Acne Woes 

“Effective treatment for acne” is a highly searched term on Google. It is a constant battle made worse with constant mask wearing in this endemic age.

What Is Acne

Acne is a skin condition caused by oil and dead skin cells congesting hair follicles. Although the condition is common among teenagers, it can affect anyone.

When you are suffering from acne, you will observe the presence of various pimple types. 

Types of Acne

Our skin contains tiny glands called sebaceous glands. These glands are attached to hair follicles, which are pores in our skin that grow out.

Hair and skin are lubricated by sebaceous glands to prevent drying. The oily substance that they produce for this purpose is called sebum. Excessive sebum production causes acne breakouts. The condition is aggravated when it is mixed with dead skin cells to form a plug in the follicle.

When the congested follicle is close to the surface of the skin, it bulges outwards, creating a whitehead. Conversely, the plugged follicle can be an open one, creating a blackhead.

When contaminated by bacteria that live on the skin, the blocked follicles become inflamed and result in papules, pustules, nodules, or cysts.

Whiteheads and blackheads, also known as comedones, are the most common acne conditions.

• Blackheads are open bumps on our skin that are filled with excess oil and dead skin cells. The open bumps appear to be filled with dirt.

• Whiteheads are closed bumps on our skin that are caused by an accumulation of oil and dead skin that seal off the hair follicles and oil glands.

There are also inflammatory lesions, which are more likely to cause scarring of your skin. These include:

• Papules

These are small, red, raised bumps that are caused by inflamed or infected oil glands.

• Pustules

Small red pimples have pus at their tips.

• Nodules 

These hard and painful lumps often develop beneath the surface of your skin.

• Cystic Acne

Cystic acne are large lumps beneath your skin that contain pus and are usually painful

Causes of Acne

Testosterone 

During puberty, testosterone levels rise, triggering acne in teenagers. A major function of the hormone is to stimulate the growth and development of the penis and testicles in boys and to maintain the strength and health of the muscles and bones in girls.

Hormones have a particularly strong influence on the sebaceous glands. As a result of higher levels of testosterone, the glands produce more sebum than the skin needs.

Genetic

Family history can play a role in acne. You are more likely to develop acne if your parents had it.

Having both parents with acne increases your chances of getting severe acne at a young age, according to one study. Moreover, it was found that if either of your parents had acne as an adult, you are more likely to develop it as an adult as well.

Hormones

Adult acne is more common in women than in men. A woman's hormone levels fluctuate at various times during her life, causing many cases of adult acne.

These times include:

• Periods
• Pregnancy 
• Polycystic ovary syndrome 

How Are Acne Scars Formed?

What is worse than acne? Acne scars!

The stubborn scars left behind by acne can make things worse, While most scars fade away with time, others need treatments to reduce the appearance of acne scarring.

Acne scars are formed as a result of inflammation in acne blemishes. The swelling in acne lesions breaks down the integrity of the pores’ walls. These inflammations cause excess blood cells to move to the affected site. Thus begins the enzyme production process, to facilitate wound healing and collagen production. Scars will not be formed when the collagen process works well.

The main group of enzymes in our bodies responsible for tissue remodeling and repair are matrix metalloproteinases (MMPs) as they trigger the production of collagen, the main structural component of connective tissue. If collagen production works normally, no scars will form. Sometimes, however, the matrix metalloproteinase inhibitors (MMPi) can affect its production to cause acne scars.

Types of acne scars

Atrophic scars

Atrophic scars are shallow, flat depressions that heal beneath the epidermis of the skin and are usually caused by severe cystic acne. The severity of atrophic acne scars varies depending on your acne history. There are three types of atrophic scars:

Boxcar scars

Boxcar scars are wide, typically rectangular-shaped depressions with distinct edges. These scars are caused by widespread acne, chickenpox, or varicella, which is a virus that causes red and itchy blisters.

Boxcar scars commonly occur in the lower cheeks and jaw where the skin is thicker.

Ice pick scars

Ice pick scars are small and narrow indentations that are sunken. They leave the skin looking like it is being punctured by an ice pick.

Rolling scars

Rolling scars appear indented and tend to measure a few millimeters wide. They are characterised by sloping edges, giving the skin a wavy, uneven appearance.

Hypertrophic and keloid scars

Hypertrophic and keloid scars, in contrast to atrophic scars, develop as raised lumps of scar tissue where the acne once was. This is often the result of a build-up of scar tissue from previous acne breakouts.

Keloid scars form a scar larger than the acne that caused them. Both hypertrophic and keloid scars occur along the jawline, chest, back, and shoulders. Patients with darker skin colors are more prone to developing keloid scars.

Post-inflammatory hyperpigmentation

When our skin heals after inflammation, it can result in a discolored patch of skin that often resolves on its own with a good sun protection. Hyperpigmentation can occur when skin is damaged by severe acne and inadequate sun protection during skin reparation. Generally, patients with darker skin are more likely to experience post-inflammatory hyperpigmentation. 

Is There Effective Acne and Acne Scar Treatment in Singapore?

There are different types of acne and acne scar treatments in Singapore. The treatment modalities for these conditions vary by individual. Seek consultation with our doctors who can prescribe a suitable course of treatments after analysing your skin condition.