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Non Surgical Solutions : Acne and Acne Scaring
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Acne is a "Chronic" inflammatory disease of the oil glands characterized by the formation of comedones (black and white heads), spots or pimples, nodules (thicker, harder, pimples), and in some cases scarring.” Factors contributing to acne are thought to be increased skin oiliness, abnormal bacterial skin population and lazy skin shedding.
Acne is a very common condition. 95% of 16 years old boys and 83 % of 16 years old girls are affected by some degree of acne. In about 20% the help of a doctor is needed; although most acne resolves by mid twenties, it is now thought that mature acne is increasing in frequency, and recent studies show that 25% of patients are in their mid-thirties (Adult acne)
Chocolate and spicy or fatty food does not play a significant role in acne; whereas marked weight loss can reduce seborrhea (production of oil), and therefore reduce acne but is not an acne treatment per se!
Up to 70% of women report acne flares 2-7 days before their period.
Living in hot and humid environment frequently cause deterioration in acne. Acne can induce severe stress in the individual and is a cause for shame and embarrassment, anxiety, lack of confidence, unemployment and impaired social contact. It is the number one reason for suicide amongst teenagers. It therefore can impair the quality of life considerably and hence must be treated.
TREATMENT:
Treatment depends upon the severity of acne. Mild acne can be treated with creams alone, such as topical antibiotics, Benzoyl peroxide preparations and Retin-A or Differin Gel. Moderate acne may need oral antibiotics, or hormonal preparations, in addition to the skin creams (topical treatment), whilst severe acne would warrant a course of Isotretinoin (Roaccutane) – this is a concentrated form of a Vitamin A derivative which is very effective, but must be prescribed by dermatologists after appropriate blood investigations. Patients on Roaccutane must not get pregnant while on the treatment and for two months after the end of the treatment as there is a very high risk of getting a child with deformities. The drug has been used safely for the last 25 years.
Roaccutane is the closest a patient can get to cure acne. It is successful in clearing acne in 85% of the cases. The course of treatment lasts usually for six months during which the patient may experience bothersome but not serious side effects including dryness of the eyes, lips, nose, fatigue and muscle aches.
Discussion with the patient of the condition and explanation of therapy, realistic expectations as well as reassurance are a very important part of acne management.
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