Have you ever wondered what causes a spot or pimple? What are the stages involved which leads to acne?

Up to the age of 10 years of age, we all have beautiful skin. However with the onset of puberty, the sebaceous glands (i.e. oil producing glands) may enlarge and produce an excessive amount of oil due to the effects of hormonal changes.

This excess accumulation of oil in the sebaceous glands leads to clogging of the pores in a similar way to “a cork in a bottle. Oil production increases, the cells clump together resulting in a vicious circle of inflammation in the hair follicle which results in a blackhead or whitehead.

The bacteria or P. acnes migrate to the area as the presence of excess oil is an ideal environment and feeding ground for these bacteria. Further swelling of the sebaceous gland causes a spot or pimple. Each spot contains a collection of white cells and debris which essentially results in pus within the sebaceous gland.

As the process evolves the sebaceous gland enlarges further accumulating further debris, dead skin cells, bacteria, inflammation and more oil. This leads to further swelling, cysts and abscesses and when this is severe it results in scarring.

What is different about our approach to treating acne at CosmeticDoctor?

Primarily, as a medical clinic, we can perform a comprehensive consultation to identify the secondary causes for your acne. In cases of female patients with adult acne we can offer the expertise to identify if you have a condition called Polycystic Ovarian Syndrome. To do so a referral for an ultrasound scan, where indicated may be advised to assess your ovaries and hormonal blood testing on day 2-3 or your cycle to check your testosterone levels.

Furthermore, for moderate and severe cases of acne, at CosmeticDoctor we advise a combination of ZO Medical or Obagi Nu-Derm products with Roaccutane which is an oral medication. The results are truly outstanding. Your suitability for this regimen will be assessed during your consultation.

ZO Medical and Obagi Nu Derm involves using salicylic acid washes, glycolic acid, vitamin A cream called retinoic acid and hydroquinone (a bleaching agent) where indicated.

Retinoid creams contain Vitamin A, and increases the rate of skin exfoliation or the rate at which the skin cells slough off. Retinoids are effective in the treatment of white heads, blackheads, skin texture and superficial scarring. We use a very potent form called tretinoin or retinoic acid. It is worth pointing out that with this regimen, you are going to look worse before you look better during the first 6 weeks. Skin redness, peeling, flaking and irritation are a normal and expected sign.

This is an example of the extent of redness, peeling and flaking to expect.

Your acne may even flare and more pimples may develop during this period. It is not for the faint hearted and “no pain, no gain” is an appropriate description for this regimen. However the results speak for themselves.

Salicylic acid washes are used in this regimen as an anti-inflammatory and removes all the oil, debris and junk from the pores. Salicylic Acid is more effective than glycolic acid because
they are lipid soluble, so can penetrate into the sebum clogging the follicle much more easily.

Often we prescribe Roaccutane for five months with ZO Medical products achieving spectacular results. Roaccutane, as a drug often receives bad press, unnecessarily so in my opinion. A careful history to outrule contraindications such as pregnancy, health issues (i.e. liver problems and high triglyceride or fat levels) and a history of mental health complaints is mandatory prior tocommencing Roaccutane. Roaccutane for severe acne can literally act as a miracle drug, treating acne effectively and minimise severe scarring which can have catastrophic effects on one’s self esteem and one’s self worth. When Roaccutane is prescribed in the correct circumstances, in lower doses and in conjuction with medical grade skincare, fantastic results are achievable.

Why do we use lower doses Roaccutane with ZO Medical products, you may ask? Well, if you take Roaccutane alone, sure your spots may look much better, but your skin texture, scarring and pigmentation due to acne scarring still remains after your course. True rejuvenation and “wow results” are achievable with this treatment combination as the photo below of one of our patients testifies.

Before treatment

After 4 months with ZO Medical Skincare products and Roaccutane 20 mg