Skin Laboratory Chemical Peels

Most Common Skin Disorder

Acne is the most common of all skin disorders. It has been diagnosed in young infants as well as the elderly, but it is most often seen in teens and young adults with occurrences of 85-100% in adolescents and up to 10% of young adults. Before children reach puberty, acne is more commonly seen in girls. During puberty, acne affects boys and girls almost equally, but boys generally have more severe cases. In adulthood, it tends to be seen more often in women due to hormonal changes associated with their menstrual cycle and use of cosmetics.

Acne is More Than Just Physical Discomfort and Damage

Acne causes physical discomfort and damage, and it can have a huge emotional and social impact. Acne pimples or zits can be tender and painful, and the pimples can drain pus and blood which may soil pillowcases and clothing. If acne is bad enough to leave scars, you may have to endure these emotional issues for years, because scarring is not readily correctable.

Sebaceous Glands Normally Work to Moisturize the Skin...

The pilosebaceous unit, which is made up of a hair follicle, sebaceous gland, and a hair, is found everywhere on the body except on the palms, soles, top of the feet, and the lower lip. The Sebaceous glands produce a substance called sebum, which is responsible for keeping the skin and hair moisturized. Normally, the sebum produced by the sebaceous gland combines with cells being sloughed off within the hair follicle and “fills up” the hair follicle. When the follicle is “full”, the sebum spreads over the skin surface giving the skin an oily appearance. When this process works correctly, the skin is moisturized and remains healthy.

...But Acne Occurs When They Become Clogged

For reasons that are still unclear, some hair follicles become obstructed. The sebum is produced but gets trapped, and the cells that are normally sloughed off become “sticky”, plugging up the follicle. A good facial routine of cleansing, exfoliating and moisturizing is important to acne prevention, especially if you are more prone to acne, like those with oily skin. It is a common perception that most cases of acne will eventually go away. But some cases of acne, if left untreated, will develop in intensity and maybe even lead to more permanent scarring. While chemical peels, laser therapy and skin fillers can certainly improve acne scarring, it is best if you can prevent their formation in the first place.

Acne Lesion Types

• Comedo (plural comedones) – A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead; its appearance is that of a skin-colored or slightly inflamed “bump” in the skin. The whitehead differs in colour from the blackhead because the opening of the plugged sebaceous follicle to the skin s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead.
• Papule – A papule is defined as a small (5 millimeters or less), solid lesion slightly elevated above the surface of the skin. A group of very small papules and microcomedone may be almost invisible but have a “sandpaper” feel to the touch. A papule is caused by localized cellular reaction to the process of acne.
• Pustule – A dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A pustule that forms over a sebaceous follicle usually has a hair in the centre. Acne pustules that heal without progressing to cystic form usually leave no scars.
• Macule – A macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border. A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the “inflamed face” appearance of acne.
"Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria."
• Nodule - Like a papule, a nodule is a solid, dome-shaped or irregularly-shaped lesion. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin.
• Cyst – A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends deep into the skin, painful, and can cause scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Some acne investigators believe that true cysts rarely occur in acne, and that (1) the lesions called cysts are usually severely inflamed nodules, and (2) the term nodulocystic should be abandoned. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing.

Besides the above indicators, skin affected by acne may also exhibit the following characteristics:

Oily skin: The sebum production increases so that your skin looks and feels oily.

Hyperpigmentation: After the inflammation subsides, the skin can be discolored by brown acne stains, (called Hyperpigmentation), and damaged by scars. Acne scars are common and may occur even in mild acne.

Tips to Keeping Acne Under Control

To keep acne under control, try to avoid the following:

• Pinching (or “popping”) pimples, which forces oil from the oil ducts into the surrounding normal skin, causing redness and swelling
• Harsh scrubbing, which irritates the skin
• Things that rub on the skin, such as headbands, hats, hair and chin straps, which also cause irritation
• Certain cosmetics (makeup), such as creams and oily hair products, which can block oil ducts and aggravate acne
• Some medications
• For young women, changes in hormone levels brought on by menstrual periods
• Emotional stress and nervous tension

  

The key to getting rid of acne lesions and preventing new ones from forming also lies in knowing that:

• Resolution takes time. Treatments that promise fast, miraculous or overnight results often capture the attention of acne sufferers hoping for quick resolution. However, the fact remains that acne does not clear overnight. On average, 6 to 8 weeks are needed to see initial results. Once acne significantly improves or clears, continued treatment is needed to keep acne from re-appearing.
• What works for one person may not work for another. It’s good to keep in mind that while some acne treatments really do work, not all acne treatments work the same for everyone. What is an appropriate treatment for one person may not clear another’s acne because many factors affect resolution, including the cause(s) of the acne, a person’s skin type and the kind of acne lesions present.
• A dermatologist's help may be required. Many people are able to manage their acne with over-the-counter (non-prescription) treatments. For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician. Sometimes a dermatologist may combine two or more treatment options. A patient may be instructed to use one medication in the morning and the other at night. Or, two medications may be combined in one prescription medication. Due to possible side effects, over-the-counter medications should not be combined unless directed by a dermatologist or other medical practitioner.

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