Acne Treatment Plans

Mild acne is characterised by a series of breakouts rather than an ongoing condition. 

The skin will generally have blackheads, bumpiness and occasional inflamed pimples or spots, but not widespread. ‘Mild’ acne generally relates to fewer than 20 whiteheads or blackheads, 15 inflamed bumps, or a total 30 acne lesions.

Mild acne can often be treated with over the counter topical products. It can take up to 8 weeks to see a significant improvement and it is best to treat it early in order to stop those nastier breakouts and prevent it from progressing to moderate or severe acne.

Blackheads

• Blackheads are filled with excess oil and dead skin cells
• The dark colour isn’t dirt, but irregular reflection of light coming from clogged hair follicles
• Blackheads can frequently be treated with over-the-counter medications

Whiteheads

• Whiteheads occur when oil and skin cells prevent a clogged hair follicle from opening.
• Many of the same over-the-counter medicines that treat blackheads are also effective against whiteheads.

In-Clinic Treatments

Choose one of the following or combination of:

1. Microdermabrasion x 3 – 1 session every 2 weeks, then 1x every 4 weeks as maintenance
2. Chemical peels – mild x 3 – combination of different acids will be used to suit your skin type, some dryness may form and some shedding for 2-4 days
3. Facial – x 6 – with steam and extraction, every 2 weeks then 1x every 4 weeks as maintenance

Homecare

Option 1 – Mesoesthetic

1. Purifying Mousse/150ml (basic)
   Daily cleansing mousse to purify and cleanse acne-prone and seborrhoeic skin. With a light texture, its main ingredients are glucosides and refreshing agents that cleanse impurities from the skin, leaving it soft and feeling comfortable and pleasant
   AM/ PM gently rub into moist skin with the fingertips. Rinse with plenty of water.
2. Acne One/ 50 ml (basic)
   Cream with an all-round effect, specifically designed for the daily treatment and control of acne-prone and seborrhoeic skin. The unique association of complementary, synergistic active ingredients in m.acne complex™stimulates exfoliation of the pilosebaceous canal while reducing sebum production. It controls bacterial proliferation and reduces epidermal redness, addressing the various factors that trigger acne-prone skin with a crosscutting approach.
   AM/PM apply daily a thin even layer to clean skin, avoid eyes and mucus membranes, follow with SPF 50 in the morning
3. Pure Renewing Mask (optional)
   Exfoliating and purifying facial mask for acne-prone and seborrhoeic skin for weekly use. The addition of inert pellets to the exclusive m.acne complex™ provides mechanical exfoliation and cellular renewal for optimum control of oily skin or acne-prone.
   To be used 1-2 times a week, apply thin layer to the clean skin avoiding the eye, massage in gently and leave to act for about 10 min. Rinse with plenty of water. Not to be used for 2 weeks after chemical peel treatment.
4. Imperfection Control/ 10 ml (optional)
   Specific, local treatment for emerging or rebellious acne breakouts. The innovative pigments in the formula have a modulated, progressive concealing effect controlled by the movements made during the application which make it possible to adapt the treatment to different skin tones. At the same time, the complementary effects of the components of m.acne complex quickly reverse the rubor and tumefaction of acneiform eruptions.
   Locally apply a small amount of imperfection control to clean, dry skin, using gentle circular motions to build up the colour and evenly cover affected areas.

Option 2 – NeoStrata & Skintech

• Foaming glycolic wash am/pm
• Or Skin Active exfoliating wash for mature skin am/pm

Combine with:

• Purigel– apply in the morning to the clean skin. It can be used several times a day (for very oily skin)
• Or Purifying Cream– apply in the morning to the clean skin and in the evening just to affected acne prone areas.
• SPF- NeoStrata

Moderate acne means that breakouts are more frequent and more noticeable. 

The skin will be bumpy and have numerous blackheads as well as inflamed papules and pustules.

Over the counter products alone aren’t usually strong enough to deal with moderate acne

Moderate Acne

If you have 20 to 100 whiteheads or blackheads, 15 to 50 inflamed bumps, or 30 to 125 total lesions, your acne is considered moderate. Dermatologists usually recommend prescription medication for moderate to severe acne. It may take several weeks to notice an improvement, and your acne may appear to get worse before it gets better.

Papules

Papules are comedones that become inflamed, forming small red or pink bumps on the skin. This type of pimple may be sensitive to the touch. Picking or squeezing can make the inflammation worse and may lead to scarring. A large number of papules may indicate moderate to severe acne.

In-Clinic Treatments

Choose one of the following or combination of:

1. Chemical peels – mild x 3 – combination of different acids will be used to suit your skin type, some dryness may form and some shedding for 2-4 days
2. Obagi Blue Peel mask – 3 sessions every 21 days
3. Derma stamp with growth factor – 3-6 sessions every 2 weeks- to reduce inflammation and improve scars. Best results for the scars are achieve when combine with TCA peels every other session.
4. Microdermabrasion x 3 – to maintain and rejuvenate skin after step 1or 2 when inflammation is subduing, to help with post acne pigmentation and improve minor scars
5. Facial – x 6 – with steam and extraction, every 2 weeks as maintenance every 21 days

Home Care

Option 1 – Mesoesthetic

1. Purifying Mousse/150ml (basic) – Daily cleansing mousse to purify and cleanse acne-prone and seborrhoeic skin. With a light texture, its main ingredients are glucosides and refreshing agents that cleanse impurities from the skin, leaving it soft and feeling comfortable and pleasant
   AM/ PM gently rub into moist skin with the fingertips. Rinse with plenty of water.
2. Acne One/ 50 ml (basic) – Cream with an all-round effect, specifically designed for the daily treatment and control of acne-prone and seborrhoeic skin. The unique association of complementary, synergistic active ingredients in m.acne complex™stimulates exfoliation of the pilosebaceous canal while reducing sebum production. It controls bacterial proliferation and reduces epidermal redness, addressing the various factors that trigger acne-prone skin with a crosscutting approach.
   AM/PM apply daily a thin even layer to clean skin, avoid eyes and mucus membranes, follow with SPF 50 in the morning
3. Pure Renewing Mask (basic) – Exfoliating and purifying facial mask for acne-prone and seborrhoeic skin for weekly use. The addition of inert pellets to the exclusive m.acne complex™provides mechanical exfoliation and cellular renewal for optimum control of oily skin or acne-prone.
   To be used 1-2 times a week, apply thin layer to the clean skin avoiding the eye, massage in gently and leave to act for about 10 min. Rinse with plenty of water. Not to be used for 2 weeks after chemical peel treatment.
4. Imperfection Control/ 10 ml (optional) – Specific, local treatment for emerging or rebellious acne breakouts. The innovative pigments in the formula have a modulated, progressive concealing effect controlled by the movements made during the application which make it possible to adapt the treatment to different skin tones. At the same time, the complementary effects of the components of m.acne complex quickly reverse the rubor and tumefaction of acneiform eruptions.
   Locally apply a small amount of imperfection control to clean, dry skin, using gentle circular motions to build up the colour and evenly cover affected areas

Option 2 – Obagi

• Obagi Tretinoin Cream, .025%, .05%, .1%- Topical retinoids are main stays in the treatment of comedonal and inflammatory acne
• Additionally, tretinoin stimulates mitotic activity and increased turnover of follicular epithelial cells causing extrusion of the comedones
• Leads to loosening and unseating of microcomedones, allowing sebum to reach surface of the skin and preventing obstruction of the pilosebaceous unit
• In addition, topical retinoids may have anti-inflammatory activity

Option 3 – Neostrata & Skintech

• Foaming glycolic wash am/pm or Skin Active exfoliating wash for mature skin am/pm
• Combine with:
  • Purigel– apply in the morning to the clean skin. It can be used several times a day
  • Or Purifying Cream– apply in the morning to the clean skin and in the evening just to affected acne prone areas.
  • AQ solution serum– can be used to help recover the skin quicker and to keep good moisture balance

Any of above options (1, 2 and 3) can be combined with topical medications like:

• Panoxyl
• Skinoren
• Epiduo
• Bactroban
• Tretinoin

Severe acne means regular or ongoing inflammation with large, red and swollen blemishes.

It’s more difficult to get severe acne under control but it is important to try and treat it as it can leave permanent scarring.

Diagnosing severe acne is an important first step to treating it.

Severe Acne Characteristics

Severe Nodulocystic Acne

• Multiple inflamed cysts and nodules
• Deep red or purple acne

Pustules

• Inflamed pimples, resembling a whitehead with a red ring around the bump
• Filled with white or yellow pus

Nodules

• Large, inflamed bumps that feel firm and often painful to the touch

Cysts

• Large, pus-filled lesions which look like boils
• Can be tender and painful

If your acne is severe, we may refer you to see a dermatologist.

Recommendation

Severe acne is often treated with oral medication. Options which may be considered include:

• Antibiotics – tetracycline, minocycline, doxycycline, or erythromycin may help by targeting bacteria and reducing inflammation
• Oral contraceptives – can reduce acne in some women,
• Spironolactone – anti-androgen hormone pill
• Isotretinoin – high-dose prescription vitamin A

In-Clinic Treatments

After inflammation is reduces by oral medication you can choose one of the following or combination of:

1. Obagi Blue Peel mask – 3 sessions every 21 days- repeat if necessary
2. Derma stamp with growth factor– 3-6 sessions every 2 weeks- to reduce inflammation and improve scars. Best results for the scars are achieve when combine with TCA peels every other session.
3. Chemical peels – x 3-6 – combination of different acids will be used to suit your skin type, some dryness may form and some shedding for 2-4 days
4. Microdermabrasion x 3-6- 1 session every 2 weeks, then 1x every 4 weeks as maintenance

Home Care

Option 1 – Mesoesthetic

1. Purifying Mousse/150ml (basic) – Daily cleansing mousse to purify and cleanse acne-prone and seborrhoeic skin. With a light texture, its main ingredients are glucosides and refreshing agents that cleanse impurities from the skin, leaving it soft and feeling comfortable and pleasant
   AM/ PM gently rub into moist skin with the fingertips. Rinse with plenty of water.
2. Acne One/ 50 ml (basic) – Cream with an all-round effect, specifically designed for the daily treatment and control of acne-prone and seborrhoeic skin. The unique association of complementary, synergistic active ingredients in m.acne complex™stimulates exfoliation of the pilosebaceous canal while reducing sebum production. It controls bacterial proliferation and reduces epidermal redness, addressing the various factors that trigger acne-prone skin with a crosscutting approach.
   AM/PM apply daily a thin even layer to clean skin, avoid eyes and mucus membranes, follow with SPF 50 in the morning
3. Pure Renewing Mask (basic) – Exfoliating and purifying facial mask for acne-prone and seborrhoeic skin for weekly use. The addition of inert pellets to the exclusive m.acne complex™provides mechanical exfoliation and cellular renewal for optimum control of oily skin or acne-prone.
   To be used 1-2 times a week, apply thin layer to the clean skin avoiding the eye, massage in gently and leave to act for about 10 min. Rinse with plenty of water. Not to be used for 2 weeks after chemical peel treatment.
4. Imperfection Control/ 10 ml (basic) –Specific, local treatment for emerging or rebellious acne breakouts. The innovative pigments in the formula have a modulated, progressive concealing effect controlled by the movements made during the application which make it possible to adapt the treatment to different skin tones. At the same time, the complementary effects of the components of m.acne complex quickly reverse the rubor and tumefaction of acneiform eruptions.
   Locally apply a small amount of imperfection control to clean, dry skin, using gentle circular motions to build up the colour and evenly cover affected areas

Option 2 – Obagi

• Obagi Tretinoin Cream, .025%, .05%, .1% – Topical retinoids are main stays in the treatment of comedonal and inflammatory acne
• Additionally, tretinoin stimulates mitotic activity and increased turnover of follicular epithelial cells causing extrusion of the comedones
• Leads to loosening and unseating of microcomedones, allowing sebum to reach surface of the skin and preventing obstruction of the pilosebaceous unit
• In addition, topical retinoids may have anti-inflammatory activity

Option 3 – Neostrata & Skintech

1. Foaming glycolic wash am/pm
   Or Skin Active exfoliating wash for mature skin am/pm
2. AQ solution serum can be used to help recover the skin quicker and to keep good moisture balance
   Combine with:
3. Moisturiser
   • Purigel– apply in the morning to the clean skin. It can be used several times a day
   • Or Purifying Cream– apply in the morning to the clean skin and in the evening just to affected acne prone areas.

Any of above options (1, 2 and 3) can be combined with topical medications like:

• Panoxyl
• Skinoren
• Epiduo
• Bactroban
• Tretinoin

Acne is doesn’t only affect the face, it is very common on the body areas too and often severe acne will progress from the facial areas to affect other areas of the body as well.

Body acne is more common and often more severe among males, but can also affect females too.

Common Areas of Body Acne

• Chest acne
• Back acne

These areas have more sebaceous glands than areas such as the arms or legs, so they’re more likely to become blocked.

Body acne occurs in the same way as acne on the face. It is a combination of overactive sebum production and dead skin cells which block a pore or hair follicle, allowing acne bacteria to create acne problems such as blackheads or whiteheads. These then progress to pimples, pustules, papules or nodules in severe outbreaks.

It generally occurs when severe facial acne has ‘spread’ to affect other areas of the body too.

Professional Treatments for Body Acne

Treatments to consider include:

• IPL – IPL (intense pulse light) can be used to improve active acne and can give significant long-term improvement when combined with a suitable home care programme
• Chemical peels – a course of chemical peels is especially effective when combined with other acne treatments. However, chemical peels should not be combined with oral retinoids due to risk of irritation
• Microdermabrasion
• Dermastamp microneedling
• Dermastamp with TCA Peel
• Dermal fillers to smooth out the depressions
• Extraction – manual and professional removal of stubborn whiteheads and blackheads carried out in clinic
• Steroid injections – suitable for large cystic or nodular acne

Home Care

The skin on the body (back, arms or chest) is a lot less delicate than facial skin, which means that more aggressive products can be used to tackle the problem.

Consider:

• Daily salicylic acid wash
• Cleansing pads containing benzoyl peroxide or salicylic acid can be wiped over affected areas
• Alpha hydroxy acid lotion (e.g. glycolic or lactic acid) to exfoliate as well as boost cell renewal

However, do be more careful close to the neck, as neck skin is more delicate. If there is any irritation, discontinue use.

Home Care

ClinicbeAcne recommend an adaptation of their mild acne treatment programme.

Option 1 – Mesoesthetic

1. Purifying Mousse/150ml (basic)
   Daily cleansing mousse to purify and cleanse acne-prone and seborrhoeic skin. With a light texture, its main ingredients are glucosides and refreshing agents that cleanse impurities from the skin, leaving it soft and feeling comfortable and pleasant
   AM/ PM gently rub into moist skin with the fingertips. Rinse with plenty of water.
2. Acne One/ 50 ml (basic)
   Cream with an all-round effect, specifically designed for the daily treatment and control of acne-prone and seborrhoeic skin. The unique association of complementary, synergistic active ingredients in m.acne complex™stimulates exfoliation of the pilosebaceous canal while reducing sebum production. It controls bacterial proliferation and reduces epidermal redness, addressing the various factors that trigger acne-prone skin with a crosscutting approach.
   AM/PM apply daily a thin even layer to clean skin, avoid eyes and mucus membranes, follow with SPF 50 in the morning
3. Pure Renewing Mask (optional)
   Exfoliating and purifying facial mask for acne-prone and seborrhoeic skin for weekly use. The addition of inert pellets to the exclusive m.acne complex™provides mechanical exfoliation and cellular renewal for optimum control of oily skin or acne-prone.
   To be used 1-2 times a week, apply thin layer to the clean skin avoiding the eye, massage in gently and leave to act for about 10 min. Rinse with plenty of water. Not to be used for 2 weeks after chemical peel treatment.
4. Imperfection Control/ 10 ml (optional)
   Specific, local treatment for emerging or rebellious acne breakouts. The innovative pigments in the formula have a modulated, progressive concealing effect controlled by the movements made during the application which make it possible to adapt the treatment to different skin tones. At the same time, the complementary effects of the components of m.acne complex quickly reverse the rubor and tumefaction of acneiform eruptions.
   Locally apply a small amount of imperfection control to clean, dry skin, using gentle circular motions to build up the colour and evenly cover affected areas.

Option 2 – NeoStrata & SkinTech

• Foaming glycolic wash am/pm
• Or Skin Active exfoliating wash for mature skin am/pm

Combine with:

• Purigel– apply in the morning to the clean skin. It can be used several times a day (for very oily skin)
• Or Purifying Cream– apply in the morning to the clean skin and in the evening just to affected acne prone areas.
• SPF- NeoStrata

All treatments should be follow with one of the home care options – failure to do so will affect effectiveness of the treatment programme

Acne scarring is often considered to be permanent and indeed it can last a lifetime in severe cases, but it doesn’t have to. 

Treating acne scarring depends very much on the nature of the scarring. Patients may have one predominant type of scar or a combination and it is vital to understand the problem properly before commencing any treatment plan.

Types of Acne Scarring

The key types of acne scarring are known as ‘Depressed’ and ‘Raised’ scars.

1. Depressed Acne Scars – generally sit on collagen rich scar tissue, which stops the skin from repairing the indentation. The 3 types of depressed acne scars are:
   1. Rolling
   2. Boxcar
   3. Ice pick
2. Raised Acne Scars – These are less common than depressed scars, but are generally more obvious. They also result from damage caused by inflammatory or papulopustular acne. There are 2 types of raised acne scars:
   1. Keloid
   2. Hypertrophic

Rolling Scars

Treatments to consider:

• IPL
• Chemical peels
• Microdermabrasion
• Dermastamp microneedling
• Dermastamp with TCA Peel
• Dermal fillers to smooth out the depressions

Box Car Scars

Treatments to consider:

• Chemical peels
• Microdermabrasion
• Dermastamp microneedling
• Dermastamp with TCA Peel
• Dermal fillers

Ice Pick Scars

Treatments to consider:

• IPL
• Dermal fillers

Keloid Scars

Treatments to consider:

• IPL
• Microdermabrasion
• Steroid creams
• Injections

Hypertrophic Scars

Treatments to consider:

• IPL
• Microdermabrasion
• Steroid Creams
• Dermal filler

Pigmentation problems and discoloration can be very challenging, but there are options and treatments which could help.

Hyperpigmentation

Excessive amounts of melanin in the affected area, causing redness or noticeable patches of pigmentation.

Treatments to consider:

• IPL
• Chemical peels
• Plasma Shower
• Topical treatments

Hypopigmentation

Lower than normal amounts of pigmentation in the affected area, caused by acne. 

Treatments to consider:

• IPL
• Plasma Shower

Erythema

Permanent redness of the skin.

Treatments to consider:

• IPL

Acne Vulgaris s the most common form of acne. Acne vulgaris can appear on your face, back, shoulders, chest and even buttocks.  It can start off mild, but it can progress quickly to more severe forms.  That’s why dermatologists and acne treatment experts recommend treating acne vulgaris as soon as you notice breakouts.

Comedonal Acne is a type of acne vulgaris. Instead of having inflamed pimples, though, you’ll have bumpiness, blackheads, and milia. This can occur anywhere on the face or body and it can become quite severe if untreated

Cystic Acne is the most severe form of acne vulgaris and includes symptoms such as inflammation, and large, painful blemishes (or cysts).

Cystic acne can occur anywhere on the face or body. Acne cysts occur deeper in the skin than a typical pimple. They can take weeks to heal and can cause a lot of damage. The deep nature of the cysts means that treatment is often very different for cystic acne.

Acne Rosacea tends to affects adults, usually after the age of 30. Acne rosacea is characterised by a redness, flushing and tiny visible blood vessels. There is usually some bumpiness and pimples. Stress, sun exposure, eating spicy foods, or drinking hot liquids can make symptoms worse. In severe cases, patients have an inflamed, bulbous nose, and even eye problems

Acne Mechanica is a type of acne caused by excess heat, pressure, or friction on the skin.  It is therefore is most common on the body and is sometimes referred to as ‘sports acne’ as it can be caused by helmets, sweat bands etc.

Acne Cosmetica refers to acne triggered by makeup, creams, moisturiser etc

Excoriated Acne is caused by chronically and excessively pick at pimples (or even healthy skin) to the point of causing wounds.