What is acne?

Acne is a disease of the skin which may result in severe scarring of the face, neck, and back.

It may persist for years, having adverse psychological effects including depression and withdrawal from society. Acne is most common in adolescence and early adulthood.

Hormonal acne in women may smolder on for years. Contrary to popular belief, acne is not caused by dirty skin or impure blood. It is a disorder of the pilosebaceous unit. This is made up of a hair follicle, sebaceous gland (oil) and a hair.

In normal skin, sebum produced by the sebaceous glands combines within the hair follicle with cells being sloughed off. When it “fills up”, the sebum spreads over the skin’s surface.

When this process works correctly, the skin remains moist and healthy. Pimples are the result of a sequence of events. There is an obstruction within the follicle itself. The sebum along with the dead cells, get trapped and dry out. This creates a plug obstructing the drainage of sebum.

This is known as a white head. As sebum becomes older and drier, it becomes brown and presents as blackheads. There are bacteria occurring normally on the surface of the skin and when oil is trapped in the follicle, the bacteria will grow into the blocked pore. The bacteria produce chemicals that alter the composition of the oil within the follicle, leading to inflammation and the formation of pus.

Types of acne

There two types of acne: – comedonal and nodula or cystic acne. Comedonal consists mainly of whiteheads and blackheads. Cystic acne presents as a red bump on the skin under which a bacterial infection has formed.

The bumps can be painful, lie deep beneath the skin surface and can also form in clusters. Combination therapies should be used particularly with women pairing topical and oral treatments.

Peeling along with products containing bacteria fighting ingredients should be used.

How to treat acne

Skin peeling

Through exfoliation and the stimulation of cell division in the basal epidermis cells, the treatment unplugs blocked pores and allows elimination of blackheads and closed comedones. These are the precursors of eruptive acne.

In addition, skin oiliness which predisposes the skin to acne is reduced. Peeling treatments can permanently control this disfiguring and confidence-destroying affliction. The Elaine Brennan Skin Renewal Peeling contains resorcinol which has antiseptic properties.

Resorcinol was used to dress minor wounds before the era of antibiotics. It is antifungal and was also applied on cancroids and syphilitic ulcers!

Our Elaine Brennan Skin Renewal Peeling System also contains Salicylic Acid which is widely used in products for oily, acne-prone and blemished skin.

Deep Pore Cleansing

Having regular acne cleaning treatments post peeling and in-between peelings. Acne cleaning is an art which not all aestheticians have mastered nor may want to master.

It is important that skin is cleaned properly in order to prevent the spread of further infection and minimize skin scarring.

Follow a Comprehensive Skincare Regime

There are many acne fighting ingredients which may seem daunting to the layman. The ingredients to look for in acne-fighting products are:

• Benzoyl Peroxide – This is my favorite. It is very effective in treating acne by killing bacteria, exfoliating the skin and removing excess oil. It is available in strengths from 2.5% to 10%. I usually recommend beginning at 5% and gradually increasing to 10% as tolerated. I suggest using it contained in a gel, spreading it in a thin layer over the skin at night before bed.
• Salicylic Acid – This ingredient is found in many peelings and acne products. It is antimicrobial and is used to slough the skin. It is known for its ability to unclog pores.
• AHA – These include glycolic and lactic acid. They slough off dead cells that cause clogged pores.
• Amino Mask – 5% sulfur with lactic acid that can be used at home after the peeling process.
• Blue LED Treatment – This is done seven days after our peel with personalized blended serums and oils that help kill bacteria, help the product penetrate the skin and soothe inflammation.
• Retinoids – Vitamin A smoothes lines and wrinkles and also exfoliates dead skin cells. Retinoids can be very irritating causing redness and dryness. Start off on a low dose increasing in strength as skin becomes accustomed to them.
• Non-comedogenic Moisturizer – I like a gel moisturizer for acne skin. Use an oil-free sunscreen every day.

Tips to Control Acne

• Short courses of antibiotics especially for men whose acne can be severe, work better than a low dose antibiotic taken regularly. Minocycline is often prescribed for acne.
• Women can switch to an anti-androgen birth control pill to help to regulate hormones that cause acne. It may take at least 3 months before any improvement is noted. These are some of the approved birth control pills prescribed for acne: Estrostep, Ortho Tri-Cyclen and YAZ.
• Studies dating back to the 1980s have demonstrated the efficacy of spironolactone (Aldactone)  for acne in women particularly acne unresponsive to no hormonal therapies, However, the drug comes with an FDA mandated black-box warning.
• Supplements such as Acetyl L Cysteine (NAC) which is an amino acid may help in clearing hormonal acne.
• Hair should be washed with an antibacterial shampoo on a daily basis. Conditioner should not be allowed to run down the face, back or chest.
• The face should be cleansed last and no face cloth, sponges or brushes should be used unless disposable or unless they are able to be properly disinfected after each use. Keep hair away from the face by tying it back.
• Makeup brushes should be kept clean and hygienic.
• Towels used to dry hands and body or towels hanging in the bathroom should never be used to dry the face. Use a clean paper towel to gently pat the skin dry and then discard. I like Viva paper towel.
• Pillowcases should be washed daily and towels changed daily if possible especially if acne on the chest and back is present.  Wash on the hottest wash cycle and dry on the hottest drying setting. Do not use softener.
• Keep your cell phone clean and sanitary.
• Do not touch or pick at your face.
• Diet is a controversial subject with many people swearing that dairy, carbohydrate-rich foods, greasy foods, and chocolate makes their acne worse. Other studies have proven that diet has little to do with acne. Milk consumption has been associated with an increased risk of acne.
• Studies have shown that a low glycemic diet that is high in fiber, fruits, and vegetables is beneficial for acne.
• Cut back on sugar and white products replacing them with whole grains.
• Drink water. Water significantly boosts blood flow throughout the body and skin.
• Sleep. Insomnia and stress increase glucocorticoid production which can make acne worse.
• Exercise helps to cut stress as well as increases blood flow.
• Shower immediately after exercising and sweating. Sweat can lead to breakouts.
• Stress causes our adrenal glands to increase production of androgen hormones which increase oil production which causes acne.

What to Expect after an Acne Peel

Please remember that post peeling; the skin will have an increased “break out” of pimples on the skin surface. Peelings can “Unmask and Accelerate” the appearance of hidden acne lesions that have not yet evolved to the surface.

It is NORMAL to have this purging phase and is a process which takes some time to work. While this can be frustrating, the peeling process cleans clogged pores that are embedded with dirt and dead skin cells and as the top layers are removed, this congestion inside the skin emerges in the form of blemishes.

The process takes several weeks to purge the skin but afterward, the skin will be noticeably smoother and clearer. You must tell your client to be patient during this time. Typically within 3 weeks, the skin begins to show improved clarity with fewer breakouts. It is a process which takes time to work. Multiple peels may be necessary to treat acne.