6 minute read
The Pain That Is Acne By Nancy Abdou
Whether it be due to excess sebum, stress, medication, diet or hormones, acne is a pain! A pain to manage and to treat, not just for the client, but also for the therapist. I would have to say it is one of the most challenging skin conditions to manage because it requires a holistic approach that also heavily involves client commitment and long-term perseverance to having treatments in clinic as well as doing the right thing outside of the clinic too.
Acne affects more than 85% of Australians at some stage throughout their life, with increased flare-ups and inflammation seen during the last 2 years. Possibly because of the increase in stress levels and or mask wearing, either way the problem is real and so many therapists’ want to know the best way to manage acne and the scars left, with the various aesthetic devices on the market. As I mentioned, a holistic approach is required: diet and supplements (very good idea to collaborate with a gut-health professional, or at least be aware of what your clients should look out for in their diet... something that will be covered in my upcoming Acne Workshop).
High quality and active skincare is a great way to help manage acne - clean, nourish, hydrate, and protect. By using topicals that will deeply cleanse and exfoliate the skin without irritating it, (such as the Skindividual Phyto-Active Multi-action exfoliant), other active can be better absorbed and penetrate where required, in the dermis. There are so many active ingredients and topicals to help with managing acne, but one of the most important ones, apart from a good hydrator and Sun protection, is an excellent liposomally encapsulated Retinaldehyde (Vitamin A). Retinaldehyde will not only regulate the production of sebum, but will also increase cellular turnover, repair damaged DNA, strengthen capillaries and allow the skin to synthesise collagen to help with remodeling and stimulating the production of collagen - especially when used prior to any aesthetic treatment, and the good news is - it doesn’t cause photosensitivity! I’m going to focus your attention on aesthetic treatments that you can provide to your clients to help manage their acne and effectively treat both superficial and deep acne scarring: Light Therapy: Blue Light LED is a brilliant for acne, it’s non-thermal and can be used on most skin types safely. Light absorption leads to photoexcitation of porphyrins and the subsequent release of singlet oxygen and reactive free radicals that have bactericidal effects on P. acnes.
Longer wavelengths, such as red LED (633nm) can be used alongside other aesthetic treatments, to help enhance results by increasing adenosine triphosphate (ATP), AKA cellular energy in the mitochondria. By increasing ATP - wound healing increases by 50% and fibroblast production is increased by 155%. Whereas, infra-red brings about anti-inflammatory properties by influencing cytokine release from macrophages, and for post-inflammatory hyperpigmentation (PIH). LED really should be a non-negotiable when performing any aesthetic treatment! On the other hand, laser therapy with 1064 Nd:YAG with the application of a carbon lotion (also known as the China Doll or Carbon Facial), infrared (IR) lasers (1320, 1450, 1540 nm) and PDT may directly cause photo-toxic and photo-thermal damage to sebaceous glands, which can reduce the gland size and production of sebum. Laser Genesis (long-pulsed lasers) is an excellent option for acne scars, as it will help promote collagen production and remodeling of scar tissue. If deeper acne scars are present, then laser treatments such as fraxel, CO2 or Erbium YAG may be recommended.
Fraxel is a fractional laser that helps to stimulate the production of collagen and elastin, while Erbium YAG is good for treating deep acne scars. CO2 lasers are ablative lasers that vaporise the upper layers of skin, helping to produce new, healthy tissue - although downtime is extensive. IPL (400–1200 nm), pulsed dye lasers (PDL, 585–595 nm) and potassium titanyl phosphate lasers (KTP, 532 nm) may also, similarly disrupt sebaceous gland function through direct photo-toxic and thermal damage, and/or exert bactericidal effects on P. acnes via induction of reactive free radicals. Hyperpigmentation from scarring can also be observed with these modalities, when used with the correct fluences. Radio Frequency (RF) energy has been used for many years to treat a variety of medical conditions, including acne scars. RF produces heat when applied to tissue, which causes collagen contraction and subsequent remodeling. Taking it one step further is Fractional RF, which uses small micro-needles to create micro-thermal zones in the skin. This allows for deeper heating of the dermis while preserving the epidermis, so down time is minimal, delivering both immediate and longterm results.
Micro-needling is hands down a favourite for many therapists, since it creates nonthermal, mechanical micro-wounds, which sets up a cascade of growth factors derived from platelets, particularly TGFB3, without significant inflammation, producing collagen and elastin. Needling is able to regulate abnormal pigmentation by altering the secretion pattern of melanocyte-stimulating hormone (MSH) and IL-10, which is up regulated at two weeks post-procedurally. MSH appears to be down-regulated two weeks post treatment. A new kid on the block is Plasma Fibroblasting, where the fourth state of matter is utilised to create tiny micro-thermal zones to both stimulate collagen and retexturize and resurface scarring.
Clients can expect about 5 days of down time, but the results are fast and impressive. Take a look at the Plaxpot Plasma Pen Instagram to check out the results! And for those new to aesthetic treatments working their way up to more invasive treatments, Microdermabrasion uses either crystals or a diamond tip, to mechanically exfoliate the skin, helping to remove the dead cells on the surface that can aggravate acne. It will also help stimulate collagen production, giving the skin a healthy glow. And of course, there are chemical and enzyme peels - but that is for another time and another cup of tea.
