Dr. Gemma Márquez.
One of the most common reasons for a trip to the clinic is acne. But, what is acne? Acne vulgaris is a multifactorial disease of the pilosebaceous unit. Not everyone who has spots on their face has acne. There are many type of acne and it can affect all age groups, teenagers and people over 25. Although it is most common to experience it during adolescence, as it affects up to 85% of 12 to 24-year-olds.
There are different types of acne and that’s why it is important to consult a dermatologist before trying a treatment that worked well for your friend or that you have seen advertised on TV.
What products should I use to treat acne?
It is quite common to see patients who do not apply any products as they are afraid of making their acne worse. It is important to explain that using products specifically designed for skin with acne means we can improve this condition.
The first step is to clean the skin, and to do this there are specific products that help to cleanse and purify the skin without irritating and maintaining its natural pH value. The skin must be cleaned daily, twice a day if possible, with particular attention paid to hygiene just before going to bed, to remove all the dirt and grease from the face that has built up over the day. This clean skin will then absorb better the topical treatments to be applied as the next step.
Depending on the type of acne, the dermatologist will prescribe specific creams and emulsions. The creams used to treat acnes usually contain either topical antibiotics or comedolytic products, or a combination of both thereby increasing their effectiveness.
How do these products work?
These products help to decrease inflammatory lesions, reduce grease, normalise follicular keratinisation and help to eliminate existing comedones and prevent new ones from forming. It is important that the dermatologist prescribes the most suitable treatment for each patient, as there is a wide range of products and patient needs to be told how, when and where to apply these creams. Light emulsions are also recommended sometimes to moisturise without adding grease, to offset the dryness that some of these products can cause for the skin while they are being used.
What cosmetics should I use?
Another important point about caring for skin with acne is the use of cosmetic products designed for this type of skin. It is quite common that some patients’ conditions get worse in summer with the use of very dense or greasy sun creams. Protection from the sun is the most important thing, and even more so for skin with spots and quite often recent scars. But it is important to know that there are a lot of sun protection creams that have been designed specifically for this type of skin, which give protection from the sun without making the acne worse. Furthermore, “anti-aging” creams and makeup should also be oil-free, so they don’t make any existing acne worse.
Does diet make a difference?
Diet is a very controversial topic in terms of acne, and it is important to explain this to the patient. Is it true that eating chocolate makes acne worse? A lot of studies have been carried out to examine the connection between diet and acne. In particular, milk and food with a high glycaemic load are those that seem to have some type of effect on this condition, but there is no solid evidence to recommend a restrictive diet. We recommend a healthy diet following the guidelines of the Mediterranean diet and drinking at least a litre and a half of water a day.
After several studies what has been proved is that smoking aggravates acne, especially acne affecting adults (over 25 years old).
What if my acne doesn’t get any better with creams?
The first thing to do, I’ll say it again, is to go and see a dermatologist. As I said before, there are different types of acne. There are some types that are best treated with oral treatments, usually antibiotics or isotretinoin. Isotretinoin (many patients will have heard of “Roaccutane” which was the old commercial name for this) is a very effective and safe treatment provided that the dermatologist thinks it is right for your specific case.