May. 02, 2020

How to treat acne?

In the previous blog we already explained the four primary factors and lifestyle factors that may influence (the severity of) your acne. In this blog we will focus on the treatments for acne.
For professional advice on this topic, we consulted dermatologist Dr. Maselis.

COMMON CAUSES FOR ACNE

Dr. Maselis, a well-known dermatologist from Belgium, explained us the most common reasons for acne in his medical practice:

1. Hormonal disorders

This may be due to contraceptive medication such as the contraceptive pills or spirals. On the other hand, some people are suffering from a hormonal disorder and are therefore more sensitive for acne breakouts.

2. Misuse of cosmetics

As we explained in the previous blog ‘lifestyle factors that influence acne’, some types of makeup or skincare are heavy and oil-based and may lead to clogging of the skin pores. Therefore, it is important to use cosmetics that are ‘non-comedogenic’.

3. Exposure to the sun

Under the influence of the sun the epidermis will become thicker, it can reach up to 6 times its original thickness. This also means that the secretion of sebum by the sebaceous gland becomes much longer. The sebum will have difficulties to get out and will cause blockages of the pores, resulting in pimples. In the summer, the sun is going to prevent an outbreak of acne. The outbreak mostly occurs later on, during fall.

4. Popping pimples and squeezing the skin

Many people try to squeeze and push the pimples. Consequently, the sebaceous gland is damaged and infected, leading to an increased production of sebum. Moreover, there is a chance that it will burst inside, causing subcutaneous inflammation. As a result, inflammation and scarring on the skin will occur.

TREATMENTS FOR ACNE

There are 4 primary factors that play a role in the development of acne on your skin. Most treatments will work one or more of these primary factors:

1. Hyperkeratinisation

The first, and most important, possibility to treat acne consist of removing the keratin plug that is blocking the skin pores. What's important here is the time between the formation of a plug and the appearance of a pimple, this process takes approximately 3 months. These products will therefore only have an effect on your skin after 3 months. Examples of treatments that actively work on this factor are:

Salicylic acid

You may recognize this molecule from our previous blog. Salicylic acid can not only be used as an exfoliant, it is also useful in acne treatments because of its keratolytic effects. Salicylic acid breaks and loosens bindings between cells in the horn layer (outer layer) of the skin. This ‘keratolytic’ action encourages exfoliation of the skin and unclogging of pores.

Salicylic acid is available in different products and concentrations. It exists in wash-off and leave-on products with a concentration varying from 0.5% to 2%. It is also available in topical drugs, in a concentration of 0.5-5%.

Benzoyl peroxide

Benzoyl peroxide in a non-prescription drug, also simply known as ‘BPO’. Benzoyl peroxide will not only remove the keratin plug on the skin; it is also bactericidal. The product will kill the bacteria involved in the development of acne. The concentration of BPO in OTC drugs ranges from 2.5% to 10%. Some acne medications contain BPO in combination with other ingredients. These products are available only by prescription.

Vitamin A derivates

Vitamin A stimulates the differentiation and proliferation of the skin. Drugs containing vitamin A derivates, are mostly referred to as ‘retinoid drugs’. Different generations of retinoids are on the market, some well-known examples are: ‘Isotretinoin’ (Roaccutane) and ‘Adapalene’. Not only in drugs, but also in skincare, multiple subtypes of vitamin A are used. The most famous example is ‘Retinol’.

2. Increased sebum production

Increased sebum production is related to hormone levels in most cases. During puberty there is a change in hormone levels, which may influence the occurrence of acne lesions. Contraceptive drugs are sometimes prescribed for teenagers suffering from acne. This is not the case for male patients.

3. Propionibacterium acnes

The third important thing is to tackle the bacteria. There are both oral and topical antibacterial agents to treat acne. In the past this was the main strategy to treat acne but due to resistance this is no longer the first step in treating acne.

Furthermore, there are also products on the market that work in de opposite way. Yun developed probiotics that add good bacteria to the skin that will fight the bacteria causing acne. A product like Yun supplies a large dose / mass of good bacteria in such a way that it gets the upper hand. Does it work spectacularly? No, with a really acne-prone skin, antibiotics will work much faster because they will actually kill the bacteria. But it's a good idea!

Next to antibiotics and probiotics, there is also ' benzoyl peroxide ' that kills the bacteria on the skin, as explained above.

4. Inflammation

Some drugs work on the inflammation process involved in the pathology of acne.

Some examples of drugs that work on this factor are:

Retinoids
Antibiotics: some antibiotics have both anti-microbial and anti-inflammatory properties.
Zinc: there are two ways zinc could potentially treat acne: orally via supplement or topically in a cream or serum. Zinc products were used in the past but are no longer considered first line therapy, and generally, do not work as well as traditional acne treatments.