A

Acne is a result of three factors; excessive production of an oil called sebum – this blocks the pores and causes an over-growth of bacteria trapped in the blocked pores. This leads to pimples and spots and sometimes cysts.  The medical name is Acne vulgaris and blackheads, whiteheads, papules and pustules and cysts are all considered to be acne, so there’s not many of us that, at one time or another, haven’t suffered from acne.

Acne Triggers

Genetics, hormones, stress, menstruation, intense exercise, IVF and certain steroid containing medications.

AHA’s

Short for Alpha-hydroxy acids – these are derived from foods including sugar cane, milk, apples, citrus fruits and grapes. AHA ‘s loosen the glue-like substance that holds onto the top layer of dead skin and allows them to slough off easily. AHA products cause exfoliation, or the shedding of dead skin cells. If you shed dead skin cells the pores will not become blocked and oil cannot become so easily trapped in the skin, meaning you have less chance of spots. It’s important to use high SPF creams every time you go out, because sun sensitivity increases after using AHA’s.

Androgens

Hormones that are present in males and females, although in higher levels in males. They stimulate sebaceous gland oil production and increase during puberty as part of the natural maturing process. That’s why acne becomes more of a problem in adolescence. Anything that increases androgens in the body will cause a breakout of spots, including Polycystic Ovary Syndrome, stress and high intensity body building. This is termed secondary acne.

Antibiotics

Antibiotics reduce bacteria and also fatty acids in sebum, this then reduces the inflammatory response in the skin.

Anti-microbial

A substance that is anti-microbial kills or inhibits the growth of bacteria.

Anti-inflammatory

A substance that is anti-inflammatory is used to reduce redness.

B

Benzoyl peroxide

Works as an anti-microbacterial to reduce bacteria. Bacteria living at the bottom of a follicle cannot live with oxygen – Benzoyl peroxide provides oxygen to the follicle and the bacteria cannot multiply. Also helps with skin turn over.

BHA

Beta-hydroxy acid is oil soluble so is able to penetrate into a follicle filled with sebum and exfoliate the dead cells that have built up, excellent for blackhead and whitehead removal.

Blackhead

a pore that is filled with dead skin cells and excess oil, that is not red or inflamed, the pore remains open and the debris oxidises and becomes black, hence the name. Sometimes called open comedones.

Box car scars

Angular scars that are usually on the temple and cheeks, they can be superficial or deep, they look a bit like chicken pox scars.

C

Chemical peels

A chemical peel simply removes a layer of skin from the face by a chemical reaction to reveal a newer, healthier layer. The chemical solution is applied which causes mild trauma to the epidermis of the skin, thus causing the outer layers to peel away. When the skin begins to heal, increased cell growth produces new, healthier skin layers. There are lots of different chemical peels available, such as Glycolic, Salycylic, lactic and TCA.

Co2 Laser Peels

Co2  laser resurfacing is performed using a beam of laser energy which vaporises the upper layers of damaged skin, it also puts heat energy into the deeper skin which reduces the bacteria and encourages repair. Be careful if you have olive or dark skin as you may risk hyper-pigmentation. Do not have Co2 laser treatment if you have used Isotretinoin or Roaccutane within the previous 6 months. If you suffer with cold sores take antiviral medication during the post-operative period to guard against an outbreak.

Comedone

A blocked pore or follicle, can be a blackhead or whitehead.

Closed comedone

A whitehead – it is not inflamed and has a white centre and the top is covered with dead skin cells.

Comedogenic

Will block pores and cause comedones – blackheads/whiteheads.

D

Dermal Fillers

Dermal fillers are made of synthetic or natural substances and are injection into the dermis to fill out lines, wrinkles or indentations under the skin. For acne scars the filler can be injected into the scar to fill the indentation and raise the surface of the skin making it look much smoother. It is not a permanent treatment. Your own fat could be used too, which has a similar effect but is also not permanent.

Dermatologist

A doctor who specialises in skin concerns and conditions.

E

A laser energy that vaporises the skin tissue and heats up the skin’s deepest layers. This process breaks down dead skin cells and encourages collagen production so the skin becomes firmer and smoother.

Estrogen

The primary female sex hormone, responsible for fertility and female cellular health – that means skin, hair and bones. It’s  also involved with female characteristics and female sexual development.

F

Follicle

A small shaft that hair grows through which also secretes sebum to the surface of the skin.

G

Genetics

Genes are responsible for how you look and how your cells behave, this includes, hair, eye colour, height and the way your skin behaves. Some people have a genetic predisposition to acne.

Glycolic acid

An AHA derived from sugar cane. It’s the AHA with the smallest molecular size and as such has the greatest ability to penetrate the skin most easily and dissolve the glue-like substance that holds dead skin on the skins surface, dislodge dead skin cells and old sebum from blocked pores. Glycolic acid will clear blackheads and spots quite rapidly. It’s important to use high SPF creams every time you go out, because sun sensitivity increases after using AHA’s.

Glycolic Peel (Mild Peel)

Glycolic peels come in a variety of strengths from an at home 5% peel to a salon strength of 20 or 40% up to a medical strength of 70 – 90% that should only be performed by a doctor or nurse. You may feel a slight stinging or warming sensation during the procedure but any significant pain is unlikely and no anaesthetic is needed for a mild peel. Most people need a course of 6 for best results. It’s important to use high SPF creams every time you go out, because sun sensitivity increases after Glycolic peels.

H

Hormones

A hormone is a chemical naturally produced by the body that sends messages out to other cells instructing them how they should work. Certain hormones are responsible for the transition from adolescence to adulthood and often cause acne.

I

Ice pick scars

Deep pits, that are the most common and a classic sign of acne scarring.

Isotretinoin

A form of vitamin A taken orally, sometimes known as Roaccutane or Accutane. Isotretinoin decreases the size and activity of the sebaceous glands in the skin, which reduces the amount of sebum that is produced. This stops the glands becoming blocked, and means bacteria are less likely to thrive. It also reduces the inflammation in the skin.

Isotretinoin can have serious side effects and its use must be supervised by a dermatologist. It is reserved for the treatment of severe acne (such as nodular or conglobate acne or acne at risk of permanent scarring) that has not improved with standard treatment involving oral antibiotics and topical medicines.

Inflammation

Slight inflammation means you may have sebum trapped just under the skins surface, often seen around the corners of your nose or on the cheeks, usually it results in blackheads and whiteheads too. If the sebum is trapped a little deeper in the skin you may get some pimples. And sebum trapped deeper still will result in a puss filled pimple that’s called a pustule, very deep trapped oil will present it’s self as a painful, very inflamed cyst, it will be very raised, not have a head and feel like a small nodule. This is the the most severe form of acne.

Laser or Light treatments

Laser Resurfacing, resurfaces the skin by vaporising the top layer and putting heat energy into the deeper layers to promote collagen production and thicker smoother skin.

Non Comedogenic- will not block pores

R

Retinoids

Retinoids are creams, lotions or gels, applied topically to the skin, containing one or other of the Vitamin A derivitives. They help turnover skin cells and soften the surface layer of the skin allowing better penetration of other skincare products.

S

Salicylic Peel

Salicylic acid, an AHA, is derived from willow tree bark. It is anti-inflammatory and is similar to the substance that aspirin is made from. Salicylic acid is a highly effective skin exfoliator and is often used in acne products and in a stronger version as a skin peel. Salicylic Peels are usually at a strength of 20% or 30% and regular peels with salicylic acid will remove blackheads and whiteheads, diminish fine lines and wrinkles and improve acne, resulting in smoother and more even toned skin by allowing dead skin cells to be detached from the skin’s surface. The main benefit of salicylic acid is that as it has similar properties to aspirin, it helps prevent any post-treatment irritation or inflammation and helps prevent excess oil making it highly effective in the treatment of acne skin. If used as part of an acne skincare treatment routine most people can achieve the same results in eight weeks – compared with approximately six months if you were just using active skincare. For a noticeable result most people need 6 – 10 sessions. Your skin may be shiny and red for a few hours after treatment. Flaking and itchiness are also possible in the first few days. It’s important to use high SPF creams every time you go out, because sun sensitivity increases after salicylic peels.

Scars

A scar is excessive fibrous tissue. In active acne, there is excessive formation of fibrous tissue because of chronic inflammation.

Subsission

is when a scar is cut at it’s deeper point to release the tethering of the skin.

Sculptra.

A treatment that can be used to fill out deep scarring, it encourages normal collagen production, you may need four treatments.

Spot injections

You can have a Cortisone based injection to help clear a large, painful spot or cyst which should shrink it within 48 hours. A great rescue plan if you have an important occasion coming up!

Systemic treatments

A treatment that works inside the body.

Roaccutane or Isotretinoin

Isotretinoin decreases the size and activity of the sebaceous glands in the skin, which reduces the amount of sebum produced. This stops the glands becoming blocked, and means bacteria are less likely to thrive. It also reduces inflammation in the skin.

Isotretinoin can have serious side effects and it’s use must be supervised by a dermatologist. It is reserved for the treatment of severe acne (such as nodular or conglobate acne or acne at risk of permanent scarring) that has not improved with standard treatment involving oral antibiotics and topical medicines. It can cause serious birth defects.

TCA Peel (Medium Peel)

TCA stands for Trichloroacetic Acid, which is derived from the acid that gives vinegar its pungent smell and taste. It is a medium to deep peeling agent that is normally used in 10 to 35% concentrations. This can be a painful peel where the skin blanches (frosts and turns white), but works well for specific skin conditions. A topical anaesthetic or pain relief will be administered to help you stay comfortable during the treatment. The peel works by causing trauma to the skin’s layers and the top layer of the epidermis may be removed, where stronger solutions are used the treatment may extend deeper into the dermis. The damaged layers of skin will peel away and the healing process encourages increased cell growth as well as collagen production and reorganisation in the dermis that produces new, healthier skin layers, giving the face a more youthful, rejuvenated appearance. Good for removing acne scars, uneven pigmentation, treating fine lines and wrinkles and on some occasions, TCA peels have been used to remove and prevent the growth of pre-cancerous lesions. However, this treatment is not recommended for dark, fine or sensitive skin. Acne scars and uneven pigmentation will be visibly reduced after a course of treatment. You may need one to three treatments, a month apart. Allow up to a week to recover. A protective layer of petroleum jelly may be applied following the procedure to keep the area moist and protected. You will most likely notice the outer layers of skin peeling away within a few days of treatment and new skin will begin to appear in one to two weeks. As the skin will be more sensitive to sun exposure it is extremely important to protect the skin with SPF30 in daylight hours after the treatment.

Topical Treatments

These are treatments applied directly to the skin and include Benzoyl peroxide, antibiotics such as Zineryt, retinoids such as Retin A, Retinova, and AHA’s such as glycolic and salicylic acids. These may be gels, lotions or creams.

Treatment Medication

Oral antibiotics can help reduce bacteria and help control moderate to severe acne, acne that resists topical treatment therapy and acne that covers large body surface areas. Oral antibiotics that may be prescribed to treat acne include tetracycline, doxycycline, minocycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim, and azithromycin.

Females are often prescribed Birth control pills that contain estrogen or other medication that can reduce the effects of male hormones.

Treatments for Scarring

There are various treatments that can greatly improve acne scarring, these include; laser resurfacing, dermabrasion, Co2 laser, Erbium Yag, chemical peels, AHA’s  dermal fillers, Sculptra and steroid injections. Individual skin types react differently to treatments so it may be necessary to try combination and individual treatment protocol to find the most effective treatment for you- what works for one may not be so effective for another.

Tretinoin

This is the acid form of vitamin A, a retinoic acid, also known as all-trans retinoic acid or ATRA. It is very often used to treat acne. It is available as a cream or gel brand names Aberela Airol, Renova, Atralin, Retin-A, Avita, or Stieva-A