Tag Archives: get rid acne

Moderate Acne: Frequently Asked Questions

 

Moderate eruption of acne, being the minimally inflammatory type of pimples, could cause scarring in some affected individuals. This calls for early consultation with a dermatologist to get rid of the acne at the earliest stage itself.

 What is Moderate Acne?

 Acne is divided into different types. Moderate acne comprises of skin colored bumps (papules) predominant acne eruption.

Moderate Acne
Moderate Acne: Minimally Inflammatory Papular Acne

Some comedones and pustules (pus filled bumps) are also present. When the number of comedones are higher than 20, even without the presence of papules or pustules, it may be considered as moderate grade 2 acne. In a nutshell, 20-100 comedones and/or 15-50 inflamed papules or pustules with a total count of 30-125 acne bumps comprise moderate acne.

 How Does Moderate Acne Develop?

The events of acne formation start with the increased production of androgen hormones. These stimulate the sebaceous glands to produce more sebum and also produce changes in the lining of the hair and sebaceous ducts. Keratinous plugs are formed in the opening of the hair follicle, the open and closed comedones. When the normal resident bacteria of the hair follicle, known as Propionibacterium acne, start multiplying within the oily sebum and produce irritant side products, this triggers an inflammatory response within the hair follicle and sebaceous glands.

Mild, Moderate and Severe Acne
Mild, Moderate and Severe Acne

When the inflammation is minimal and contained within, the sebum and the products of the inflammation accumulate within the hair duct, raising the surface of the skin, forming skin colored or slightly reddish bumps.

What is Grade 2 Moderate Acne?
Grade 2 Moderate Acne

When the inflammation is significant, these results in formation of pus, which is actually the debris formed from the inflammatory cells, dead and damaged cells and living and dead bacteria. Thus are formed pustules, the other type of lesions seen in moderate acne, albeit in a limited number.

 

What are the Triggers for Moderate Acne?

The acne triggers inducing, exacerbating and maintaining moderate acne is similar to all other types of acne.

What are the Complications of Moderate Acne?

As with other inflammatory acne, there are chances of scar formation in untreated moderate acne patients. Though it is not possible to predict who will get scarring, a family history of scarring and predominance of papules and pustules should alert the acne sufferer to seek early treatment.

While healing, post inflammatory pigmentation (dark spots) may occur in some patients, especially those with dark skin.

Anxiety and depression may affect the individual from fear of disfigurement from the pimples.

What is the Best Treatment for Moderate Acne?

The best treatment of moderate acne is a combination of topical retinoids (isotretinoin, tretinoin, adapalene) and antibacterials, along with oral antibiotics when inflamed bumps are present.

Being the transition state between non-inflammatory and inflammatory types of acne, it is imperative for moderate acne be treated early so as to avoid the complications of scarring and progression to severe type of acne.

 

Published by Dr Hanish Babu, MD on 28th 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

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