Exploring the Complexities of Acne: Understanding, Treatment, and Management.
Acne, also known as Acne Vulgaris, is a prevalent and persistent skin condition that affects individuals worldwide. It's estimated to impact around 9.4% of the global population, making it one of the most common skin diseases. Adolescents, in particular, are vulnerable, with over 85% experiencing acne. It often continues into adulthood, especially among females, leading to most dermatologist consultations for this condition.
Acne presents with various lesions, including non-inflammatory types like blackheads and whiteheads and inflammatory types such as papules, pustules, nodules, and cysts. These lesions primarily appear on the face, neck, upper back, and chest. Acne manifests in different forms, including neonatal and infantile acne, occupational acne, acne conglobata, and others, each with unique characteristics and severity.
While acne cannot be prevented or cured, it can be effectively managed with appropriate treatment. However, treating acne often requires prolonged and persistent therapy, and it is associated with significant financial costs.
In the classical understanding of acne vulgaris, several factors are believed to play a significant role. These include genetics, environmental conditions such as temperature, pollution, humidity, sun exposure, and using unrefined oils and halogenated hydrocarbons. Nutrition, hormonal fluctuations, stress, smoking, comedogenic medications like androgens, halogens, corticosteroids, bacterial infections, and certain cosmetics are also implicated in acne's onset, exacerbation, or worsening.
Acne vulgaris commonly leads to physical discomfort, emotional distress, and potential scarring. Furthermore, individuals affected by acne may experience feelings of anxiety and embarrassment, which can contribute to a sense of mental distress.
Acne's development is complex, involving various factors like excess sebum production, bacterial colonisation, and inflammation. Increased sebum, influenced by hormones like testosterone and Insulin Growth hormone (IGH-1), is a major contributor to acne severity. Hyperkeratinisation, where skin cells accumulate in hair follicles instead of shedding, further exacerbates the condition. Propionibacterium acnes (now Cutibacterium acnes) bacteria thrive in these follicles, secreting enzymes that exacerbate inflammation and lead to acne lesions like pustules and cysts. Inflammatory responses, triggered by the immune system's reaction to bacteria, contribute to acne's progression. DNA methylation, an epigenetic modification, may play a role in acne development, offering potential insights for future treatments. Conventional acne treatments aim to manage existing lesions by addressing factors like excess sebum production, abnormal follicle keratinisation, and bacterial infection. These treatments include anti-inflammatory and antibacterial drugs, administered either topically or systemically, and non-drug options like light therapy. Combinations of treatments, especially using both topical and oral medications, are often the most effective.
Topical treatments are applied directly to affected areas, reducing systemic absorption and targeting the follicles. These treatments include creams, gels, lotions, and solutions, with retinoids and antibiotics being common choices. Retinoids, like tretinoin, adapalene, and tazarotene, reduce sebum production and promote healthy skin turnover, although they can cause dryness and irritation. Antibiotics, such as erythromycin and clindamycin, combat bacterial growth and inflammation, often used alongside benzoyl peroxide to prevent resistance.
Combination topical therapies offer additional benefits, often including ingredients like benzoyl peroxide, salicylic acid, niacinamide, azelaic acid, and dapsone. These combinations can provide synergistic effects, simultaneously addressing multiple aspects of acne pathology.
Systemic treatments are reserved for severe cases or when topical options are ineffective. Oral medications like isotretinoin, a powerful retinoid, and antibiotics are commonly used. Isotretinoin is particularly effective but can have significant side effects, requiring careful monitoring. Hormonal treatments, such as oral contraceptives, may also be used in certain cases, especially in females with hormone-related acne.
Recent advancements in acne treatment focus on targeting specific pathways involved in acne formation, including inflammatory mediators and bacterial growth. Therapies that release nitric oxide (NO) show promise due to their anti-inflammatory, antibacterial, and antioxidant properties. Efforts continue to develop novel therapies to eliminate acne while minimising side effects and improving treatment outcomes.
Nutrient-rich foods to incorporate into your diet include cruciferous vegetables such as broccoli, cauliflower, and dark leafy greens, aiming for two to three servings daily. Probiotic-rich foods and omega-3 fatty acids in fish like tuna and salmon, nuts, seeds, and avocados are also beneficial additions. Ensure each meal includes a balance of fruits, vegetables, lean proteins, and whole grains. Zinc-rich foods, including lean meats, seeds, and legumes, are important for overall health. Be mindful of potential irritants such as dairy and gluten in your food choices.
At Juve Skin Studio, our mission is to facilitate the attainment of enduring skin wellness, fostering timeless beauty and vitality. Central to this objective is our commitment to optimising the skin's microbiome, its primary defence mechanism. We achieve this through tailored cleansing protocols and applying an acidic toner, ensuring the skin remains in optimal health.
Following meticulous assessment, we implement customised treatments and specific ingredients tailored to each client's unique needs. Our protocol includes salicylic acid, glycolic acid, trichloroacetic acid, tea tree extract, colostrum, antioxidants, and retinol, as well as advanced modalities such as light therapy, sonophoresis, and SkinPen medical needling for targeted treatment of acne scarring. Each intervention is carefully selected to deliver optimal results while prioritising the long-term health and vitality of the skin.
Book with one of our skin experts to discuss a treatment plan best suited for individual needs.
Listed under ‘Skin Therapy’
References
https://www.sciencedirect.com/science/article/pii/S2405580823001590
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986265/
https://doctortaz.com/why-holistic-medicine-doctors-want-women-to-eat-more-cruciferous-vegetables/
https://doi.org/10.1016/j.ijwd.2015.02.001
https://doi.org/10.3390/molecules27020555
https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
https://doi.org/10.3390/healthcare9060668
https://www.rupahealth.com/post/using-functional-nutrition-to-address-hormone-imbalances