Cystic Acne Treatment
What is Acne?
Acne and cystic acne are chronic skin conditions that appear as a result of the oil (sebaceous) glands in the skin at the base of hair follicles being clogged with oil, dead skin cells, and bacteria, leading to inflammation. Acne can appear most commonly on the face as well as shoulders, back, neck, chest, and other areas of the body.
While not a dangerous condition, acne can leave acne scars on the skin, causing emotional distress. The earlier you treat your acne, the lower your risk of acne scars and emotional trauma.
What Are the Types of Acne?
Depending on the severity of the congestion, acne comes in various forms, and hence, calls for different treatment protocols:
- Whiteheads; small white dots on the skin with closed clogged pores
- Blackheads; small black/brown dots on the skin, with open clogged pores
- Papules; tiny red tender bumps with no white or yellow centre
- Pimples/pustule; papules with pus at their tips
- Nodules; large (over 5mm wide), painful lumps not filled with pus
- Cysts; large (over 5mm wide), painful lesions filled with liquid or pus
When Does Acne Appear?
Acne is a common occurrence during adolescence (between 10 and 19 years old) but can also appear well into adulthood, also called adult onset acne.
During adolescence, boys and girls go through puberty, which sees an increase in the androgen hormone. This hormone initiates the skin to produce oil, leading to pubescent acne, and is more common in males although some females do get it too. In males, acne tends to be more acute, while in females, the condition is less severe but prolonged, often continuing as adult onset acne.
Acne Treatment in Singapore at SL Aesthetic Clinic
- The first step to treating acne is understanding the patient’s medical history, lifestyle habits, diet, and exercise. The doctor will go through a series of questions to find out any relevant information.
- Second, the doctor assesses the severity of the patient’s acne. This is done so using an Acne Grading System, which classifies acne into Grades I through IV, or mild to severe. When grading the severity of the acne, the doctor will consider several factors; the distribution of acne beyond the face such as back, chest, even upper arms, the type and number of acne, as well as the presence or absence of scarring.
- With the above information, the doctor can identify the variant of acne the patient has and treat it accordingly. The most common variants are acne vulgaris and acne mechanica. Other less common variants include drug-induced acne, acne inversa, acne conglobata, acne fulmians or acne maligna, occupational acne (a result of exposure to insoluble materials causing follicle obstruction), and even acne with a psychological and emotional cause – excoriated acne.
Acne Treatment Options in Singapore
With all the above factors considered, the doctor will then work with the patient to come up with an acne treatment plan. The treatment plan can be simple, like applying a topical cream, or a complex one that involves a change in lifestyle habit, diet plus oral medication or a combination of treatments.
With this in mind, here’s a summary of acne treatment options the doctor may consider.
Mild acne (comedonal with few papules and pustules) can typically be treated at home with over-the-counter topical products such as gels, soaps, creams, lotions containing resorcinol, benzoyl peroxide, salicylic acid, and azelaic acid.
On top of that, to avoid the risk of acne scars due to accidental squeezing of acne, patients can also seek the help of facial therapists who are better trained and equipped to maximise results with minimal scarring.
Pricing: Over-the-counter products can vary from several dollars to the twenties or more.
A simple but effective therapy that can target a variety of factors that contribute to acne formation. Chemical peels are also known to enhance the effects of other topical treatments.
Chemical peels involve the application of a peeling agent in varying concentrations onto the affected area for a controlled amount of time.
While generally safe, these peeling agents should be administered under the supervision of a doctor for the treatment of acne as the benefits and complications of chemical peels vary among racial groups and skin tones.
Pricing: Professional chemical peels start from slightly over $100 per session.
A proven option in the armoury of acne treatments, there are several laser technologies that have been used with variable efficacy. Typically, lasers are used in combination with other therapies to enhance the overall result.
Patients may prefer laser therapy for acne as they do not desire or are able to use topical or systemic treatments. However, some drawbacks with lasers are potential pain and skin discolouration (especially for those with darker skin).
Pricing: SL Aesthetic Clinic’s Fotona Acne & Acne Scar Laser, From $350 per session.
As acne is largely caused by bacteria, oral antibiotics can be taken as an acne treatment. This is typically prescribed by the doctor to treat moderate severity of acne.
Pricing: varies by the clinic and brand of medication.
Oral Isotretinoin Medication
This US Food and Drug Administration (FDA) approved drug provides long-term remission of acne symptoms in about two-thirds of people who take an adequate dosage (1mg/kg). However, it does come with several side effects such as cheilitis (drying of the lips), facial redness, dermatitis (skin dryness, dandruff), mood changes, and more. Birth defects are also a concern, which is why the drug is not given to women of child-bearing age.
Pricing: varies by the clinic and brand of medication.
A type of steroid injection, cortisone shots can be administered by a doctor for occasional use to treat a cyst or nodule. The injection can quickly reduce swelling and heal the lesion, thus helping prevent scarring. Patients typically prefer this as a last-minute treatment should an acne appear prior to an important social event.
Pricing: From $100 per injection.
Not sure which treatment option is best for you? Speak to our doctor for a personalised acne treatment plan. Schedule now.
Prevention and Management of Acne and Cystic Acne
As the saying goes, prevention is better than cure. While not to be taken as medical advice, here are some tips that you can follow to reduce acne outbreaks:
- DO NOT squeeze or pop your own pimples as this can cause scarring or even cause even more acne outbreak
- Wash your face twice a day with warm water and a mild soap made for acne
- Seek help from a facial therapist for professional extractions and a chemical peel
- Practice good hygiene habits such as washing hands frequently and avoid touching your face
- Avoid oil-based makeup
- Avoid excessive sun exposure as this can stimulate your skin to produce more oil, thereby increasing your risk of acne formation
- De-stress every so often
Acne can occur on any part of the body that has pores, but is most commonly seen on the face and upper body (back, chest, back of neck, shoulders) because these areas have a high density of pores producing skin oil. These pores are connected to oil glands underneath the skin via follicles.
Oil glands produce a liquid called sebum/skin oil to carry dead skin cells through the follicles to the surface of the skin. When dead skin cells, oil, and hair form a plug in the follicle, the pore is said to be clogged. And when it gets infected by bacteria (predominantly Propionibacterium acnes or P. Acnes), it starts to swell and become inflamed, developing into a pimple.
As the inflammation continues, pressure builds up inside the clogged pore, eventually breaking the walls of the pore and spilling its contents into the surrounding skin.
The body’s immune system then senses the spillage as “foreign” and activates immune cells, notably white blood cells, to fight the infection. This causes the acne lesion to become red and sore.
Eventually, the immune system reduces the attack on the “foreign” contents, and attempts to repair the damage the acne may have caused. However, if the immune system puts up an excessive attack, or does not heal the acne quickly enough, scarring can occur.
Acne is caused by multiple factors, such as Hormones, Inflammation or the body’s immune response, Genetics, Stress, Vitamin Deficiency, Diet, and even the use of certain medications, amongst others.
This is why treatment of acne is a highly individualised one; always speak to a doctor to find a suitable treatment plan that tackles your root cause of acne.
[07 Jan 2021] Written by Dr. Wei Xiang
Dr Wei Xiang has been heavily involved in the arts throughout his life. During his formative school years, he studied fine arts under the prestigious Art Elective Programme, where he developed his artistic talent and creative expression across various media, including painting, charcoal, digital media and photography.
After graduating from the Yong Loo Lin School of Medicine in 2014, Wei Xiang pursued postgraduate surgical training in a residency programme, where he honed his surgical skills over the years. His artistic side remained strong, and he constantly yearned to express a greater aesthetic element in his work. In 2019, he left his surgical career in search of his calling.
A fateful encounter with Dr Kelvin Chua brought Wei Xiang into the world of Aesthetic Medicine. It was in Aesthetic Medicine where Wei Xiang found his “ikigai” of sorts. Under Kelvin’s mentorship, Wei Xiang grew steadily and became adept at a wide range of aesthetic procedures including Botox, fillers, lasers, HIFU, Thermage, Ultherapy and PicoCare Laser. His keen eye for beauty, coupled with his steady hands, allows him to bring out the best in his patients.
Wei Xiang occasionally still creates artwork in his free time, when he is not spending time with his wife and daughter, or jamming and making music.
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