Teen acne: focus

Acne is a chronic inflammatory disorder of the hair follicle and sebaceous glands.
There are three stages of acne development, characterised respectively by the presence of comedones (closed and open blackheads), papules (inflamed elements) and pustules (pimples with a white or yellow spot). The blackhead develops due to obstruction of the outlet of the follicles or pores of the skin. Then follows an inflammatory phase with red papules that may become pimples with a white or yellow tip. There are different types of acne. Among them is juvenile polymorphous acne: it is called ‘polymorphous’ because comedones, papules and pustules are present on the skin of the sufferer at the same time.

Description

Teen acne is a chronic inflammatory disorder of the hair follicle and sebaceous glands, commonly affecting individuals between the ages of 12 and 18. It is described as polymorphic because it causes the formation of a combination of comedones (blackheads and whiteheads), papules (inflamed elements), and pustules (pimples with a white or yellow tip).

Causes

People with teen acne often have an increased sensitivity to hormonal stimuli.
Common causes include genetic predisposition (if one or both parents had acne, it is likely the teen will have it, too); stress (which can exacerbate acne), and the use of occlusive cosmetics.
Diet, however, is not considered a causative factor.

Symptoms

Symptoms of teen acne include the presence of comedones, papules, and pustules.

Diagnosis

Diagnosis is made through a dermatological examination, highlighting the polymorphism of the lesions and the constant presence of significant sebum production.

Treatment

Micropeeling with Glicosal Lotion

Remove make-up, cleanse the skin with Eudermic Cleansing Base and dry well.
Place 7 – 10 drops of Glicosal Lotion on a cotton pad. Gently rub the pad in a circular motion across the face, continuing until the pad is dry. This causes a gradual exfoliation of the skin which will release comedones, cysts and reduce inflammation. Do not wash the face or use any other products after applying Glicosal. The morning after, only wash the face with tap water and apply no other products, including moisturizers.
For make-up, use only mineral-based products, such as Sun Clay or Argillina Skin Color which are both non-comedogenic and remain only on the skin’s surface. Foundation and other colored creams must not be applied as they can penetrate follicles, causing comedones and folliculitis.

Side effects of micropeeling

Some possible side effects of micropeeling can be skin dryness and an initial worsening of the acne.
Dryness is caused by the peeling agents and the fact that moisturizers cannot be applied following application. While dryness can be irritating, it will improve as the treatment progresses.
Similarly, the results from micropeeling are not immediate. Indeed, they will appear after the second or third month of treatment.
It is important to be aware of this, so as not to feel discouraged into stopping the treatment before it has had a chance to work. Sometimes, there is a worsening of symptoms during the first few weeks of using micropeeling treatments. This is because the elements blocking pores are brought to the surface and, before their elimination, they may become more evident. It is important to remember, though, that this worsening is only apparent, and should not be confused with a treatment failure; on the contrary, it is a sign that the treatment is working. After this period of adjustment, about 90% of patients begin to control acne and prevent breakouts.

When micropeeling isn’t enough: combined micropeeling

In more severe cases of acne or where the skin is very seborrheic, micropeeling alone will likely not be enough to control acne. In such situations, combined micropeeling treatment can be adopted, which includes the addition of tretinoin lotion, a retinoic acid. The choice between following a simple or combined micropeeling treatment plan is up to the dermatologist who will base their decision on the type of acne, skin type and seasonality. Tretinoin lotion is not available ready-made and must be prepared by a pharmacist. To request the lotion, the following prescription, preferably signed by a doctor, can be presented to the pharmacy.
Recipe for Tretinoin Lotion
Place and date …………………………..
Name and surname: ___________________________
R/
Tretinoin 0.05 %
Propylene Glycol 40 %
Ethyl Alcohol (96%) 59.9 %
AlphaTocopherol 0.05%
Stored in a dark 50 ml bottle with a dropper cap.
S/ Apply once in the evening, rubbing well into the skin. The amount of product to use and the frequency with which to apply will be recommended by the dermatologist.
As with Glicosal Lotion, tretinoin contains micropeeling agents. However, to avoid the risk of retinoid dermatitis, tretinoin should be used only once or, at most, twice per week instead of Glicosal Lotion. In order to get the right dose of tretinoin, it is important to ask for a dropper cap when the lotion is being prepared. The number of drops is exactly the same as required for Glicosal Lotion, that is, seven to ten drops per application. Combined micropeeling, therefore, involves applying Glicosal Lotion for five to six nights per week, alongside tretinoin once or twice (on non-consecutive days) per week.

Micropeeling rules

While the micropeeling technique is very simple, some rules need to be followed to make it truly effective:

During the treatment, remember to:
Do not use soaps, cleansing milk, micellar water but wash/make-up with a non-foaming cleanser (such as Eudermic Cleansing Base)
Do not use coloured make-up creams (foundation).
For make-up, it is advisable to use Mineral Make-up such as Sun Clay which does not penetrate the skin and therefore does not induce acne. If you wish to mask skin imperfections during the Micropeeling treatment you can apply Argillina Skin Color. This concealer does not cause folliculitis or blackheads because it is formulated with components that cannot be absorbed by the skin.

• Do not use moisturizing or emollient creams during the day
• Do not have facials or other types of intense facial cleansing.
• Do not squeeze pimples or blackheads.
• Do not expose yourself to UV lamps or sunlight.
• Do not use other medications or vitamins.
• Do not follow specific diets.
• Do not use sunscreens, as they are loaded with chemical compounds. To protect the skin from UV rays, apply the mineral, light reflectant Sun Clay.

During the treatment the skin becomes dry and flaky to allow the acne to clear, if burning or redness appears the Micropeeling is suspended for a few days, the skin returns to normal and then the treatment can be resumed using fewer drops or performing Micropeeling on alternate evenings.
In the summer months since you cannot use sunscreens, you use Sun Clay.
When the skin is too dry and tight, not being able to use moisturizing/emollient creams, you can apply a veil of Extreme Emollient Ointment in the morning, which does not penetrate the skin and is therefore non-comedogenic. The same Ointment can be used as an under makeup for Mineral Makeup. If you use Argillin Skin Color, which also has moisturizing action, you do not need to useExtreme Emollient Ointment as an under makeup.

From micropeeling to photodynamic therapy

Simple or Combined Micropeeling treatment is a very effective treatment for most forms of acne, however there is now another equally effective treatment available which is Photodynamic Therapy or PDT.
Briefly, this treatment involves applying an ointment containing 5 Aminolevulinic Acid (5 ALA) to the acne areas. This substance, which is not a drug, is able to penetrate inside the inflamed acne follicles. Two hours after application, the substance is transformed inside the follicles into a compound, Protoporphyrin IX, which is activated by red light of a particular wavelength and intensity. Activation with light causes a prompt release of oxygen radicals. This results in the immediate sterilisation of the follicle and thus, in the following days, in the disappearance of the inflammation.
In addition, there is an intense desquamation action (photo peeling effect) so that many blackheads and microcysts are eliminated after just one week.
Photodynamic Therapy is very efficient in extinguishing inflammation and, as it does not use drugs, is harmless and can be performed without limitation, however it requires more time than Micropeeling, about 3 hours per application, and is also more expensive.

Prevention

For people with acne, some preventative measures can include:

• Cleansing the skin no more than twice per day with gentle, non-foaming products. Doing so will cleanse the skin of dead cells and excess sebum without irritating it.
• Avoiding using creamy cosmetics as they can trigger acne. As an alternative, use mineral makeup.
• Protecting the skin from sun with mineral light reflectant products instead of traditional sun creams.
• Removing makeup with a non-foaming cleanser before going to sleep to allow the skin to breathe.
• Wearing cotton t-shirts, open collars and avoiding scarves to reduce friction and trapping heat from clothing which can aggravate symptoms.

For more on the subject see here:
Resolving Acne without pharmaceuticals: it is possible!
Adult acne: the impact of stress
Micropeeling as a cure for acne