However, for depressed scars, the public must understand that no treatment can make them go away completely,” he stresses. While improvement of up to 70 per cent can be achieved, don’t expect flawless skin.
 Indeed, whether it comes to preventing acne, treating acne, or correcting scars, patience, composure and realistic expectations are an absolute must. So go into hysterics the next time you notice a bump ©