Acne Guide: Dermatologist Truths

What is acne?

Acne vulgaris is an epidermis inflammatory disease of the human sebaceous follicle and is a common dermatologic condition. Typically beginning in adolescence, it may persist into adulthood when left untreated.

How is acne developed?

The development of acne is not fully clarified, but it is agreed upon that the causes are multifactorial. A major cause of acne is related to a bacterium called Proprionibacterium acnes (P. acnes).

As a bacterium that grows deep inside of pores, P. acnes feeds on the sebum produced by sebaceous glands surrounding the base of the hair shaft. P. acnes grows best in an environment with accumulated sebum. P. acnes uses sebum as an energy source, causing the breakdown of sebum by the bacterium to produce byproducts that are inflammatory.

According to Dr.Teo Wan Lin, a dermatologist at TWL Specialist Skin and Laser Centre, she says: “To combat this inflammation, your body releases destructive enzymes to fight the infection. This immune response can cause damage to surrounding skin cells and is responsible for symptoms observed in acne as it permanently damages the skin and leads to acne scars.”

What are the causes that trigger acne?

One major cause is our genetic predisposition. Other factors that aggravate acne include:

• Oil-based cosmetics and facial massage
• Medicates that promote acne development e.g. steroids, lithium and iodides
• Food with a high glycemic number e.g. dairy products, candy
• Severe anxiety or anger may aggravate acne as it can stimulate stress hormones

Where does acne occur?

Acne occurs most prominently at skin sites with high density of sebaceous glands e.g. the face, back and chest.

Are there different types of acne?

Generally, acne can be divided into comedones, cystic acne. Comedones are hair follicles that are formed by the blockage of pores with sebum, debris and dirt, causing the pore to become infected.

Open comedones are blackheads, caused by an overproduction and buildup of oil that is oxidized, thus explaining its blackish appearance. Closed comedones are whiteheads, where the follicle is blocked completely. As the opening to the skin is obstructed, the rupturing of closed comedones can lead to skin inflammation.

Cystic acne is angry, red bumps filled with bacteria and pus. Caused by inflammation, it can start off as comedones that were left untreated, leading to an excessive growth of P. acne.

How can I treat acne?

Current treatments include topical formulations in the forms of creams, gels, lotions such as antibiotics, antibacterial agents and retinoids. Yet, patients need to be cautious of such treatments as it can lead to dryness, peeling or erythema. Different forms of acne would require alternative treatment techniques.

To treat open comedones, a mixture of carbon laser peels and chemical peels can be considered. For closed comedones, be sure not to pick those whiteheads as it exposes the skin to bacteria.

If you suffer from cystic acne, oral medication is likely to be given to shrink oil glands or prescription creams that contain tretinoin.

The use of lasers to treat acne is also increasingly popular due to minimal complications involved to allow benefits of treating acne scarring. The lasers will target the colonization of P. acne and high levels of sebum production on the face, chest and back.

If you may find it confusing to face acne alone, talk to a dermatologist. It is also important to visit your dermatologist before the acne gets severe and prevent scarring.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.