What Is Pimple ?
Pimples has been a major problem of youngsters for ages. It appears as multiple reddish spots on the face and can hamper ones beauty significantly. In medical terms it is called Acne Vulgaris.
What causes Pimples ?
There are multiple oil producing glands in the deep layer of the skin, they are called the sebaceous glands,they produce oily secretions which is transmitted to the surface of the skin via small ducts. Inspissated(dried) sebum along with dead cells and dust, can block the small ducts. Duct blockage causes the oily material to collect inside the glands inducing inflammation and infection. Under these circumstances p.acne bacteria starts multiplying, giving rise to infection and pus formation. So, in acne, multiple red spots appear on the face of the patient. Some of these red spots ultimately turn into pus points. They are quite painful. Although face is most commonly involved, back and upper arms can also be affected.
Is There Any Effective Treatment For Pimples ?
Traditionally acne has been treated by long term oral antibiotics such as tetracycline, minocyline, doxycycline, erythromycin etc. They were prescribed for long courses extending for up to many months. This was usually supplemented by local application of antibiotic ointments or lotions. Strict avoidance of oily food and constipation was also advised. The use of long continued antibiotics does provide remission of the disease. But it soon comes back after the given course of medicine is finished. With the appearance of new pimples patients get distressed. Doctors, therefore felt inclined to restart the long course of antibiotics. Nowadays, the management of pimples has changed. Patients no longer have to take strong antibiotics for months at a stretch. Rather, safer antibiotics like azithromycin are given in short courses of 3 to 5 days with variable intervals in between. Research has shown that diet and bowel habits have no real bearing on the management of acne. The advent of Phototherapy (PT) and specific lasers can practically stop recurrent attacks of acne. Isotretinoin, which is a derivatives of vitamin-A is also very effective in the treatment of resistant acne. But the main draw back of this drug is its teratogenic potential (chances of babies being born with birth defects). Therefore, it can not be prescribed pregnant ladies or in nursing mothers. Specific herbal medicine containing glycyrrhizinic acid and aloe vera used topically gives promising results in most cases.
Phototherapy is another option for acne treatment. Here, a combination of red and blue light is used to treat the affected area. It is delivered by special device containing small lamps oriented at varying angles (to conform to the curvatures of face) Each session of phototherapy lasts for 20 minutes. And the patients requires 8 such sessions at intervals of 3 days. This means that a full course of phototherapy will take 4 weeks time. The treatment is entirely painless and the patient lies down comfortably with his/her eyes protected by special eye wear. What happens with phototherapy is that the bacteria (p.acne) at the depth of the oil glands are effectively killed by this procedure. It has been claimed that phototherapy can permanently stop acne upto 70%.
What Are The Complications Of Acne ?
1. Pastule formation: Sometimes acne spots can progress to small abcesses. They should be treated by incision and drainage under local abaesthesia.
2. Cyst: Pent up secretions in the glands can lead to cyst formation. Cystic acne does not respond to antibiotics or even phototherapy. They require surgical treatment.
3. Pits and Scars: pits and scars can occur in a patient with long standing or recurrent acne. Scarring of the skin ultimately produces pits and depressions on the face which is difficult to treat. Microdermabrasion (MCD) and lasers can help to minimize the scarring produced by acne. But multiple sessions are required and the improvement is gradual. Sometimes Filler Injections ( containing hyaluronic acid in gel form ) is used to correct big craters.Dermabrasion can also be used in selective cases.In dermabrasion a rotatory device is used to abrade the outer layers of skin. It is done under local anaesthesia.A new layer of skin regenerates within the next few days-giving the final appearance much smoother than before. Laser treatment can also help smoothen the surface irregularities. It works by gradual collagen(protien fibres) remodelling at the deeper layers of the skin. But multiple sessions are required to achieve any significant change.More recently dermaroller has been intreduced which provides good results in extensive pits and scars treatment. This procedure is often combined with MCD. Dermaroller is a rolling device studded with multiple fine needles. Using a local anaesthetic gel the device is rolled over the pitted skin in different directions. With few sessions of this treatment the pits and scars are significently reduced.
4. Hyperpigmented spots: This can usually be prevented by avoiding direct sun ray on the acne spots. With the UV radiation of the sun ray the acne areas produce increased amounts of pigments called Melanin.This pigmentation causes darkening of the areas. Regarding treatment, microdermabrasion is a useful procedure. In microdermabrasion the outer most layer of the skin is abraded by a forceful jet of crystals (aluminum oxide). This procedure is entirely painless and threrefore local anaesthesia is not required. Pigment lightening gel or bleaching agent like hydroquinone and kojic acid containing gel is also helpful.
Are these modern treatments of acne available in Bangladesh ?
Yes, all the above mentioned modalities of treatment including Laser, Dermabrasion, Microdermabrasion (MCD), Phototherapy (PT), Filler Injections are now available in Bangladesh.
Treatment of acne is therefore no longer as frustrating as it was before - thanks to the recent developments in medical science.
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