Treatment of Mild Acne

 

How to Get Rid of Comedones

Treatment of mild acne involves limiting or controlling triggering factors, life style management and getting rid of the comedones with topical medications.

Mild acne refers to non-inflammatory type of acne presenting with open or closed comedones, the blackheads and whiteheads respectively.

Acne Comedones
Mild Acne: Pathogenesis and Treatment

In most cases of adolescents and teenagers, the comedones on the forehead, cheeks and nose are the first signs of arrival of puberty. In majority of affected cases, the acne eruptions are too mild to necessitate any treatment. But when the eruptions are generalized and appearing in crops, early treatment will effectively control the acne.

 What are the General Measures Advised to Treat Mild Acne

 General advices and tips for dealing with acne are the same for all types of acne. These include advices on washing, skin care and lifestyle adjustments. Teens suffering from comedones, especially the blackheads may try to pick, squeeze and scrub the zits leading to worsening of the condition, and, possibly, inflammatory changes like redness and infection. This should be avoided at all costs. If you want to remove the debris from the blackheads, have it done by an experienced dermatologist or a cosmetologist using a comedone extractor only.

How to Treat the Mild Acne?

Following is a step by step guide to get rid of the comedonal acne:

  1. Wash the skin no more than twice a day with mild soap and water.
  2. In general, the mild acne is treated with a single topical application. Topical retinoids are considered the first line therapy for comedonal acne.
  3. Apply the retinoids only at night.
  4. To begin with, start at the lowest strength of the topical retinoid. Most commonly used retinoids are tretinoin, isotretinoin and adapalene, either in gel or cream forms. Gel has a drying effect and is preferred in those with an oily skin.
  5. Benzoyl peroxide 2.5-5% is the second choice in comedonal acne; but used only if the topical retinoids are not tolerated well. Azelaic acid may be used if the patient cannot tolerate benzoyl peroxide.
  6. During a follow up after 4-6 weeks, the physician will assess the response to treatment. If the response is evident and positive, same regimen is continued till new eruptions cease to appear. A maintenance application of 2-3 times every week is advised till there is no evidence of acne eruptions for at least 2-3 months at a stretch.
  7. A non comedogenic, water based moisturizer is used in the morning if the anti-acne medication is causing excessive skin dryness.
  8. Some patients may experience a flare up of the acne bumps during the first 2-3 weeks of topical retinoid application. This is mistaken as a worsening of the acne and the medication is stopped by the patients. Actually this reaction is an inflammatory blowout of the comedones and indicates the beginning of the recovery period. Hence, the applications should be continued in such cases, albeit at a lower concentration and frequency than before, till the reaction subsides. At times, a course of oral antibiotics may be required to tide over the inflammatory reaction.

In females requiring contraception, a combination pill may be advised, as these also help control the acne eruptions.

It is possible that even minor acne eruptions can cause significant negative psychosocial impacts in the affected teens. The treatment of acne will not be complete unless this issue is also taken care of through relevant supportive therapies.


Published by Dr Hanish Babu, MD on 27th May, 2018

Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

Copyright 2018 © Dr Hanish Babu, MD

Mild Acne: Frequently Asked Questions

Mild Acne: Comedones: To Treat or Not to?

Mild acne, being the commonest type of acne affecting majority of adolescents and teenagers need not be actively treated. The following are a few of the most frequently asked questions on mild acne.

What Comprises Mild Acne?

Mild comedonal acne
Comedonal acne
Mild Acne
Mild Acne Black-heads

Acne is divided into different types depending upon the severity of the eruptions. Mild acne denotes a few eruptions of the comedones, both open and closed varieties. This is the most common type of acne that makes its first appearance in adolescence. Most cases of mild pimples do not require any active treatment and they rarely cause any scarring.

Comedonal Acne
Acne Grade 1: Comedone

How is Mild Acne Formed?

The arrival of puberty causes a surge of androgenic hormones in the body.  They have specific action on the sebaceous glands, which start secreting thick, sticky oily sebum into the hair follicle ducts. The hormones also act on the lining cells of the follicular wall, which become thickened and keratinous. This cellular debris and the sticky sebum accumulate in the hair follicle duct and form a plug to close the pore. This plug is known as a microcomedone.

When the keratinous plug pushes out under a thin layer of the skin, it is known as closed comedone or whitehead. When the opening is open, it widens under the pressure from the plug to form a blackhead or open comedone.

The black color of the blackheads is not due to dirt accumulation, but due the action of oxygen in the atmosphere on the fatty acids of the sebum.

What is the Clinical Appearance of a Comedone? 

Closed comedones or white heads present as skin colored, white or slightly reddish bumps on the facial skin. Open comedones or blackheads have wide rimmed opening with a characteristic black plug covering the opening. This black color is not due to dirt, but caused by oxidization of the sebum when it comes in contact with the atmospheric oxygen. The treatment of mild comedonal acne do not warranty use of oral medications, topical applications will work well in most cases.

Does Mild Comedonal Acne Cause Scarring?

 This is an important question which requires specific clarification, as it may have a bearing in treatment decisions; both by the patient and the physician. Though rare, mild comedonal acne can cause scarring in some affected teens. A family history of acne scars and hard, wide open comedones should prompt the sufferer to seek prompt medical treatment.

When Should Mild Acne be Treated?

Almost everyone, at least once in their life time would have suffered from mild attacks of acne, mostly of the comedonal type, or a few cases of scattered papules (skin colored bumps). Most of these does not warranty any treatment and will go away by themselves. The following are the indications for seeking treatment if you are suffering from mild acne:

A family history of acne scarring.

Widespread comedonal acne.

Large comedones which are hard in consistency are more prone for ice pick scars and should be treated early.

The habit of picking at the comedones and squeezing or picking at the blackheads can cause worsening and inflammation of the acne bumps and warrants early treatment.

 Is it Advisable to Extract the Comedones?

 Actually, it is not the comedones that are extracted, but the mixture of the oily sebum and the cellular debris blocking the hair duct within the comedones that is being extracted.

Clearing the blocked ducts in blackhead will result in faster healing, if done properly.

Never squeeze or scrub the comedones, this will worsen the acne and may precipitate an inflammatory reaction resulting in scarring.

Do not try to extract contents from a white head or a closed comedone. Breaking of the sebum and debris into the dermis may result in inflammatory acne formation.

The procedure should be carried out by an experienced dermatologist or cosmetologist only, with a comedone extractor.

How to Treat Mild Acne?

Mild acne treatment is carried out through topical applications, topical retinoids being the most preferred agents.

Read more about treatment of mild acne.


Published by Dr Hanish Babu, MD on 27th May, 2018

Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.
Copyright 2018 © Dr Hanish Babu, MD