How to tackle acne

Acne is a condition of the skin, that manifests as pimples, blackheads, whiteheads, cysts, bumps, papules, pustules and postinflammatory hyperpigmentation.

Acne is very common in all ages, men and women, boys and girls and usually begins in adolescent ages but can be seen in mature adults, so-called adult acne.

Acne is usually caused by hormones and can be genetic or inherited.
Acne is important because it impacts self-esteem, it can cause permanent facial skin scars.

Taking care of skin with acne can be challenging. Acne skin tends to be very oily. In Nigeria, because of the humid weather conditions, skin can be oily and this does not help the acne condition.

I would recommend a rigorous skin care routine as follows:
1. A facewash for acne or oily skin. should be labelled as such and usually has salicylic acid as its first product composition. Washing the face twice a day is ideal, morning and night. A charcoal facewash is also great for drawing out excess oil that predisposes to pimples and acne. A facemask used once a week, can smoothen out acne scars and reduce darkened spots.

2. After washing, apply your acne treatment product in the problem areas and then apply a small amount of gel or lotion with SPF (sun protection factor) to the face, must be labelled as non-comedogenic and for oily skin.
Non-comedogenic means it does not cause comedones which means a clogged pore.

When a pore is blocked with keratin it is called blackhead, when it is closed with pus, it is called whitehead.

3. For ladies, after SPF you can apply oil-free foundation, and powder.
If you have oily skin, best to avoid heavy creams. You should use lotion or gel (preferred).
In my opinion, oily skin does not require moisturization, as this only causes the skin to look more oily.

4. At bedtime, after washing, apply acne treatment lotion or gel. There are so many over-the-counter formulations that help reduce the appearance of pimples, also there over the counter are products with small amounts of glycolic acid or salicylic acid that helps reduce post-inflammatory hyperpigmentation.

5. Few times a week, use a gentle exfoliating facewash or facemask to reduce excess oils and assist cell turnover.

6. Men also suffer with acne or pimples that can affect self-esteem or self-confidence. Teenagers with acne should be assured that acne is likely a temporary condition that will improve over time.

Skin care products for men with acne can be found in the facial products or skin care section in a supermarket. I recommend reading the labels or product description before buying. There are various facewash products, facescrubs, and facemasks designed for men with Acne. Facewash is for twice a day use (morning and night) , while facescrubs and facemasks are used once or twice weekly.

In Nigeria, you can find various combinations of  affordable and effective topical treatments containing salicylic acid for acne. You can speak to your Pharmacist about the best one to try.

For serious acne, there are prescription and over-the-counter retinoid gels (Retin A, Differin gel) and lotions. I suggest you talk to your Doctor about this. Retinoids are very effective in treating acne, however precautions must be used in women of childbearing years who want to use retinoids. As a warning, retinoids are contraindicated and not for use by pregnant women.

If your skin is dry but prone to darkened spots, a night cream with glycolic acid might help fade the appearance of the spots.

There are also prescription fading lotions for spot treatment of hyperpigmentation. There might be a temptation to use bleaching soaps or creams; I do not recommend bleaching soaps or creams because of the longterm after effects such as thinning of skin and green discoloration of skin. Also beware of buying skin care products that do not list the components on the labels, some of these products contain hydroquinone which is a bleaching agent and is not for long term use. Some people who have sulfa or sulphonamide allergy can develop reactions from hydroquinone.

On a personal note: As an acne sufferer I can tell you I have tried most products over the counter, non-prescription products and prescription products. My one area of challenge is the darkened areas that occur after an acne episode, this is called post-inflammatory hyperpigmentation. I have been able to control this by using a prescription lightening lotion for spot treatment only, usually a few applications improves this hyperpigmented area after a few days.

Comedones is another area of concern. This is kept in control with a light exfoliation facewash and use of a retinoid gel. For the occasional pustule and papule, I use a topical antibiotic gel for spot treatment which prevents this from becoming a full-blown cystic boil.

The morning application of SPF is a must for me because all these products can cause sensitivity from the Sun’s rays and damage from the Sun’s rays can cause premature aging of skin and skin cancer.

Take home points: Wash face twice a day. Oily skin use gel or lotion over cream if you must. Don’t forget the SPF.
A good skin Doctor (Dermatologist) can help you tackle your acne. Don’t suffer in silence.

Written by Dr. Ngozi Onuoha.

Updated 1/2020
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