Acne Treatments

We use a combination of therapies to treat acne.

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Acne is extremely common, and most of us will be affected by it at some stage. Generally starting at puberty, it may sometimes continue into adult life.

Acne Stages.

Stage 1 - Mild

Minor pimples
Blackheads and milia
Comedonal (whiteheads)
No inflammation

Stage 2 - Moderate

Blackheads/milia
Papules/pustules
Slight inflammation
Acne breakout may progress to other areas

Stage 3 - Severe

Significant inflammation
Severe papules/pustules
Cystic nodules present
High risk for scarring & post-inflammotory hyperpigmentation

Causes.

The three main causes of acne are genetics, diet and hormones, while stress can also be a common trigger.

Increased levels of dihydrotestosterone may cause a series of effects leading to blocked follicles, overgrowth of bacteria and yeasts in the follicle, and overproduction of oils in the sebaceous glands.

Bacteria and yeast can feed off triglycerides formed from the sebum. When the plugged follicles start to leak their contents into the surrounding tissue, an immune reaction occurs, and the lesions become inflamed.

Treatment.

Once acne reaches an inflammatory stage, it requires reversal of hormonal changes, a reversal of follicular plugging, elimination of bacteria and yeast, and reversal of inflammation.

To achieve this, we provide a combination of therapies, while waiting for the reversal of the acne to take effect. Reversal may take 1-2 months for mild acne, 2-4 months for moderate acne and 4-6 months for severe acne.

Diet has a significant effect on the hormonal changes triggering acne, and acne sufferers should consider cutting out dairy and processed foods. We recommend a Paleo-style diet until acne is cleared, followed by avoidance of processed foods and limited amounts of dairy, as tolerated. Recurrence of the condition may require cutting out dairy again.

Cutting out dairy and sugary, processed foods can lead to an 80% improvement in acne in many cases.

Sticking to ideal body weight is important and best achieved by following a low-carbohydrate, low processed-food diet, such as the Paleo diet, as suggested above.

If you smoke, STOP! Adult acne has been linked to smoking.

Avoiding greasy creams will help unblock pores. Using a suitable cleanser, appropriate skin care regime, and incorporating treatments such as Microdermabrasion, chemical peels, and Dermapen™ micro-needling may also help.

Dermapen™ micro-needling has also shown to be an effective treatment for acne scarring.

Extractions can also clear blocked pores/blackheads, and are performed under medical supervision by either Dr Simpson or our skin therapists.

For mild acne, an over-the-counter cleanser and improved diet may be all that is needed. For moderate and severe cases, it is important to discuss your options with a qualified health professional. Scaring needs to be avoided, and early treatment is vital.

Oral and topical antibiotics, & Roaccutane.

Oral and topical antibiotics are widely prescribed mainly for their anti-inflammatory effects and Roaccutane – an oral retinoid – is often prescribed for severe cases referred to dermatologists.

Dr Simpson prefers to avoid these medications and concentrate on diet, lifestyle and topical therapies, but when Roaccutane is needed a prompt referral to a dermatologist will be made. Dr Simpson can discuss your acne with your dermatologist to reduce the waiting time if necessary.

A relatively new treatment for acne is Photodynamic Therapy (PDT) which uses a topically applied naturally-occurring substance, which when activated with intense LED light causes shrinkage of the oil glands and reduction of the bacteria.

Long term results can be similar to Roaccutane but without any systemic side effects. A standard treatment involves three treatments spaced 3-4 weeks apart, with top-up treatments as needed according to the response.