Acne in dark skin types

People of color are a very large group, which in South Africa includes people of African and Asian descent. It also includes patients of mixed backgrounds who have more darkly pigmented skin. Darker skin type people represent a significant and growing group of patients seeking aesthetic procedures. This is because of the increased awareness of safe, affordable aesthetic procedures. These procedures include amazing new lasers that are colour blind and are less invasive than previous generations of lasers. Yet special concerns have to be addressed when treating skin of color.

Acne vulgaris, the most common skin disorder, affects virtually all individuals in all nationalities at least once. Acne mainly affects the following areas: face, neck, upper trunk, shoulders and proximal arms. Incidence peaks in 18-year-olds, but substantial numbers of 20- to 40-year-olds also develop the disease.

In dark skin types, the biggest challenge is avoiding scars or marks from things such as acne and chicken pox that last for life as the pigment is so hyper-sensitive . When treating persons of color, post-inflammatory hyperpigmentation PIH (brown spots after the acne blemishes have healed) and active acne need to be differentiated. It is important to note that when one is treating acne, the brown spots that occur afterwards are only residual effects, not active acne.

Women are more likely to suffer from ongoing acne that commences or reappears during their early adult years. Around 8 % of women have acne persisting into their 30’s and in some it continues into their 40s and occasionally 50s. Why this occurs is poorly understood but may be related to hormones, childbirth, menopause, or stopping the pill. Adult women may be treated at the period and at ovulation when acne is especially severe, or throughout the entire cycle

There is also a subset of women with “true” hormonal acne who have abnormal levels of androgenic (male-type) hormones. These women often have accompanying excess facial hair (also hormonally regulated) and irregular menstrual cycles, although women who have normal hormone levels may also have excess hair. The sebaceous glands of patients with acne are likely to be hypersensitive to androgens (male-type) hormones.

The effects of acne should not be underestimated. It can persist for years; produce disfigurement and permanent scarring; and have significant psychosocial consequences, including diminished self-esteem, embarrassment, social withdrawal, depression, anxiety and unemployment. The extent and severity of these effects underline the importance of providing adequate therapy, such as the new launched Clarity range by Lamelle which produces more than 80 % improvement in 8 weeks in most cases.

The two main causes of acne are blockage of the pores and bacterial growth. Oil and cells get trapped below the surface of the skin, creating a growth medium for the bacteria. White cells migrate to the site to fight the bacteria, in turn releasing chemicals that lead to swelling, redness and further attraction of white cells (inflammation). The result is a dilated pore, filled with white cells, inflammatory and anti-inflammatory chemicals and bacteria. This is the content of the acne pimple.

Acne can be classified as mild, moderate or severe inflammatory acne and is based on lesion count and whether nodules are present.

• Mild to moderate acne has none or a few nodules present in the skin
• Severe acne has many papules, pustules and nodules present in the skin

This severe acne may be more common in males and this kind of acne should be referred to a Skin Renewal doctor as scarring is inevitable.

At Skin Renewal we offer topical and in office therapies for acne .

Topical therapies: At Skin Renewal we offer traditional topical therapies with Neostrata, Nimue and Dermalogica Medi Bac acne range as well as Antibiotics and prescription medicines if indicated.

Skin Renewal is pleased to introduce an innovative acne range - Clarity ™ by Lamelle- available at all Skin Renewal branches.

The goals of acne treatment are to:

• lessen physical discomfort from inflamed acne lesions,
• improve appearance
• prevent or minimize potential adverse psychological effects,
• minimize any scarring
• treating lesions and preventing new lesions from developing.

Topical treatment – Clarity is indicated for patients with non inflammatory comedones or mild to moderate inflammatory acne. Medications used in topical treatment may act primarily against comedones (comedolytic agents) or inflammatory lesions (antibacterial agents and antibiotics). A principal goal of therapy should be reduction or elimination of the precursor of all acne lesions— microcomedones.

Skin Renewal is pleased to introduce an innovative acne range - Clarity ™ by Lamelle which is available at all Skin Renewal branches. And can be used in all skin types including dark skins.

Most skincare ranges try to manage acne with varying success. The Clarity by Lamelle addresses this problem with the “inside- out” principle that incorporates a topical treatment range together with an oral supplement. The Clarity range incorporates specialized and encapsulated ingredients to synergistically address the four primary factors associated with acne as well as the secondary concerns that include dark marks, scarring , skin dryness and sensitivity.

There are many products on the market for the management of the condition known as acne vulgaris. There are four key primary pathways involved in the development of acne, and most products try to address these 4 factors with varying success.

Clarity by Lamelle introduces an inside-out approach to problematic skin by the synergistic use of both oral therapy- Acnevelle and topical therapy - Clarity ™ for the management of acne.

Aimed at specifically the mild to moderate inflammatory acne patient, the combination approach promises to revolutionize the management of acne at the skin professional level.

• Acnevelle oral therapy changes the rules of the game completely. Regarded as a complementary medicine, Acnevelle has proven efficacy in the management of mild to moderate inflammatory acne vulgaris. Patients taking the capsules showed an 85% improvement in their condition after just 8 weeks of supplementation The synergistic blend of high dose Nicotinamide and Zinc complexed with Picolinic acid make a very powerful anti-inflammatory combination. This supplement MUST be used in conjunction with Clarity to optimize outcomes. Without the concurrent use of the Clarity range of products, efficiency will be less.
• Clarity ™, the topical range has been developed to be user friendly yet as powerful as possible. A few significant product ‘firsts’ really make the range stand out from the crowd.

• The first range that can be used in all skin types without the sensitivity that occurs with traditional and prescription acne products
• The first acne range to make use of encapsulated Salicylic acid.
• The first acne range to use encapsulated Azelaic acid, an agent widely used in acne therapy, but never in cosmeceuticals due to its instability.
• The first acne range to use encapsulated Retinaldehyde, a retinoid similar to prescription vitamin A but with less irritation. It too has been encapsulated for enhanced stability and effect.
• The first acne range to use the powerful Lactoferrin protein which is found in tears and breast milk; Lactoferrin is a powerful anti-inflammatory and anti-bacterial peptide that boosts the body’s immune system to the acne insult.
• The first acne range to use ‘medicinal’ dose of topical nicotinamide to reduce the number of P.Acnes bacteria in the skin.
• The first acne range to address all 4 triggers of acne as well as the three complications; scarring, post inflammatory hyperpigmentation and impaired barrier function.
• The first acne range to include Nobel Prize winning recombinant human growth factors to accelerate healing of the acne lesions.

All in all, Clarity ™ is another innovative first from Lamelle.

Topical Therapy

Active Cleanse used twice a day
Corrective AM Tea tree oil
Corrective PM plus Retinaldehyde
Active control Nicotinamide used twice per day

Oral Therapy:

Acnevelle capsules containing Nicotinamide and Zinc Picolinic acid twice per day

What are the In Office treatments available at Skin Renewal to improve and the post healing acne scarring?

Home therapies: AT Skin Renewal we usually employ a combination approach in order to achieve optimal results for acne .

Treatments available at Skin Renewal to treat acne and improve results in all skin types including dark skins:

• Deep Cleanse Facials are cleansing facials which are prescribed every to remove pustules and comedones so as to facilitate healing of the acne condition with as little damage to the skin as possible
• The Acne Plus Facial treats problematic skin such as acne using a combination of Beta Plus peels ( Salicylic Acid) , Purity Clay mask and a Retinol serum which address the triggers for acne and ongoing oil production
• The Laser Genesis procedure , a 5 in one treatment , reduces the size of the sebaceous gland, reduces inflammation in the papule and nodule , reduces pore size, improves acne scarring and pigmentation-.
• 10 % TCA Peel overlays to the affected areas improves the active acne lesion as well as improving PIH and acne scarring.
• PDT photo dynamic therapy uses red and blue light therapy to improve acne by destroying bacteria and reducing inflammation in the acne lesion
• Carboxytherapy around acne lesions / into acne scars reduces the acne lesion and improves the acne scarring
• Intralesional steroids into acne nodules reduces the acne lesion by decreasing inflammation.

As each patient's case is different we will tailor a treatment program specifically for your circumstances and budget. A highly professional team led by a medical doctor assesses every patient and an appropriate combination treatment together with long term maintenance program is recommended.

Nodular /Severe acne must be seen by a medical doctor at Skin Renewal for further assessment and work up

Treatment for ance in black skin is available in Johannesburg, Sandton, Pretoria and Cape Town at the Rivonia, Parkhurst, Sandton, Fourways, Irene, Cape Quarter, Claremont and Willowbridge branches

Skin Renewal Tip.

Dark skinned patients who are looking to treat acne with peels and lasers or lights would be well advised to consult with a medical doctor with experience in treating skin of colour to prevent unwanted effects such as full thickness burns, permanent scarring and post inflammatory hyperpigmentation. At Skin Renewal hundreds of Patients with dark skin types have been treated. If the above recommendations and treatments are followed virtually any patient can be a candidate for improvement of their acne , acne pigmentation and scarring. Every client is provided with a fully customised solution dependant on the patient’s age, relevant skin problem and skin type , budget and expectations.

Mild acne can be treated with the Clarity range which is available at all Skin Renewal branches. For mild acne a doctors consultation is not necessary and the Clarity range and Acnevelle may be purchased from the skin professionals at all Skin Renewal branches.
If you suffer from moderate to severe acne ( many nodules) a consultation with one of the Skin Renewal doctors is necessary as a customized program and additional prescription medications may need to be prescribed.