Pimples, zits, blemishes, breakouts; only a lucky few of us go through life without our fair share of these and the spotty majority of us, whether we realise it or not, are suffering from acne. It is one of the most common skin complaints, affecting millions of people worldwide, most famously, teenagers. Teenage acne clears up around the late teens and early twenties; however, acne can affect almost anyone, at any age. It consists of blackheads, whiteheads and ‘spots’ which appear on the face and sometimes on the body. The condition can range from extremely mild to very severe and has several different varieties. Almost all varieties and severities of acne can be treated .
Acne forms when the pores of the skin are blocked by sebum, an oil naturally produced by the sebaceous glands in the skin. During adolescence the heightened activity of hormones increases the production of this oil which is why around 80% of teenagers suffer from acne. When excess sebum is produced it cannot drain properly. This clogs the pores. Clogged pores attract dead skin cells, bacteria and dirt which form a blockage called a ‘comedo’. A closed comedo is called a whitehead, while an open comedo is called a blackhead. These blackheads and whiteheads are non-inflamed pores but if they are affected by bacteria they can become inflamed .
The Causes of Acne
The overproduction of sebum (natural oil produced by the skin) is the cause of acne, yet exactly what causes the sebaceous gland to be overactive is unknown. In teenagers the cause is usually hormonal but the specific causes vary from person to person. The most usual cause of acne is a combination of the following factors:
- Hormone levels
- Vitamin deficiencies
- Environment – humid, damp, oily or greasy atmospheres.
- Some medications
Common Acne Myths
Not only are the exact causes of acne unknown but to confuse matters further there are a huge number of old wives tales about the condition. For example, it is widely believed that greasy and fatty foods such as chips and chocolate can cause acne. Happily, there is no real evidence that this is true.
It is also a myth that the more you wash your face, the less likely you are to have acne. If your skin produces too much sebum then, chances are, you will get acne no matter how often you wash your face.
Symptoms and Diagnosis of Acne
Acne is easy to recognise, a doctor or dermatologist will simply inspect the skin in order to make a diagnosis. Further testing is only necessary in extremely rare cases. It is also simple to diagnose yourself; however, if you are experiencing anxiety, discomfort, unusual symptoms or uncertainty it is important to consult a professional. The main symptoms of acne include:
- Blackheads and/or whiteheads
- Skin inflammations or ‘spots’ such as cysts, pustules, papules and nodules.
- Redness and/or crustiness around these skin inflammations
- Scarring from previous skin inflammations
Common Acne Treatments
Initially, for mild cases of acne, it is recommended that you attempt home treatment using simple measures such as washing your face once or twice a day with a gentle soap, keeping your hair grease-free and avoiding touching your face with your hands. If this does not reduce your acne after 4-6 weeks then over-the-counter products can be tried.
If after 4-6 weeks over-the-counter remedies and a good skin-care regime have made little or no improvement you should consult your doctor or dermatologist.
Cosmetic Treatment for Acne
Microneedling, originally known as collagen induction therapy or percutaneous collagen induction (PCI), is now a well-documented treatment option in atrophic acne scars and for skin rejuvenation. The therapeutic indications for this treatment option have increased over the last few years .
Microneedling, as the term indicates, means the use of needles or ‘microneedles’ to achieve a therapeutic effect.
Principle of microneedling
Microneedling relies on the principle of neocollagenesis and neovascularisation that occurs as a result of the release of growth factors following needle piercing of the stratum corneum. These growth factors are believed to be responsible for the beneficial effects of the procedure in the treatment of scars and photoageing.
- Formation of microchannels with resultant healing response: previously, it was proposed that following microneedling, thousands of microchannels or tiny wounds are produced through the epidermis into the papillary dermis of treated skin. These microchannels create a confluent zone of superficial bleeding that acts as a powerful stimulus for the release of various growth factors which initiate the normal process of wound healing by stimulating the migration and proliferation of fibroblasts that promote collagen deposition5,7
Applications for microneedling
Although microneedling was initially proposed as a treatment modality mainly for scars and wrinkles, its use has also been extended to stretch marks, facial rejuvenation.
Scar treatment still remains a challenge . Scarring continues to be a distressing condition for the patient, especially when it involves the face at a young age, this is seen commonly after acne. Post-acne scarring, besides causing cosmetic disfigurement, leads to psychological issues in this age group.
There are a number of advantages of using microneedling for the treatment of post-acne scars. It can be performed with no down time, is safe for acne scars on all skin phototypes. Additional advantages include the cheaper cost, the comparative ease of the overall procedure, and also the minimal downtime associated with Dermapen treatment vis-à-vis ablative or even non-ablative laser resurfacing techniques. The Dermapen can also be used on areas that are not suitable for peeling or laser resurfacing, such as near the eyes. No demarcation line is formed between treated and untreated skin following microneedling, as is commonly seen after other resurfacing procedures. This means that specific areas of scarring can be treated without the need to treat the entire face There is no risk of photosensitivity and post-procedure infection is not seen because the microholes created during the procedure close immediately.
A few adverse effects have been reported with microneedling treatment. These include pain during the procedure, transient erythema and oedema.
General scars removal
Microneedling has found its place in the treatment of general scars.
Microneedling treatment is becoming popular all over the world not only in the management of post-acne scars but also as an anti-ageing therapy. There are certain advantages with microneedling therapy over laser resurfacing as the former does not lead to any epidermal injury as is seen with lasers; there is minimal downtime associated with the procedure unlike ablative laser resurfacing, and the treatment is far cheaper. The treatment can be performed in an office setting and does not need any long-term special training or any expensive instruments.