1. Why do teenagers get acne? We’ve always thought that it’s because of the puberty hormones, but recently some cosmetologists have been rejecting this theory. What do you think?
Dr Meder: It is impossible to deny the role of the hormone changes in the development of acne. It has been scientifically proven that adolescent acne is caused primarily by hormonal changes. The intensifying of the hormonal syntheses and the increase both in the skin’s sensitivity to androgens and in the amount of dihydrotestosterone in the skin enhance the production of sebum and cause the change in its properties, bringing about inflammatory elements in the skin.
2. This problem used to affect 13–14 year old boys and girls, but now we see them getting acne at 11 or 12. Why do you think that is?
Dr Meder: Accelerated growth is not a myth—modern kids grow up faster and enter puberty sooner.
3. What kinds of acne are there?
Dr Meder: This is a rather comprehensive topic. If we’re still talking about teenagers, modern classification goes as follows: comedonal acne (mild), papulopustular acne (moderate), acne conglobata (severe), acne fulminans (a very severe skin disease affecting the body, often develops in very tall and quickly growing teenagers and causes significant aggravation) and acne mechanica (caused by friction or pressure against the skin).
4. What is a cornerstone of teenage acne treatment? How to cleanse the face properly? What active ingredients should the cleansers contain primarily?
Dr Meder: Cleansing is a very important step in acne therapy. The cleansers should be nonirritating and gentle, but provide a light exfoliation and antiseptic effect on a daily basis. Cleansing gels and foams with small content of acids (salicylic acid being the most effective against acne), herb extracts with antiseptic action (green tea, aloe vera, mallow, citrus, camomile, some types of sea weed, ether tea tree oil, etc) have normalising effect. But most importantly, teenagers should be taught to use the cleansers properly—wash their hands before washing the face, apply the cleanser generously, rub thoroughly, rinse with a large amount of cool water, and also wash their hair, change clothes and bed linen daily.
5. When 11 year olds get acne, their skin is still really thin, and at 15 it’s thicker and more mature, isn’t it? Does this mean that acne treatment should be different at 11 and at 15?
Dr Meder: The basics of acne treatment are always the same, but the therapy can vary—depending on the severity of the skin condition. In any case thorough cleansing, gentle daily exfoliation, moisturising and anti inflammatory protective creams are essential at any age if there’s acne. Recently prebiotic solutions have come to be used to treat acne (e.g. Bioecolia)—in most cases they are in fact rather effective and normalise the skin.
6. How to treat isolated pimples, appearing on the skin? What is the best solution to apply directly on them (when the skin is generally clear, with just a few big spots on the face?)
Dr Meder: First thing that you definitely should not do is trying to get rid of the pimples yourself, squeeze them out or even touch them. Singular inflammatory elements constitute mild acne, so any therapy will be aimed at normalising the skin in general: cleansing, exfoliation and suppressing inflammation. You can apply locally various anti inflammatory solutions designed to disinfect and heal blemishes: from spot removers (Russian cosmetic professionals love Double-Action drying solutions, produced by Holyland, Israel) to mini-patches with anti inflammatory effect that also mask the problem.
7. Can I use facial scrub if I have pimples? If yes, then when should I use it?
Dr Meder: Mechanical facial scrubs are not recommended for acne, they can further spread the inflammatory process. The only exception is double action scrubs with peeling particles (e.g., polyethylene microspheres) designed to enhance the effect of acids or enzymes. The best choices are enzyme (based on papain, bromeline, bacterial enzymes) and acid scrubs (with a small contents of salicylic, glycolic, phytic and some other acids).
8. What do you think of peelings for acne treatment? How effective are they?
Dr Meder: Chemical peelings may be very effective for acne treatment, they are one of the standard methods with proven efficacy. However, you should remember that a professional peeling done by a cosmetologist, is not an ultimate solution to the problem. In fact, chemical peeling implies three stages, two of which are a patient’s responsibility, and only one, the shortest, is carried out by a cosmetic professional. Pre-peeling—the application of acid-based and antiseptic solutions—is a very important stage in the preparation for the procedure and is often recommended in the course of acne treatment. Post peeling is a necessary stage—after a chemical peeling the patient must use the prescribed healing and skin regenerating solutions. Without either of these steps it is very difficult to achieve a lasting result. One ought to bear this in mind when planning to have a peeling and factor it in the budgeting.
9. What mechanical procedures are effective for acne treatment? What about mesotherapy, is it effective against acne?
Dr Meder: I don’t support the use of mesotherapy for acne treatment—for a variety of reasons. As for mechanical procedures, ultrasound facial cleansing, microcurrent therapy and galvanic facials are a beneficial addition to acne treatment. Dermabrasion (including gas-liquid, with Jet-Peel and other similar hardware) and barophoresis (often called non-invasive mesotherapy with the same Jet-Peel, Infusion Viora-like machines, etc) can be recommended. Finally, laser and photo therapy proved to be effective.
10. What would be the three foundations of anti-acne skin care at home?
- Proper and regular skin cleansing.
- Regular gentle exfoliation.
- Daily moisturising and skin protection.
It is essential to maintain proper hygiene, not only when it comes to the skin, but also with the clothes and bed linen, including pillows and duvets (no feather and down!), as well as air purity—the less dust and dirt is around, the easier it is to treat acne. Food does not have a defining role in the development of acne, but starvation diets and diets very low on one of the macro nutrients (fats, proteins or carbohydrates), vitamin and mineral deficiency, consuming a lot of sweets and foods with large amounts of preservatives, dyes, irritants and potential allergens can interfere with treatment and contribute to a relapse.
In other words—stay sensible. Eat fresh fruit and vegetables, meat and fish, do not reject fats too radically. Listen to the advice of your cosmetologist. Reconsider the things you keep in your bedroom, in your bathroom, at home and at work. Be patient. And most importantly—don’t allow acne occupy all of your thoughts and don’t try to give yourself a torturous facial cleansing in front of the mirror.