Acne and Acne Scarring

Acne affects 80% of people at some point in their lives and is the commonest skin condition that people consult their Doctor about. About 20% of acne sufferers will have acne so severe that they will require aggressive medical treatment to avoid the risk of secondary scarring.

Although the diagnosis of acne is straight forward and effective treatments are available, acne is still a challenging dermatological problem. There are several reasons for this. Firstly, people commonly delay consulting their Gp for acne in the hope that it will just go away. In adolescents the average time between the onset of acne and seeking medical help is about 1 year despite the significant impact on their self-esteem and psychological wellbeing that acne causes. Acne is a chronic skin condition with no quick fixes or overnight cures. Treatments often take 6-8 weeks or longer to be effective with the result that many people give up on their treatments thinking that they haven’t worked. This results in under or suboptimal treatment and is another reason why acne presents such a challenge.

Many treatments are available for acne, most of which are well tolerated, safe and effective. Gps need to encourage people with acne to present and engage in treatment programmes which require regular follow up and may entail using several treatment options to see which is most effective. This requires commitment on both sides. Even mild acne can have a profound effect on a person’s emotional wellbeing so it is extremely important that acne is treated at the earliest opportunity.

The causes of acne are not fully understood but we do know that several factors contribute to its development. It is thought to be due to a combination of follicle plugging, excess sebum or oil production, colonisation of the follicles by a bacteria (Propionibacterium Acnes) and subsequent inflammation. Any effective treatment regime needs to target all of these processes.

Treatment options include topical skin creams, oral antibiotics, hormonal preparations, oral Roaccutane (a type of Vitamin A) or a combination of these. Changing to a mineral based make-up and using specific acne skincare products such as Obagi can also help. Treatments not available in the NHS include Intense Pulsed Light (IPL) which is used to eliminate the causative bacteria and reduce excess sebum production. Other treatments available in private dermatology clinics include Radiofrequency which uses heat to reduce sebum production which helps keep acne in remission. For optimal effect all of these treatments should be combined.

Treatment of the scarring caused by acne has dramatically improved in the last few years. Advances in cosmetic treatment of acne scarring include Dermaroller (medical micro-needling) which is a pioneering treatment that reduces scarring by stimulating new collagen formation. This is a straight forward clinic based procedure with minimal recovery time and excellent results. Other options include laser treatments and the new Intracel treatment which combines medical needling and radiofrequency.

Acne is a common skin condition and although there are effective treatments available there is often significant delay in seeking treatment and poor compliance with the treatment with potential risk of significant physical scarring and psychological distress.

Author: Dr Johanna Ward is one of a handful of UK based Doctors trained in Intracel treatments.
The Skin Clinic 2 The Square, Riverhead, Sevenoaks TN132AA Tel: 01732 462844
www.theskinclinic.org.uk