According to Dr. Nicolas Perricone, dermatologist, there are 7 different stages of acne that can be distinguished. Stage one being the beginning, stage 7 being the worst state of acne.
- Retention Hyperkeratosis. In a healthy skin, dead skin cells are shedded in a natural, ongoing manner. This also goes for the skin cells INSIDE the pores. In the case of retention hyperkeratosis, the dead skin cells inside the pores do not exfoliate in that natural manner and cling together with the sebum (natural skin oils). As a result of this, pores get clogged. The condition is triggered by several factors, one of them being genetics. In order to normalise this process, vitamin A derivatives like Tretinoin or Retinol can be applied to the skin. Retinol normalises the way skin cells behave inside our pores. Salicylic and glycolic acid can help prevent new pores from getting clogged, as these ingredients will further help exfoliation (elimination of dead skin cells).
- Bacterial accumulation and multiplication inside the follicle. The acne bacteria, Propionibacterium acnes, starts multiplying inside the clogged pores. Infection is around the corner. Antibiotics are used (as well orally as topically) by dermatologists, but there is a risk of developping resistant strains. Benzoyl peroxide kills the acne bacteria by releasing oxygen into the skin. This also means that free radicals are being formed, leading to possible cell damage and premature ageing. Benzoyl peroxide can also be very harsh to the skin and is not tolerated very well by sensitive skin types. Light Therapy with a wavelength of 410-420 Nanometer is very effective. Combined with the stage 1 treatments good results can be achieved.
- Microcomedones/comedones formation. Meaning whiteheads and blackheads. Treatment should now be focused on anti-bacterial and light therapy.
4/5 Papule and pustule formation.Also called “stage 2 acne” by dermatologists. These are the well-known red, irritated and inflamed pustules that are so typical for people with acne. Treatment as in stage 3.
6/7 Nodules and cyst formation. This is a severe form of acne. Not every patient/acne sufferer gets to this stage. I did myself, unfortunately, mainly due to bad treatment in those days. Treatment now consists of Roaccutane (Isotretinoïn) orally. A course of about 3 to 4 months is generally effective at clearing the acne. Roaccutane has some serious side effects, like :
- Bad vision at night
- Hair loss (at high dosages)
- Dryness of lips, nose, eyes
- Increased triglyceride levels (this has to do with liver functions)
- Severe birth defects in pregnant women
I personally did a course of 3 months of this medicine. It saved my skin and got me back on my feet after years of being depressed because of my severe acne. I only suffered dryness and had some increased triglycerides levels by the end of the course. This gets back to normal once you stop taking the medicine.I an soooo happy I did this !
What I also discovered during this stage, is how important GOOD, NON-AGRESSIVE skin care can be. It makes the whole difference, during and after the acne.
SKIN CARE REGIMEN FOR ACNE:
- Start the day with a GENTLE, non-drying cleanser. Avoid foams if you can. A cream or milk will be just as affective, believe me ! Céravé Hydrating Cleanser, Mad Hippie Cream Cleanser, Klapp Bèta-Glucan Cleansing Milk, Clinique Take the Day Off are excellent.
- Use a SPOT treatment ON your pimples. Try a solution with BHA/Salicylic acid. It will help reduce inflammation and “dry out” your spots (no, I know, you can’t litterally dry them out, but some of you NEED to hear it this way J)
- Use an oil-controlling/mattifying product if you need to. A light moisturizer can be great too. Look for anti-inflammatory ingredients like Centella, Green Tea and Chamomile. Silver is great too.
- Use suscreen (oil free) SPF 30 at least or a make-up with SPF. Avoid stick/compact make-up, as these often have waxes which could clog your pores.
- Doublecleanse (see my articles about cleansing). Your first cleans eremoves make up and SPF. The second one cleanses your skin.
- Spot treatment
- Use a Retinoid:vitamin A derivative like Retinol. Many brands have good retinols and they all have different percentages. If you want a stronger one choose Paula’s Choice or Neostrata. If you want to start milder look for Klapp Micro Retinol Soft Cream or Mad Hippie serum.
- Moisturize:with a light moisturizer. Hyaluronic acid based product are great. A gel like l’Occitanes Aqua Réotier or Leegeehaam Serum is wonderfull at this stage.
SOME INGREDIENTS TO AVOID:
- Mineral oil
- Cinnamon oil
- Cocoa butter
- Coconut oil
- Isopropyl myristate & palmitate
- Myristyl myristate
- Propylene glycol (some persons, not all)
- Sodiul lauryl & laureth sulphate.
Remeber that not everyone has the same reaction to cosmetic ingredients and some of the above mentionned will be perfectly ok for some.
Be consistent in what you do and seek for medical/dermatological advise if your acne doesn’t get better or gets worse.