Ever wondered why those annoying pimples keep popping up from the time you are a teen, well into your 30's. You regularly wash your face with all sorts of face washes, apply face packs and several gels and creams available over the counter. Your aunt says haldi (turmeric), your mom says malai (milk cream), your grandma says basan (gram) flour with malai and yet they keep coming back. You squeeze it, you pick it, you rub it and you wash your face 5 times a day!
Pimples or Acne are disorders of oil producing glands of your body known as sebaceous glands.
The 1st stage is when the opening of the gland gets blocked leading to accumulation of the oily or cheesy material called sebum. This leads to what we commonly call as black heads and white heads. Black heads are due to oxidation of sebum which makes it black and white heads are due to completely blocked sebaceous glands with the white sebum inside.
The 2nd stage is when the secretions collect so much that they cause oxidative damage to the oil glands and cause a reaction which appears as red pimples.
The 3rd stage is when these pimples get infected with a bacteria known as Propionibacterium acnes. This leads to formation of pus filled pimples which can be quite painful.
The 4th stage is the formation of large boils which are painful and filled with pus and are many times hot and tender. This is called nodulocystic acne.
The 3rd and 4th stages often leave behind permanent scars on the skin and also lead to pain and discomfort.
These glands are sensitive to various hormones in your body, mainly what are known as Androgens (Male hormones), yes females have them too! These glands swell up under the influence of these hormones and hence tend to occur at the time of puberty or sexual maturity.
What can you do to control your acne?
Simple measures like a healthy diet, avoiding fatty food, avoiding milk and dairy products, exercise and plenty of water will help those with mild acne. Oil controlling face washes and water based moisturizing creams or gels will also help. If your face is studded with multiple black heads and white heads, it can be removed by a simple procedure done at a dermatologist's clinic.
Recurring acne will require a detailed history of underlying hormonal disorders and sometimes a blood checkup for hormonal or other abnormalities.
If there are lot of pus filled pimples they will require antibiotic creams/gels/ tablets. The choice of antibiotic often depends on the accompanying medicines, age of the patient and tolerability.
In those who want to avoid tablets, procedures like chemical peels and IPL (Intense pulsed light) can be performed. These procedures can also be performed on patients who desire quicker results and an overall improvement in the quality of their skin.
Other medicines like retinoids (Vitamin A derivatives) form the backbone of Acne treatment.
You must always remember that Acne is a chronic disorder and there will be flares and remissions. Our goal is to provide long term solutions with minimal undesirable effects keeping in mind age of the patient, grade of acne and duration of acne.
Often Acne is associated with hormonal disorders like PCOS (Polycystic ovarian syndrome) and infertility in women. It such cases it can lead to hair loss, unwanted facial hair, darkening of skin on body folds and skin tags. These cases warrant a through investigation and treatment from a gynaecologist as well as these can be associated with infertility.