Severe acne

Severe acne

This type of acne usually requires treatment with isotretinoin, which can only be introduced by a dermatologist (teratogenic risk). While waiting for the appointment, we already prescribe a pre-therapeutic check-up (lipid and liver test), check for contraindications and start another type of treatment.

The general practitioner prescribes oral antibiotic therapy for anti-inflammatory purposes (such as doxycycline 100 mg once a day or lymecycline 300 mg once a day) combined with a local treatment combining local retinoids such as adapalene 0.1%: 1 application per day in the evening at bedtime with benzoyl peroxide 2.5% gel: 1 application per day in the evening at bedtime. There is a specialty containing the 2 molecules: Epiduo© (but not reimbursed unlike the two products prescribed separately).

Among other tips, it is helpful to advise the patient not to squeeze the blackheads. Alcoholic or antiseptic products are not recommended because they are ineffective and irritating and/or sensitizing. The application of a moisturizer in the morning is recommended to improve the tolerance of anti-acne treatments. The use of a gentle toiletry product is recommended (for example: a product that respects the skin’s pH) so as not to aggravate the irritating effects of certain treatments.

For therapies other than isotretinoin, it is helpful to discuss with the patient :

• The suspensive nature of the treatment and the need for local maintenance treatment for as long as necessary;
• The long nature of the treatment and the ineffective nature on old scars;
• The delay of a few weeks or even 2 to 3 months necessary to obtain an improvement, with a possible initial worsening in the first few weeks;
• The need for regular applications (for local treatments/the treatment only works if it is used every day);
• The frequent irritating effects of local treatments and the measures to be taken to prevent and manage them (spacing out applications at the beginning of treatment and using a daily moisturizer);
• Photoprotection is recommended in the event of sun exposure;
• That there is no reason to recommend a modification of the diet in order to improve acne.

Severe acne and IPL

IPL (Intense Pulsed Light) is an effective method for treating severe acne, especially inflammatory forms. This technology uses high-intensity light beams to target and reduce acne-causing bacteria (Propionibacterium acnes), decrease inflammation, and reduce sebum production. IPL also helps to reduce acne-related scars and redness.

How does IPL work on severe acne?

1. Bacteria Reduction :
   • IPL emits light that penetrates the skin and targets bacteria that cause inflammation and breakouts. It thus helps to reduce infection and reduce acne breakouts.
2. Sebum control :
   • IPL regulates sebum production by acting on the sebaceous glands, reducing excess fat on the skin, a trigger for breakouts.
3. Reduction of scars and redness :
   • By stimulating collagen production, IPL improves skin texture and diminishes acne scars, while reducing redness due to inflammation.

Benefits of IPL for severe acne:

• Non-invasive treatment : IPL is a gentle method that does not require an incision or aggressive medication.
• Few side effects : Side effects are usually mild, such as temporary redness, and there is little to no downtime.
• Overall skin improvement : In addition to treating acne, IPL improves the overall appearance of the skin by reducing scarring, dark spots, and texture irregularities.

Number of sessions:

To treat severe acne, several IPL sessions are often necessary (usually between 4 and 6), spaced a few weeks apart to achieve optimal results.

Peeling and severe acne

Peeling is an effective method for treating severe acne, especially inflammatory forms and scars left by breakouts. This technique involves applying chemical agents to the skin to exfoliate the surface layers, promoting cell renewal and improving the appearance of the skin.

Types of peels for severe acne

1. Superficial peels :
   • Use mild acids like glycolic acid or salicylic acid.
   • They absorb lightly into the skin and are effective in treating small blemishes and mild breakouts.
   • These peels stimulate cell turnover and help clear clogged pores, reducing the chances of new breakouts.
2. Medium peels :
   • Contain stronger acids, such as trichloroacetic acid (TCA).
   • They penetrate deeper into the skin and are used to treat more severe forms of acne, acne scars, and skin irregularities.
   • These peels promote a more significant improvement in the texture and appearance of the skin.
3. Deep peels :
   • Carried out under medical supervision, using agents such as phenol.
   • This type of peel is less common for acne, but can be used to treat severe acne scars.
   • It requires a longer recovery time and can lead to prolonged redness.

Benefits of peeling for severe acne

1. Pore clearing :
   • Peeling helps remove dead skin cells and clear pores, reducing the risk of new breakouts.
2. Reduction of inflammation :
   • The acids used in peels have anti-inflammatory properties that help decrease the redness and swelling associated with acne.
3. Scar Improvement :
   • By promoting cell renewal, peeling helps to reduce acne scars, thus improving the texture of the skin.
4. Collagen Stimulation :
   • Peels promote collagen production, which can improve the elasticity and firmness of the skin over time.

Sessions and follow-up

• In general, several peeling sessions are necessary to achieve optimal results, especially for severe acne.
• The sessions are usually spaced a few weeks apart to allow the skin to heal.

Precautions and side effects

• Side effects may include temporary redness, irritation, or peeling. It is essential to follow your dermatologist’s advice to minimize these effects and optimize recovery.
• It is recommended to avoid sun exposure after a peel, as the skin is more sensitive.

Conclusion

IPL is an attractive option for people with severe acne, especially those looking for a non-invasive treatment. It works by reducing bacteria, inflammation, and improving the appearance of the skin, while providing a complementary solution to traditional treatments.

Peeling is an effective treatment option for severe acne, capable of improving skin texture, reducing inflammation, and treating scars. In combination with other treatments (topical or medicinal), it can offer significant results for acne sufferers. A consultation with a dermatologist is essential to determine the most appropriate type of peel and develop a personalized treatment plan.