• acne
• acne scarring
• birthmarks - brown
• birthmarks - port wine stains (red)
• facial volume loss
• fat deposit reduction
• gynaecomastia / man boobs
• hand rejuvenation
• injectable lip enhancement
• keloid / hypertrophic scarring
• laser hair removal
• laser tattoo removal
• leg veins / spider veins
• neck rejuvenation
• non surgical facial shaping
• rosacea and facial capillaries/redness
• skin analysis
• skin pigmentation
• sweating - excessive
• wrinkles

• anaesthesia/analgesia for procedures
• anti-wrinkle injections
• chemical peels
• dermal fillers
• laser - apogee
• laser - gemini
• laser - medlite
• laser - ruby
• lipodissolve
• make-up - dermacolour
• make-up - glo minerals
• microdermabrasion
• photodynamic therapy
• plasma skin regeneration
• retinoids - topical
• sclerotherapy
• skin care - asap
• skin care - cosmedix
• skin care - rationale
• skin needling

Acne Treatments

What causes acne?

There are a number of contributors to the formation of acne. Excess oil and sebum production exacerbated by hormonal influences on sebaceous glands, as well as dead skin physically blocking pores can cause acne. A bacterium named Propionobacterium acnes has also been implicated as a cause of acne. All treatments for acne will address one or more of these issues.

There have been no studies showing that acne is caused or exacerbated by your diet, contrary to the usual belief that certain foods can worsen acne.

What treatments are available?

Acne can be treated in a number of ways. The first step in treating acne is usually appropriate skin care.

Case Study: Acne Treatment

This male in his twenties presented to The Victorian Cosmetic with persistent acne since his teenage years. He had tried several creams, including Proactiv with no real improvement in his skin. The before and after pictures are spaced 3 months apart. The treatment during this period included; commencement of a glycolic based cleanser from ASAP, a topical retinoid, topical clindamycin (antibiotic), a short course of minomycin (antibiotic) tablets, and two 20% salicyclic acid peels. There was significant improvement noted over his entire face by him and his close friends and family.

Skin care

A good cleanser is the first step in the treatment of acne. A cleanser containing alpha-hydroxy acids or beta-hydroxy acids, such as those found in ASAP and Cosmedix skin care products, can help remove the oil and dead skin cells from the surface of the skin to prevent the physical blockage of pores and acne. Exfoliants with these ingredients can also be used. Beta-hydroxy acids (including salicylic acid) have the advantage of having anti-inflammatory properties and are more oil soluble making them penetrate oily skin better than alpha-hydroxy acids. For those with sensitive skin types, a gentle cleanser can be used and then active products like alpha-hydroxy acids or retinoids can be placed on the skin after as tolerated. Good gentle cleansers include the Benefit cleanser/Gentle clean Rx from Cosmedix or the Preparatory cleanser from Rationale.

Benzyl peroxide is a good product for reducing active acne lesions and also has anti-inflammatory properties. It is found in well-known products such as ëPro-activí but is also available more inexpensively over-the-counter at your local pharmacist. It is available in concentrations up to 10%. The higher the concentration, the more flaking and irritation to the skin. Therefore, commencement should be with the lower concentrations.

Microdermabrasion and chemical peels

Make-up/foundation

Make-up is also implicated in the cause of acne. Foundations, even those claiming to be ëoil-freeí can physically block pores and cause acne. This often leads to a vicious cycle of applying make-up to cover acne lesions, and in turn this causes more acne, leading to the use of more make-up. Acne due to make-up use is termed ëacne cosmeticaí. Mineral make-up does not block pores, and instead sits on top of the skin. At The Victorian Cosmetic Institute, we recommend Glo-minerals foundations as they have anti-oxidants and anti-inflammatory properties as well as being a mineral make-up. Importantly, they also have a SPF factor to help prevent aging and post-inflammatory hyperpigmentation from acne lesions (see below).

Antibiotics

Antibiotics have also been widely used in the treatment of acne. Antibiotics work by reducing the acne-causing bacteria (including Propionobacterium acnes) at the surface of the skin.  Antibiotics are most suited to inflamed acne lesions. They do unfortunately also affect the rest of the body as well as the skin, and can result in side effects such as oral and vaginal thrush, diarrhoea, liver function abnormalities, and sun sensitivity. Minomycin has also been associated with hyperpigmentation when used for prolonged periods. Antibiotics such as doxycycline, minomycin, clindamycin, trimethoprim, trimethoprim plus suxamethoxazole (Bactrim), are commonly prescribed for prolonged periods. The author does not believe in the long-term use (greater than 2 months) of antibiotics for acne as their efficacy is low and the potential side effects can be significant. Penetration into the skin can also be minimal. With widespread use of antibiotics for acne, there is increasing resistance of the acne-causing bacteria to the commonly used antibiotics, resulting decrease in their effectiveness.

Hormonal treatments

Particular hormones, in particular androgens, have also been known to increase oil and sebum production and exacerbate acne.

Oral Isotretinoin/Roaccutane

Roaccutane, or oral isotretinoin, also a derivative of Vitamin A, is the gold standard in the treatment of acne. Prescribed only by dermatologists, it is mostly used for severe forms of acne only, as it has a number of significant side effects. Generally, a six-month course is prescribed, and involves taking a tablet or two each day. The side effects from Roaccutane are the main problem with treatment and include; dry skin, dry eyes, dry lips, cracked lips, hair loss, mood changes, and liver function abnormalities. Pregnancy must be completely excluded during treatment with Roaccutane, as it is known to cause serious birth defects. 

Photodynamic therapy

Recently, there have been advances in the treatment of acne that do not involve drugs with significant side effects, and can be highly effective. Photodynamic therapy is such a treatment that targets sebaceous gland activity. Being a localised treatment, it only has localised side effects, ie on the treated skin. There has been some studies showing that it may be as effective as Roaccutane in some cases. Photodynamic therapy works by placing a substance called 5-aminolevulenic acid on the skin, which is attracted specifically to the sebaceous glands, and then activating the substance with a light source or laser. This specifically disrupts the function of the sebaceous glands and reduces their activity and the acne they cause. The results can last up to a year and some people require no further treatments for acne after their initial treatments.

Sunscreens

Sunscreens are important to help reduce pigmentation after an acne lesion has passed. However, some sunscreens themselves can cause acne by blocking pores. At The Victorian Cosmetic Institute, we recommend Reflect sunscreen from Cosmedix. Reflect is a spray on, non-oily sunscreen with Titanium Dioxide.

Why should I choose The Victorian Cosmetic Instituteís doctors to treat my acne?

Our doctors specialise in skin treatments and will be able to give you the proper advice on the right treatment for you. Our doctors also have a special interest in acne, and they are up-to-date with the latest treatments.

The first step is simply contacting us for your initial consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.    
 
Making that first phone call can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.