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8 Acne Blunders: Common Mistakes to Avoid When Working With Acne

By: Mark Lees, PhD
Posted: January 31, 2014, from the February 2014 issue of Skin Inc. magazine.

Acne-prone skin is a condition that affects many professional skin care clients. Yet, both consumers and estheticians are sometimes disappointed with results of treatment. There are some very important factors in acne development and treatment that are frequently forgotten or overlooked. Keeping these in mind can make a big difference in treatment success.

1. Don’t forget that acne is a genetic condition. The basic tendency to develop acne and comedones is genetic. Retention hyperkeratosis causes skin cells to accumulate inside follicles instead of desquamating as normal skin does. This cell buildup mixes with excessive sebum produced by the sebaceous glands. This oiliness factor is also genetic. The blockage caused by this clumping of dead cells and solidified sebum obstructs the follicle, preventing its aeration. Propionibacterium acnes (P. acnes) bacteria, which exist normally in every follicle, are anaerobic, meaning they only survive in the absence of oxygen. These bacteria are normally fairly harmless and, even though they are in every follicle, their numbers are kept low because oxygen penetrating the follicle helps to eradicate them. However, when follicles are impacted, oxygen cannot penetrate to keep bacteria levels in check.

The blunder occurs when clients and estheticians forget that this is a genetic and ongoing battle. Once the skin is clear from the treatment, clients often believe that the condition is cured. They forget that it is chronic and will reoccur, so they stop treatment.

Solution. Constant management of this condition using a mild leave-on keratolytic on a daily basis, such as benzoyl peroxide (BPO) or hydroxy acids, will help clear the skin; however, use of these agents must be continued to battle genetically induced recurrence of cell buildup. Quality and consistent education about the importance of continuous treatment is vital.

2. Treat beyond what you can see. Both estheticians and clients are understandably focused on the current appearance of the skin. They forget that microcomedones, which are not visible to the eye, are constantly forming and reforming inside the lower follicles. For every visible pimple or clogged pore, there are many new microcomedones forming under the skin’s surface. These will eventually become a comedo, papule or pustule. Unless treated, clearance will never be achieved or maintained.

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