What is Acne?
Acne is a skin condition involving the oil-producing glands in the skin. It can affect people in their teens, 20s, 30s, 40s and beyond. It is caused when the oil glands are influenced by hormones called androgens. Androgens are male hormones but are present in both men and women.
How does the acne form?
• When faced with a trigger like stress, pollution, consumption of certain foods or usage of certain skin care products, the hormones affect the oil glands making them overactive and increase the production of oil.
• The inner lining of the follicle thickens making the duct narrower.
• The increased oil and dead skin flowing through narrow ducts causes a traffic jam kind of a situation plugging up the follicle.
• The decaying and stagnating oil becomes food for skin bacteria called Propionibacterium Acnes which then thrive, multiply and establish a “bacterial housing society” under the skin surface, resulting in breakouts of acne from time to time or for years to come.
• The bacteria secrete various enzymes that cause inflammation, redness and swelling that is typically seen in acne.
• The severity of the resulting lesions depends on the extent of the damage. It may range from a small pimple to a larger nodule or cyst.
What are the types of Acne?
Acnes are of many types, the commonest seen in clinical practice are listed below.
d) ACNE ROSACEA
BLACKHEADS AND WHITEHEADS
Blackheads and whiteheads are forms of acne. They are caused due to excess accumulation of oil and dead skin cells in the oil glands. The difference between a black head and a white head is simply whether or not the pore is open or closed. If the pore is open, the sebum or oil content comes in contact with oxygen in the air, gets oxidized and turns black. Thus it is called a blackhead. If the pore is closed, it’s a whitehead.
Blackheads and Whiteheads – Clogged Pores on Face
Squeezing blackheads might seem very tempting, but it can cause infections and even scarring of the skin with tiny pits. Invasive methods of using sharp objects to scoop them out or scrubbing your face obsessively should be strictly avoided.
ACNE VULGARIS (THE TEENAGE ACNE)
Almost 70 percent of teenagers passing through puberty suffer from acne. This happens primarily because of the hormonal changes taking place in the body during puberty. However other factors like genetics, vitamin deficiency, stress and atmospheric pollution may also play a contributing role. The various triggers put together increase the oil production causing bacterial infection and acne breakouts.
Acne Vulgaris (The Puberty Acne)
The puberty acne comes up in various forms like whiteheads, blackheads, pus filled pimples or nodules. Other than the face, the acne can also come up on the chest, back and arms.
Studies have shown that acne in puberty is more severe in males as compared to females due to excessive production of androgen which is a male hormone. Left untreated, puberty acne can lead to irreversible scarring on the face. Thus early medical intervention is required before it can scar the person for life.
THE NODULOCYSTIC ACNE (THE MIDDLE AGE ACNE)
Acne does not restrict itself to any age. More than age, it’s the skin type and genetic makeup of the oil glands that cause acne. Therefore if a person’s skin is oily and the oil glands are genetically more sensitive to various triggers like stress, hormones, pollution etc then acne can occur even at the age of 50 years. That is why waiting for acne to get better with time and age is not the right thing to do as in the process they may cause irreversible scars.
Cystic Acne (The Adult Acne)
Adult acne is acne that has a late onset. Adults who have never had acne even as teenagers tend to suddenly breakout into painful, deep seated and inflamed acnes. The cysts either occur in isolation or in thick clusters on the face, neck, scalp, back, chest and shoulders. Adult acne is also called as the Nodulo cystic acne and is the most devastating form of acne because of its scar forming tendency.
Adult acne is triggered by stress, fluctuating hormones, hereditary factors, improper use of cosmetics etc. Apart from these triggers, adult acne can also be a warning sign of an underlying medical condition like polycystic ovarian disease in which case along with acne, there may be other symptoms like excessive facial hair, irregular periods and weight gain.
Acne Rosacea is another common form of adult onset acne. When faced with certain triggers, there is a sudden increase in the blood flowing through the capillaries under the skin. This causes the blood vessels to become wider causing redness of the skin and the flushed appearance. It causes the facial skin to become very sensitive, blush easily and react to simple products like lotions or soaps.
Adults with this condition tend to have rosy cheeks with the slightest provocation, like after exercising, after a shower or during a bout of anger or excitement. As rosacea progresses, it may lead to rhinophyma, wherein the nose becomes red and enlarged with thick nodules.
THE PERSISTENT ACNE
Most people regard acne as a cosmetic problem and do not attend to it in the early stage which is the main reason for it to become resistant with time. In such cases teenage acne can persist well into one’s 30s, 40s, and even 50s. This type of acne that does not clear by mid twenties is called Persistent Acne.
The Persistent Acne
In the Persistent variety, the acne tends to form a pattern; it comes and goes no matter what you do. Persistent acne is an indication of a resistant bacterial infection thriving and multiplying under the skin. For treating Persistent acne it is necessary to eliminate bacteria but it is more important to get rid of the environment which helps them thrive.
Picking and squeezing acne happens by reflex to people who are anxious about their acne and want to recover from it as soon as possible. But it is the most unsanitary activity as it can push the infection deeper and cause permanent scarring of the skin, a condition called Acne Excoriee. It is common in young women and men who are very conscious of their looks.
The anxiety regarding the skin is so high that they unknowingly resort to picking at acne sometimes even before it appears on the surface. At the end of the day it is a bad habit and needs will-power and self-control to overcome it. Often in such cases, some counseling may be required to help the patient get out of the habit. In severe cases medication may be required to relieve the anxiety.
Mild obsession with acne is normal during teenage years. It is the age where teenagers want to look their best and have a clear, flawless skin. However skipping college, becoming depressed and spending hours in front of the mirror picking at acne could be indications of a medical condition called Acne Dysmorphia.
With acne dysmorphia the person becomes fixated or obsessed about having a clear complexion. The person is often found gazing at the mirror for hours checking on the skin condition and obsessively checking for flaws. Even if the acne is mild, the person may think of them as awful and horrible and may desperately try to pick or squeeze out the acne, not realizing that it is causing harm to the skin. Mild cases of Acne dysmorphia can be treated with counseling or behavioral therapy. Severe cases may need medication.
As the name suggests, Acne Cosmetica is triggered by the use of cosmetics especially the comedogenic ones. The thick pore-clogging ingredients block the pores causing bacterial infection and acne formation.
In such cases, identifying the pore-clogging product is important. If small bumps and whiteheads are found around the eyes, it could be eye cream or eye make-up that may be clogging the pores. If there are tiny breakouts scattered over the entire face, then it could be sunscreen or foundation that may need to be changed. The cosmetic in each of the above case tends to clog the pore making a perfect breeding ground for bacteria. Identifying the cosmetic, stopping the use, cleaning the pores, eliminating bacterial infection and minimizing the use of cosmetics helps prevent relapses.
THE BODY ACNE
Body Acne is commonly found on the back, chest, neck, shoulders and thighs. Just like the facial skin, skin in the above areas has abundant hair follicles connected to sebaceous glands. So the same high rate of sebum production that causes facial acne can also clog pores in other areas and cause body acne.
The Body Acne
The acne on the back takes several forms like blackheads, red pus filled boils, nodules and cysts which are painful and form deep under the skin surface. The back acne tends to be more severe than the face. This may be either due to improper skin care as the back is not very easily accessible for cleaning purposes or due to the fact that treatment is usually delayed as it is not an exposed area.
The breakouts are usually triggered due to excessive perspiration and friction on the back due to tight fitting clothes or backpacks. Some fabrics like lycra or nylon that fit close to the body can trap perspiration and contribute to acne. People who exercise in these fabrics are especially prone to it. Genetics and poor immunity can also make one more prone to body acne. Women usually experience body acne after hair removal methods like waxing. The most common hormonal trigger found in women is polycystic ovarian syndrome wherein the elevated androgen levels cause increased production of oil.
Body acne can also be caused due to sweating. This type of acne is medically termed as Pityrosporum Folliculitis. It is caused by a naturally occurring organism called pityrosporum fungus that feeds on human sweat and oil. If oil or sweat gets trapped for long hours or if there is excessive perspiration, the organism proliferates and causes infection resulting in acne bouts.
Sweat Induced Acne
Pityrosporum folliculitis therefore appears in areas that perspire most like the chest, back, thighs, buttocks and arms. Tight fitting clothes, headbands, synthetic materials, collars and backpacks usually aggravate acne due to localization of sweat in certain areas.
THE BEARD ACNE
While shaving by itself does not cause acne; using the wrong method to shave or using an improper blade can cause acne breakouts. These breakouts are seen as a result of inflammation in the hair follicle brought on by shaving.
The Beard Acne
The beard region is also prone to shaving bumps which are caused due to ingrowing hair. An ingrowing hair results because of a hair shaft deformity which makes the hair curl, penetrate back into the skin and get trapped there. The trapped hair gets infected causing a condition called Pseudofolliculitis Barbae. On the surface, it appears like tiny red bumps with a characteristic black dot (the trapped hair) in the centre. On touching the skin feels rough & grainy like sand paper. This is seen in men on the beard area and in women on arms and legs. Any method of hair removal, shaving or waxing, that cuts the hair too short can cause it. For a close shave, men tend to shave in the opposite direction of the hair growth. This triggers acne as the close shave cuts the hair much below the skin surface. As the hair grows back, it tends to irritate the skin causing inflamed red bumps.
THE SUDDEN ONSET ACNE
At some point of time, almost all of us have experienced the sudden acne that comes up without any warning. And the timing is always bad. You have an event coming up and you want to look perfect for the event. But you wake up that morning and see a cluster of red blazing acne on your face and your world shatters!
The sudden-onset Acne
Sudden acne breakouts are usually triggered by stress, hormones or indiscretions in food. Hormonal triggers include sudden rise in sugar levels, abnormal thyroid function or hormonal surges around menstrual cycles or ovulation. Foods like dairy products; sankranti specials like til and jaggery, rich heavy foods cooked with dry fruits and ghee are all sudden acne triggers.
THE T-ZONE ACNE
The forehead, nose and the chin forms the T-zone on the face. Most people suffering from acne tend to have a combination skin with their T-zone being oily and the other areas being either dry or normal.
The T-Zone Acne
As the nose is a part of the T-zone, it tends to be oilier and therefore prone to clogged pores, whiteheads and blackheads. This further makes acne breakouts more common on the T-zone.
What are the causes of acne?
c) OILY SKIN
The most potent stimulator of oil gland is the male hormone testosterone. While both women and men produce all three types of hormones (testosterone, estrogen and progesterone), the testosterone levels are much higher in men; and therefore the acne tends to be more severe in men as compared to women.
• Puberty – Almost 70% teenagers passing through puberty suffer from acne. It is the rising level of testosterone which acts as a trigger.
• Oral contraceptive pills – Intake of oral contraceptive pills can trigger acne bouts.
Acne due to oral contraceptive pills
• Pregnancy – change of hormones during pregnancy can trigger acne.
Acne due to pregnancy
• Menstrual periods – Breakouts of acne typically increase around menstrual periods. It can almost be said that like the menstrual cycle the acne too follows a 28 day cycle with flare-ups during periods. Some studies have shown that the size of the pores keep varying and are narrowest before periods thereby increasing the clogging of secretions.
• Middle age hormonal changes – Testosterone also impacts Adult Acne. Adult men and women, who have never had acne in their entire life, suddenly start breaking out with lumps of acne.
• Polycystic Ovarian Disease – Acne could be a symptom of Polycystic Ovarian Syndrome (PCOS). PCOS is a condition in which the ovaries secrete abnormally high amounts of androgens (male hormones) that often cause problems with ovulation. Women with PCOS have enlarged ovaries which contain multiple, small cysts. The symptoms of PCOS are – Acne, oily skin, weight gain, hirsutism (abnormal hair growth on chin, chest or other unwanted areas), irregular periods, enlarged ovaries. Acne, along with other signs may prompt an evaluation for PCOS.
• Thyroid disorder – Thyroid disorders can cause acne breakouts. A diagnosis of thyroid disorder can be made from its symptoms which include acne, fatigue, menstrual irregularities, weight gain, constipation, depression, inability to focus, brittle nails, dry skin and hair loss. However in mild to moderate cases the above symptoms may not always be present and thus it is best to rule out any abnormality through a blood test.
Acne due to Thyroid disorders
Genes play a role in predisposing a person to acne. Having ‘acne genes’ does not mean that a person will automatically get acne, it just makes the person more vulnerable to getting acne, given certain environmental influences or triggers.
Genes can influence how sensitive the skin is to hormones. It can also influence the strength of inflammatory response to bacteria. This is the reason why some people suffer from acne and others don’t despite identical diets, lifestyles and environmental factors.
Oily skin is associated with acne, yet all individuals with oily skin do not suffer from the condition. Oily skin makes a very good breeding ground for bacterial, viral and fungal infections. Most people with acne have a combination skin which is oily in certain areas and dry or normal in other areas. Oily skin is high maintenance and tends to clog easily giving rise to acne. Even the touch of oily, unwashed hair can cause friction acne on areas where it brushes with the skin.
To keep skin oil free, wash face at regular intervals. Washing not only cools down the skin but also relieves inflammation. Keep hands and hair off the face. Shampoo regularly to ensure hair is fresh and oil free. Avoid oiling hair for extended periods of time.
Stress is one of the commonest acne triggers. When one is tensed, the body releases stress hormones including cortisol. This sets up a chain reaction causing excess oil production, clogged pores and the perfect environment for bacteria to grow, thrive and cause acne breakouts. Recent studies have shown that Adult Acne cases in middle aged women are at an all time high & the primary aggravating factor is chronic stress. The pressure to work outside the home, maintain a steady family income & juggle with household work and kids can be quite a task which the present generation of women in their 20’s, 30’s and 40’s are constantly exposed to.
Taking adequate rest and managing stress is an important part of a healthy lifestyle. If the stress condition is short-lived, such as a student getting an acne flare during exams, there is not much to do because these are episodic. But if the stressors are more chronic, such as bereavement, difficult marriage or unemployment then the patient may need anti-stress medication along with the acne treatment.
WRONG SKIN CARE / OVER-USE OF COSMETICS
Suppressing acne or using heavy make-up to conceal blemishes on the skin can add fuel to fire. The more you try to hide, the more gross they appear with time. The vast number of quick-fix-over-the-counter products meant for cleansing, toning, skin-lightening, scrubbing etc can make a person confused about the right skin care. Healthy skin is not dependent on the use of too many products. Healthy skin is all about identifying your skin type and keeping the use of products simple and to the point.
Acne due to wrong skin care
Know your skin type – Identifying your skin type is the first step to choosing the right skin care. There are 5 different skin types – normal, dry, oily, combination and sensitive or problem skin. Dry skin feels papery and coarse to touch. It feels tight and stretchy without a moisturizer and tends to have fine lines around the mouth and eyes. Dry skin is prone to premature ageing. Oily skin appears waxy and has large and visible pores. By midday it starts appearing waxy and absorbs make-up quickly. It easily breaks out into pimples, whiteheads and blackheads. Combination skin is dry mostly on the cheeks and oily on the T-zone. After washing some areas feel dry and some smooth. By afternoon the T-zone appears shiny and greasy. Sensitive skin can be dry, oily or normal. It reacts adversely to environmental factors like sun exposure and also to cosmetics containing alcohol, fragrances and artificial colors. Once you know your skin type, the choice of products becomes easier.
Choose products as per your skin type – When it comes to choosing products, the general perception that herbal is always safe or that expensive products work better are wrong. Imported products are made to suit the skin type and climatic conditions of people living in that particular region and do not necessarily suit one and all. It is best to avoid products with thick pore-clogging chemicals, strong fragrances or PABA sunscreens. The 3 basic requirements of skin are cleansing, moisturizing and exfoliating and the products required for the same are to be chosen as per the skin type. The idea is to never overdo on skin care, even make-up needs to be minimum.
FOOD AND BEVERAGES
Studies have shown that high glycemic diet or foods that produce high levels of blood sugar can aggravate acne. These foods include breads, highly refined grains and cereals, French fries, potato chips, dairy products, sodas and other aerated drinks etc. The more is the intake of high-glycemic foods, the higher is the sugar level in the body. As the sugar levels rise, so does the sebum level, leading to clogged pores and the perfect environment for bacteria to grow, thrive and cause the development of acne.
Excessive intake of Tea & coffee can worsen acne by their stimulating action on the oil glands. Similarly alcohol works like an astringent causing the pores to shrink making them more prone to clogging. Drinking in moderation is the answer.
One of the best ways to deal with acne is to have foods rich in antioxidants. Apart from protecting the skin from free radical damage, it helps in building the natural immunity of the skin. A healthy skin is far more resistant to acne breakouts. Fruits like pomegranate, blue berries and grapes are rich in antioxidants. Vitamins A, C and E are also strong antioxidants. Drinking sufficient water is an essential part of a healthy diet.
Personal hygiene is another aspect that can trigger acne. Most people with acne have an oily skin or perspire heavily. If the oil and perspiration is allowed to stagnate on the skin especially in areas which are not well ventilated like the chest and back, it can trigger infection and acne formation. The choice of clothing is also important. Materials like lycra, silk, polyester clothing trap perspiration and trigger acne.
To prevent oil and sweat from stagnating on the skin it is best to shower twice a day. Shower immediately after any physical activity or workouts. Apart from washing away sweat and body odor, showering helps to remove excess oils. Exfoliating soaps or scrubs can also be used while showering to remove dead cells. Tight clothing especially fabrics like nylon, silk and polyester trap perspiration and should be avoided. Choose loose fitting clothing made from breathable fabric like cotton or linen which allows for good ventilation of the skin.
A regular exercise regime can be extremely beneficial to the overall skin health and can help to get rid of acne. So exercising per say cannot cause acne. However acne breakouts can result due to other factors associated with exercising. Exercising can leave your skin warm and sweaty which is a perfect environment for acne to develop.
The exercise clothing can trigger acne. The tight fitting lycra or nylon track pants can trap a lot of heat and perspiration resulting in bacterial infection. The use of unhygienic gym equipments can be a source of infection. Furthermore Testosterone levels increase due to exercising which can lead to acne. Lastly the high protein supplements and special body building food can trigger acne breakouts.
Constipation is a well known acne trigger. A sluggish digestive system cannot eliminate toxins correctly and therefore finds an outlet through the skin causing acne.
Severe cases of constipation may require medication. However as medicines can be habit forming, it is best to treat mild to moderate cases of constipation through a fiber rich diet. Fiber can be found in fruits like apple, bananas, pears and prunes and in vegetables like spinach, corn and beans. Eating a bran cereal every morning is the best way to keep constipation under control.
Pollution does play a contributory role in contaminating the skin. Furthermore, by causing free radical damage; it causes the skin to lose elasticity, age prematurely and breakout easily. Heat, sweat and sun exposure is an added trigger. The skin contamination gets worse in areas where there is heavy construction going on. Constant exposure to cement dust can cause the skin to become rough and dark.
To protect the skin against pollution, it is important to use a good cleansing routine. A good cleanser includes soap or a face wash and an exfoliating facial scrub which can regularly de-clog the skin pores. Use a moisturizer to keep skin well hydrated. Moisturizing is one of the key components for maintaining a healthy and youthful skin. Moisturizers not only increase the water content of the skin, but also protect the skin and make it appear smooth. Use tan removing face masks at regular intervals to prevent skin darkening. Add antioxidants in your diet. Use an umbrella or a scarf to physically protect your skin along with a broad spectrum sunscreen.
It is a well established fact that a poor lifestyle contributes largely to the development of acne. Working at odd hours, lack of sleep, excessive intake of tea or coffee, smoking, drinking, irregular eating habits, constipation, sluggish digestive system, stress at work, poor hygiene, and exposure to atmospheric pollution are some of the factors that constitute a poor lifestyle.
Night shifts and odd working hours can upset the biological cycle and trigger acne breakouts. Apart from the stress of working at night, there are other factors like irregular eating habits and irregular bowel movements that trigger acne.
While some of the above factors cannot be completely avoided, minimizing the exposure can prove effective for acne treatments.
PARLOR TREATMENTS (FACIALS AND WAXING)
People with sensitive and acne prone skin are likely to suffer from acne breakouts after parlor treatments. Furthermore it can make the bacterial infection spread to larger areas. Acne which are manually scraped or scooped out during facial treatments can leave behind scars, blotchy marks or uneven skin. The removal of facial and body hair by means of procedures like threading and waxing also are acne triggers. Apart from acne, it can also cause ingrowing hair. An in growing hair results when the hair is cut too short due to which it curls, penetrates back into the skin and gets trapped there. The trapped hair then gets infected and appears as tiny red bumps on the surface with a black dot. Unless some precautionary measures are taken, this may occur with every session of hair removal and continue in perpetuity.
Avoid elaborate facial treatments or chemical peels. Women with tendency to premenstrual tensions should avoid parlor treatments around periods. Follow a post-waxing skin care regime after hair removal sessions like waxing or epilating. Cold fomentation of the skin immediately after waxing followed by application of an antiseptic solution helps to prevent infection of the hair follicles. Using a body scrub on an ongoing basis and increasing the interval between waxing sessions also helps.
CONSUMPTION OF MILK AND DAIRY PRODUCTS
A study conducted by American dermatology association has concluded that milk was a principal contributor for some people’s acne. During the study which was conducted on 1000 teenagers it was found that acne reduced when milk consumption went down.
It was believed that fat and sugar in milk caused acne. Apart from this the hormones in milk (produced by pregnant cows) break down into androgen, stimulate excess production which clog the pores and cause acne. Completely restricting dairy foods is however impractical. The key is to limit the consumption for a while till acne is controlled.
What are the complications or after-effects of Acne?
b) ACNE SCARS
BLACK & BLOTCHY BLEMISHES AFTER ACNE
Black marks of acne are caused due to a sluggish healing mechanism of the skin. Normally it may take anywhere between 10-14 days for acne marks to heal. However in a few cases, the acne marks seem to stay forever. This is found in cases where acne is also associated with a condition called Post Inflammatory Hyper Pigmentation.
Black & Blotchy Acne Marks
In this condition, although the acne heals, it leaves behind a dark purplish or black mark. On an acne prone skin, this type of pigmentation is not only found in places where acne have erupted but also in areas like the nose corners and lip corners. While it is true that most acne leave black marks only when they are tampered with or suppressed by a quick fix ointment, for many it happens even otherwise. They seem to have a tendency for every eruption, injury or even a simple mosquito bite to leave behind a black mark. The tendency is known to run in families and is more common in people with darker skin. Apart from heredity, excessive exposure to sun and polluted environment can also cause acne to leave long lasting marks.
Not all acne cause scarring. In most cases, the skin heals with absolutely no trace of acne. Amongst the various types of acne, scarring is most commonly seen with Nodulocystic Acne.
When a person has an acne lesion with considerable infection, swelling and redness under the surface, the body attempts to ward off the infectious process by laying down fibrous or scar tissue to surround the area of infection and try to shrink it down. When this scar tissue forms under the surface it pulls down the overlying skin, thus causing a depression in the skin. In areas where the inflammation is much more severe, the scarring process may actually extend up to the surface causing a raised scar or a keloid, common on chest and back.
The acne scars are generally of 2 types –the depressed scars and the raised scars. The depressed scars are also called as ice pick scars and can be shallow or deep. The shallow ones can give the skin a typical wave-like appearance making it look old and loose. The deeper ones can be more deforming making the skin appear pitted. The raised scars are called keloids and can appear quite unsightly.
SKIN AGEING DUE TO ACNE
Pimples can hasten the formation of wrinkles by causing free radical activity. Free radicals are minute chemical particles which are released during normal chemical processes.
Ageing skin due to Acne
When a pimple occurs, the skin generates hydrogen peroxide to kill bacteria. Hydrogen peroxide is a free radical which damages the skin. Repeated pimple bouts increase the free radical activity, thereby accelerating premature ageing of the skin. The more severe the acne, the greater is the damage eventually leading the skin from pimples to early wrinkles.
How is acne treated?
Like any other disorder, acne needs early medical intervention so that any disfiguring of the skin or permanent scars on the face can be avoided.
The key to choosing an acne treatment depends on the severity and type of acne. Quick fix solutions can be a waste of time. It is not worth getting rid of acne when there is another just waiting to emerge. Instead it is important to treat what is causing the acne at its source and prevent breakouts.
Invasive methods like skin peels and derma abrasion are not indicated in every case of acne especially those with hypersensitive skin. Overuse or abuse of invasive treatments like acid peels and abrasive methods can damage the skin and deplete the level of protective antioxidants thereby accelerating skin ageing. The more invasive the treatment, the greater is the damage eventually leading the skin from pimples to early wrinkles.
Dr. Health’s Acne Therapy is an integrated approach towards treating acne. Free from the side-effects of invasive treatments, the Acne Therapy is designed to treat acne with a skin friendly approach. It consists of 4 important steps.
• External applications – includes exfoliating agents to flake off the outer layer and loosen the plugs in the oil glands. Also includes skin lightening agents to fade away the acne marks. Regular application of these external applications can help to keep the pores clean and reduce the oil activity.
• Oral medications – includes medication to stabilize the oil glands & anti-bacterial medication to eliminate the bacteria.
• Skin Care advice – includes advice on daily skin care regime and products to be used as per specific skin type.
• Dietary advice – includes advice on healing foods and other foods to be consumed in moderation.
Each of the above steps has a specific area of action and thus combining the above steps can help to achieve optimal results. After all, the goal in treating pimples is to promote a clearer skin without damaging the skin.