TYPES OF ACNE
Nodular / Cystic Acne
Nodules are larger (>1cm), raised, solid lesions. They are located deeper than papules and pustules, primarily in the dermis and/or subcutaneous tissue (below the dermis). Most of the nodule may well be “hidden” below the skin surface, such that it is more often palpated (felt) under the skin rather than seen. Similarly, to papules, nodules form from a build-up of bacteria, skin cells, and sebum in the follicles, but this formation is rooted deeper in the skin. Nodules can be very painful on touch.
Nodules can remain under the skin for a long time. They may be dormant and then suddenly “flare up” again. If squeezed or ruptured, these nodules can spread over a larger area of the skin and cause deep infections. These can then cause damage to the skin and lead to the formation of scars.
Cysts are similar to nodules, except for the presence of pus within them. They may appear as a large, fluctuant (swollen), and red lumps on the skin. They may occur independently, or may merge and become bigger.
Why should nodular/cystic acne be treated early?
Nodular/cystic acne when not treated early or effectively can result in acne scarring.
Acne scarring causes permanent damage to the skin and results in uneven texture.
It can be severe, and may result in emotional distress and lowered self-esteem. Psychological distress due to acne should not be taken lightly as it affects the daily lives of many acne sufferers, especially those with nodular/cystic acne.
How should nodular/cystic acne be treated?
At Aeras, we always aim to treat the cause and ensure that it does not return after treatment.
The treatment of nodular/cystic acne aims to reduce severe inflammation and bacteria count, and to reduce sebum production which fuels the growth and activity of acne-causing bacteria.
The objectives of treatment include;
- Reducing inflammation and bacteria count
- Reducing sebum production
Reducing Inflammation and bacteria count
The reduction of bacteria and inflammation can be achieved through in-clinic procedures and topical/oral medication. Oral medication is often required due to the nature of nodular/cystic acne being situated deeper in the skin. Daily skincare routine to reduce sebum production and inflammation is also crucial in reducing nodular/cystic acne.
Procedures to help treat nodular/cystic acne by reducing severe inflammation include;
- Aeras Hypertec Q-switched and Quasi-long pulsed Laser
- Aeras Healite II Light Therapy
- ProYellow Laser
- Steroid injections
These procedures not only reduce bacteria count, but also specifically aim to reduce acne inflammation with heat energy or steroid injections.
Reducing Sebum Production
P-acne, the acne-causing bacteria, grows optimally in the presence of sebum. Increased sebum production attracts the bacteria into the hair follicles. Sebum production can be reduced and controlled with in-clinic procedures.
Procedures we do that help reduce sebum production include;
- Carbon Laser Peel
- Aeras Clinical Acne Peel
- Aeras Healite II Light Therapy
- Aeras Ultra-Healing Acne Facial
Medication & Skincare to treat Nodular / Cystic Acne
Our Aeras skincare range is specifically designed to include different products for different types of acne.
For nodular/cystic, topical and oral medication should be used in conjunction with your daily skin care to reduce bacteria, sebum production, and inflammation.
Topical antibiotics kills and reduce bacteria on the skin surface and in the pores. This helps reduce inflammation and also prevents clogged pores from getting inflamed. Antibiotics are a mainstay in the treatment of inflammtory acne.
Topical Benzoyl Peroxide
Benzoyl peroxide, or BP, is commonly known as Oxy in Singapore. BP is used to treat mild to moderate acne. It is best used with topical antibiotics and it helps break down the outer protective film of a bacteria to allow topical antibiotics to destroy these bacteria.
BP also dries up and reduce small papules to reduce acne.
Differin Gel/Topical Retin A
Both Differin and topical Retin A contain retinoids. Topical retinod is a keratolytic agent that softens and causes desquamation of the epithelium. This means that these agents slough off the dead skin cells and promotes skin renewal. This aids the natural exfoliation of the skin and unclog pores. These topical medications are used to prevent clogged pores and in turn reduce inflammative acne.
Aeras Acne Spot Treatment Gel
Aeras’s doctor-compounded Acne Spot Treatment Gel combines topical antibiotics, BP, and ingredients such as Niacinamide and others to reduce redness and soothe the skin. This fast-acting topical acne gel reduces papules and pustules quickly and reduces the chances of acne scarring.
For more severe inflammation, oral antibiotics can be used to reduce inflammation. Oral antibiotics can be taken for about 1 – 6 months, depending on the condition. Oral antibiotics for acne have few or mild side effects, and is safe to take long term for most people.
More commonly known as Accutane or Nimegen, oral isotretinoin is an oral Vitamin A. Oral Vitamin A (or retinoids), work by greatly reducing the amount of sebum produced by the skin. Oral isotretinoin helps treat severe inflammation by reducing the amount of sebum that the bacteria acts on. However, there are precautions and side effects associated with oral isotretinoin and professional healthcare advice is needed before starting on a treatment.
Sometimes, oral supplements like zinc or probiotics are given to boost the immune system. These supplements do not work well on their own, but rather in conjunction with other medication or skincare products.
For moderate to severe nodular / cystic acne, we recommend skincare ingredients that reduce severe inflammation, reduce oil production, and reduce bacteria count.
AHAs and BHAs are mild acids that are widely known to help unclog pores and exfoliate the skin. Examples of AHAs and BHAs used in our various skincare products for comedonal acne include Salicylic acid, Glycolic acid, Mandelic acid, Lactic acid, and Lacobionic acid.
Products that contains AHA/BHA include Clarifying Cleanser, Multi-action Cleanser, Multi-action moisturiser, Chest and Back acne spray, DoubleaAct toner, Bionic lotion, 15% gel plus.
Triethyl Citrate helps reduce excessive sebum production and also reduces bacteria activity on sebum to prevent inflammation. Triethyl Citrate also helps destroy bacteria by breaking down acid molecules to help kill bacteria.
Products that contains Triethyl Citrate include Multi-action Cleanser, Multi-action moisturiser, Chest and Back acne spray.
Ethyl Linoleate is broken down by the skin to form Linoleic Acid, Linoleic Acid reduces sebum production on the skin and reduces bacteria activity. It also helps renews the skin and prevent post-acne marks which are more common in moderate to severe inflammative acne.
Products that contains Ethyl Linoleate include Multi-action Cleanser, Multi-action moisturiser, Chest and Back acne spray.
GT peptide 10
GT peptide 10 has the ability to break down the outer membrane of bacteria. This kills the bacteria or allows medication such as antibiotics to further destroy the bacteria. GT peptide 10 works best together with Triethyl Citrate in combination to reduce inflammation as it reduces the skin response to oil-producing hormones to control sebum production.
Products that contains GT peptide 10 include Multi-action Cleanser, Multi-action moisturiser, Chest and Back acne spray.