Tag Archive: comedones

Fighting back and chest acne

December 10, 2018

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.

Topical treatments

  • 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.

Oral antibiotics

Antibiotics work to limit the proliferation of P.acnes, which makes them useful in treating moderate to severe acne.

Hormonal therapies

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.

Oral isotretinoin

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.

Cleansing

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.

Cosmeceuticals

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.

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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 appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

 

 

Does Makeup Cause Acne?

November 27, 2018

 

Does makeup cause acne? The straightforward answer is no. However, certain ingredients in cosmetics can aggravate acne. We explain how and which products to avoid below.

How do cosmetics aggravate acne?

The two major causes of acne are genetics and a bacterium called Proprionibacterium acnes (P. acnes). Neither of these originate from makeup.

However, several substances in your makeup can be comedogenic or acnegenic, both of which can cause skin irritations that aggravate the acne condition.

Comedogenic products

Comedogenic substances cause comedones.

Comedones are small bumps that arise when pores get blocked by excessive sebum and dead skin debris. Closed comedones, or whiteheads, have a cover of skin cells that prevent oxidation. Open comedones, or blackheads, are exposed to the environment which causes the sebum to oxidate and turn black.

Comedogenic products trigger a disorder in the cells lining the pores.  The normal process of cells shedding is interrupted by an excess of keratin. This causes dead skin cells and sebum to stick together and cause blockage.

Acnegenic products

Acnegenic products cause inflammation of hair follicles which leads to the formation of papules or pustules. Papules are small reddish raised bumps on the skin. They are often painful and hard when you touch them. Pustules are swollen and resemble blisters with a yellowish pus.

How to choose the right cosmetic product?

When choosing your cosmetic products, look for non-acnegenic and non-comedogenic labels. The former is less common than the latter.

The absence of a label does not mean a product is acnegenic or comedogenic though so look next to the ingredients.

Potentially comedogenic substances include cocoa butter, corn oil, lanolin, oleic acid, olive oil, paraffin, peanut oil, safflower oil, sesame oil, sodium lauryl sulfate, stearic acid and stearyl alcohol. Potentially acnegenic substances include fragrances, harsh chemicals and alcohols.

However, this list should also not be blindly followed. In any cosmetic formulation, it is likely that the substance that may be comedogenic or acnegenic in raw form is present in much lesser concentrations. Certain individuals are also more prone to comedone formation than others so some users can use a moisturizer formulated with cocoa butter without difficulty while others cannot.

As a result, the only way to know for certain if a cosmetic product is going to irritate your skin is to try it and observe what happens. If a breakout is due to cosmetics, it typically occurs 48 hours after application. Such breakouts usually disappear quickly after application is discontinued.  In comparison, the development of acne takes about 2 to 4 weeks.

If breakouts continue even after discontinuing a product’s use, switch to dermatologist-recommended products or visit a dermatologist.

Are your makeup brushes clean?

If you find you’re having consistent reactions to cosmetics, the culprit may be your dirty makeup brushes. These applicators can provide the perfect environment for bacteria to thrive and cause an infection called gram-negative folliculitis. Gram-negative folliculitis causes pustules.

To avoid this, clean your makeup applicators weekly to remove bacteria, dead skin cells and sebum. Also, do not share your makeup brushes.

Keep your face clean and clear

To minimize breakouts and skin irritations, put greater care into removing makeup thoroughly. Use a gentle cleanser, preferably one that is formulated for acne-prone skin like Miel Honey™ CleanserA skincare regime for acne-prone skin should also include antioxidants, such as VITA C GOLD™ Serum Antioxidants help to reduce oxidation of sebum, thus reducing the inflammation that can lead to acne.

© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.
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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 appt@twlskin.com. Alternatively, you may fill up our contact form here.