SINGAPORE - Comedones are seen in people with acne. They are bumps that form on the skin when the pores become clogged by dead skin cells and sebum (oily secretion) Bacteria then grows rapidly in the clogged pores, causing inflammation.
Adult-onset acne can occur in people who have not had acne for years.
It can even occur in people who have never had acne before.
Women are more susceptible.
Adult-onset acne may be triggered by stress, hormonal fluctuation (such as during the pre-menstrual period or pregnancy), the use of medication (such as corticosteroids and certain anticonvulsants) and the use of oily skin or hair-care products.
Some people may have a genetic predisposition to acne.
Adult-onset acne often occurs on the jawline and around the mouth.
If a woman's acne is associated with excessive facial hair, thinning scalp hair and irregular periods, she should consult her doctor as these may be symptoms of medical disorders such as polycystic ovary syndrome (a disorder with hormonal imbalance and cysts in the ovaries), adrenal gland disorder (when the adrenal glands produce too much or too little hormones) and androgen-secreting tumour (abnormal growth that produces the male hormone called androgen).
Mild acne can be treated topically with medication containing benzoyl peroxide, retinoids (such as tretinoin and adapalene) or antibiotics (such as erythromycin and clindamycin).
Treatment of moderate to severe acne requires oral medication in addition to topical therapy. Useful types of oral medication include oral contraceptive pills, antibiotics (such as doxycycline, minocycline and erythromycin) and isotretinoin.
As your acne has shown some improvement with the use of the oral contraceptive pill, you can discuss with your doctor the option of combining this with topical retinoid therapy, which is also effective for comedonal acne.
Once your acne has improved significantly with the combination therapy, it may be possible to discontinue the oral contraceptive pill and maintain your skin condition with topical retinoid therapy.
Alternative therapeutic options for comedonal acne include comedo extraction (removal of comedones), gentle electrocautery (use of electricity to burn off the comedones) and chemical peeling (use of chemicals to remove a superficial layer of skin).
Studies have shown an association between drinking milk and acne, as well as between eating a high-glycaemic diet and acne.
The glycaemic index is a measure of how quickly blood sugar rises after a person eats a particular type of food, on a scale of zero to 100. A score of 55 and below is low; that of 70 and above is high. The higher the index, the faster the food is digested and blood sugar rises.
However, these studies have not proven that drinking milk or eating a high-glycaemic diet actually causes acne. Until more rigorous research studies are done on this rather controversial subject, I would advise you to eat a healthy well-balanced diet and avoid any food that makes your acne worse.
DR CHAN YUIN CHEW
Dermatologist at Dermatology Associates at Gleneagles Medical Centre
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