Pimples also called as Acne vulgaris is the most common skin disease of adolescents and young adults with reported prevalence being nearly 80%. Its predominance in this psychologically labile age group coupled with its potentially lifelong sequelae makes it a matter of huge financial and psychosocial concern.
Excessive sebum production, changes in the microbial flora, as well as inflammatory and immunological host reactions have long been considered to be the four pillars of acne pathogenesis. Ongoing research has seen the changing importance of one factor over the other from time to time. With advancements in dermatology, personalized approaches to pimple treatment in Bangalore now address these root causes more effectively.
What′s New in Topical Therapy?
Topical antibiotics, benzoyl peroxide (BPO) and retinoids have been the cornerstone of topical treatment of pimples.
Synergistic Topical Combinations
BPO has been combined with antibiotics (essentially clindamycin and more recently, nadifloxacin), retinoids (only with adapalene), and with salicylic acid (SA). BPO 2.5% or 5%/clindamycin combination has demonstrated superior efficacy than either agent as monotherapy in treating inflammatory lesions. This combination has also been compared with the previously established clindamycin 1.2%- tretinoin 0.025% gel.
Topical SA alone is only moderately effective in pimples. 5% BPO used in combination with SA has shown better efficacy than even BPO/clindamycin gel in reducing both inflammatory and non-inflammatory lesions in the early weeks of therapy. Its exfoliant ability has been utilized in conjunction with the BPO/clindamycin gel.
Newer Formulations
Microsphere formulations of topical tretinoin and BPO, currently in the market, have demonstrated good efficacy and tolerability. Microsphere encapsulation eliminates the rapid delivery of high concentrations of active drug to the application site, while it facilitates controlled release of potentially irritating drugs. It makes tretinoin photostable in the presence of fluorescent light or ultraviolet radiation.
A micronized formulation of tretinoin (0.05%) gel has also been developed that enables more efficient penetration into the skin layers because of its optimal particle size. It enables the use of lower concentration of tretinoin with better cutaneous tolerability than tretinoin gel microsphere (0.1%) without compromising its efficacy.
Oral Isotretinoin
Oral isotretinoin continues to be the mainstay of therapy for severe acne, because of its efficacy, ability to target all the four pathophysiologic factors, high rates of permanent remission and prevention of permanent scarring in acne. However, there remains ambiguity regarding the best dosage, including desired cumulative dose of isotretinoin. The current recommended dose of 0.5-1.0 mg/kg/day for 4-8 months (average cumulative dose of 120-150 mg/kg), quite often encounters relapse cases in clinical practice that require further medical management.
Use of Chemical Peels
The treatment of acne is based on a combination of topical therapies, systemic treatments, chemical peels, dermabrasion, and laser.
Chemical peeling is among the most common cosmetic procedures in medical practice and has been used for decades.
Salicylic acid (SA)
SA is a 2-hydroxybenzoic acid (from willow tree) used for superficial peeling due to its strong keratolytic and comedolytic properties. It promotes shedding of epidermal cells and due to its lipophilic properties can penetrate comedones and pores to prevent clogging and neutralize bacteria.
Glycolic acid (GA)
GA belongs to the group of α-hydroxy acids (acids derived from fruit) and is used as a superficial or medium depth peel in acne treatment. GA is an exfoliative agent that causes epidermolysis with desquamation of the skin by reducing corneocyte adhesion and keratinocyte plugging at the stratum granulosum.
Lactic acid (LA)
LA is another α-hydroxy acid (derived from sour milk or bilberries) used as adjuvant therapy for acne either alone or in combination with other peels.
Mandelic acid
Mandelic acid is an aromatic α-hydroxy acid widely used for the treatment of mild to moderate acne.
Frequently Asked Questions (FAQs)
Q1. What procedures does the best cosmetic surgeon in Bangalore commonly perform?
A. The best cosmetic surgeon in Bangalore offers a range of treatments including rhinoplasty, liposuction, facelifts, breast augmentation, tummy tucks, and non-invasive procedures like Botox and fillers.
Q2. Are anti ageing treatments in Bangalore safe?
A. Yes, most anti ageing treatments in Bangalore are safe when performed by certified dermatologists or cosmetic specialists using FDA-approved techniques.