When it comes to acne, most of us tend to think of facial acne – the most visible form of acne vulgaris. Back and chest acne, or truncal acne, is often overlooked even though more than half of people with facial acne can also have truncal acne. Further, acne on any part of the body can impact one’s self-esteem, body image or self-confidence.
What causes truncal acne?
Truncal acne develops in a similar way to facial acne. Major causes of acne include excess sebum secretion, abnormal desquamation (shedding) of skin cells, the presence of the bacteria Propionibacterium acnes (P.acnes), and inflammation. These elements can be found as much on the back and chest as on the face.
Genetics is also a crucial component. Your genetic disposition can influence the formation of comedones or the way your body responds to the P. acnes on your skin.
Acne forms when abnormal desquamation of epithelial cells causes sebum and keratin to accumulate and block hair follicles. This creates comedones – either open blackheads or closed whiteheads.
An increased production of sebum also creates an ideal environment for P.acnes to thrive, especially during puberty when oil glands are excited by hormones called androgens. The activated oil glands produce inflammatory factors, such as cytokines, that increase the skin’s inflammatory response.
Your back, shoulders and chest are also more prone to acne mechanica, meaning acne caused by the pressure, occlusion, friction or heat of clothing or physical activity. Sports equipment, such as shoulder pads and tight straps, can further exacerbate acne. Sweaty clothing traps sweat, oils and substances that support the growth of P. acnes. As a result, be sure to change out of sweaty clothing after a workout or seek shade when the sun is at its strongest.
How can I treat truncal acne?
First-line therapy for truncal acne should always be a combination of a topical and antimicrobial treatment to reduce the risk of bacteria resistance. Treatment lengths should also be kept as short as possible – to a three to four month course – and cautiously managed by an accredited dermatologist.
- Benzoyl peroxide: Decreases inflammation and abnormal desquamation. It also contains anti-microbial properties that kill bacteria, but can bleach clothing and bedding. As such, it may be less desirable for treatment of truncal acne
- Retinoids: Reduce comedonal formation, expel mature comedones and exert anti-inflammatory effects.
- Antibiotics e.g. erythromycin, clindamycin: Reduce the proliferation of P.acnes but are not recommended to be used as the only form of treatment due to the risk that bacteria will grow resistant to the effects of medication.
- Azelaic acid: A newer form of treatment that has three pharmacological effects: anti-inflammatory, antimicrobial, and stabilizing on abnormal desquamation. Above all, azelaic acid also fades post-acne marks by inhibiting the release of tyrosinanse, an enzyme that controls the production of melanin.
While skin on the body can withstand acne medication that may be too irritating on facial skin, they can be harder to apply on the back. Also, skin on the body is thicker than the face and may respond more slowly to treatment.
Antibiotics work to limit the proliferation of P.acnes, which makes them useful in treating moderate to severe acne.
Oral contraceptives work to reduce androgen levels, which in turn decreases sebum production. Oral contraceptives are effective against inflammatory acne in females. Patients who do not mind being on contraceptives can consider this treatment.
Isotretinoin is a form of oral retinoid that is effective against severe. It helps to decrease sebum production, bacterial proliferation, inflammation and abnormal rate of skin cells shedding.
However, isotretinoin can have severe side effects. It can disturb the development of a fetus and cause birth defects if the mother is taking it at the time of conception or during pregnancy. Other potential side effects include mood changes, liver damage, or fluctuations in lipid levels. As a result, this medication should be cautiously managed by a dermatologist.
Proper cleansing should also follow alongside other treatment therapies. Dr. TWL’s Miel Honey™ Cleanser is a dermatologist-formulated cleanser ideal for acne-prone skin and uses medical grade honey as an anti-bacterial and anti-inflammatory agent. A gentle cleanser that lathers up from botanical emulsifiers, the foam produced is generous and refreshing on the skin.
Truncal acne patients can also consider cosmeceuticals as part of their treatment. Cosmeceuticals are cosmetic products that contain active ingredients that deliver medical benefits to the skin. Vitamin C, in particular, works as an antioxidant that helps clear the skin of inflammation. Another botanical to consider is Arnica Montana flower extract, which is especially beneficial for acne-prone skin as it stabilises inflammation and reduces skin flaking.
© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.
Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr Teo, call us at +65 6355 0522, or email firstname.lastname@example.org. Alternatively, you may fill up our contact form here.
Planning for your big day? Yes, you have finally found your dress, and you are beyond ecstatic. Only to be bogged down with issues about the wedding venue, sending invitations, your flowers and finding suitable photographers. Nevertheless, don’t let all the stress get to you, and your skin! You would certainly want to walk down the altar with glowing radiant skin after all, so here’s an expert guide to skincare routine just in time for your D-Day.
When it comes to wedding beauty, women tend to get more hardworking with their regular masking and night-time skincare routine. Changing your skincare routine two or three months before your big day can give you ample time for your skin to reach its optimal condition. Apart from religiously looking after your skin, keep a lookout for your lifestyle habits. Start exercising, take regular meals, and cut down on the alcohol. Make sure you are sleeping well; a lack of sleep will certainly play no help in skin recovery.
Treat those dark spots and wrinkles with a chemical peel
If a major skincare concern such as hyperpigmentation has been troubling you, visit a dermatologist to see what your options are. You can go for chemical peels to reduce the appearance of sun spots, fine lines, wrinkles, enlarged pores and acne scars.
Performed by a dermatologist, a chemical peel treatment improves the appearance of the skin by gently stimulating the top layer of the skin cells by applying a solution made of fruit-derived acids. Such acids include alpha-hydroxy acids, glycolic acid, lactic and salicylic acid. This treatment can stimulate the skin to regenerate, revealing a taut, baby-smooth skin.
Chemical peels are more cost-effective compared to other treatments such as lasers, and more beneficial for the skin than beautician facials. A thorough evaluation is required before proceeding with a chemical peel. It is not recommended to undergo chemical peels with aestheticians or beauticians. In Singapore, only medical doctors have access to the prescription-level peel strength required to allow results.
Consult your dermatologist for an assessment for a chemical peel treatment plan catered for best results leading up to your wedding day. After the treatment, you may experience a reaction similar to sunburn where redness can be seen. Commence your chemical peel treatment plan at least three months prior to the wedding, for time buffer in particular, for your skin to be optimally renewed ahead of time and avoid any potential redness.
Common beauty concerns before a wedding include back and chest acne. Being in a wedding dress means your back and neck area will most likely be exposed. Acne at these areas as well as the face, may be well managed and controlled with chemical peels by your dermatologist, for your most radiant self to be presenting on the big day. Do avoid the sun as much as you can and stick to complete sun protection, such as sunscreen and sunglasses to reduce the sun damage.
Makeup may have varying results on camera, so it’s probably unwise to count on that to capture your best on the wedding day. To ensure that radiant glow on photos, a little more effort now on your skincare routine, could be a very worthwhile investment to yield super glowing and almost flawless (if not flawless) skin on camera on your big day.
Pre-wedding skincare routine at home
Go for a rich, nourishing serum like the Elixir-V™ Total Recovery Serum for hydrating, lifting and tightening of your face for the sculptured V-face look. Using such a serum in your skincare routine is perfect for pampering the facial skin before your big day. The Larecea™ extract found in the serum supports skin regeneration and helps in reversing signs of aging.
Hyaluronic acid is also included to preserve and replenish moisture, working to keep our skin hydrated. Antioxidants such as Resveratrol protects the skin against sun damage and lowers incidence of skin disorders. Infused in the Elixir-V™ is also Oligopeptides, which are essentially protein molecules that can help to repair and lift the skin, giving brides the perfect V-face look.
Vitamin C should also be an imperative component in your pre-wedding skincare routine. Try the Vitá C Gold™ Serum if you are guilty of living without Vitamin C previously, as a proprietary formulation with a super-stabilized form of Vitamin C that delivers more anti-oxidant efficacy than the conventional ascorbic acid which deteriorates quickly.
Vitamin C is a superstar ingredient that helps fade pigmentation and uneven skin tone. The ability of this vitamin to aid the skin in healing and resist acne, keeps it a top favourite ingredient, and you can also bid farewell to errant sun spots and scars from your youth. It also protects skin cells from damage, keeping the skin healthy and bright for your wedding day.
Other miscellaneous tips you will need
It’s a proud moment, and you have the right to flaunt it. Everyone will be throwing glances at your rings, so ransack your vanity drawers for that spare hand cream you never used. Toss it in your hand bag and perhaps another on your bedside table. Start a habit of lathering your hand cream on, and that will be one problem crossed off the list.
And if you are rocking a backless wedding dress, you would want to keep your back acne far away. It can be nerve-racking, but if you start a skincare routine early, you can still bring back the sexy back. Apply a minimum SPF30 sunscreen liberally, as clothing does not block all the UV light. Keep your sunscreen lightweight with like the SunProtector™ to avoid the greasy feel whilst ensuring that the sun does not cause more damage or breakouts.
For mild acne, even on the back, commencing a diligent skincare routine with cosmeceuticals could yield very tangible results ahead of your wedding day. For best results and in cases of more severe acne, however, consult your dermatologist for peels, topicals and a complete treatment plan to help in skin renewal, to unclog pores and reduce back acne.
Lastly, to avoid looking greasy on camera, dust some good setting powder to limit the shine while still keeping the glow.
© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.
Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email email@example.com. Alternatively, you may fill up our contact form here.