Many new patients schedule
themselves initially for “cleaning” at our clinic. However, it seems that when they schedule
themselves for cleaning, different patients have different procedures in mind.
Acne used to be a teenage
disease. But in this day and age of
chemical and steroid laden meat and poultry products in our diet, dietary fads
advocating the intake of multiple oral health supplements, suffocating pollution
in the air, abundance of pore-clogging cosmetic products and high levels of stress
in our daily grind, acne in adults has been increasing in incidence.
To simplify, I grade acne in my
patients as mild, moderate or severe.
In its simplest form, mild acne
begins with a plug. Under hormonal
influences, when our skin pore gets clogged with dirt or make-up, excess oil in
our skin, dead skin cells and bacteria join forces to produce a comedone, more
popularly known as a blackhead or whitehead.
A patient easily sees open comedones or blackheads due to the dark color
of the oxidized plug specially on the nose. On the other hand, a closed comedone or
whitehead is most often perceived as little bumps on the skin.
Patients often seek treatment when these
comedones become unsightly or feel itchy.
If a blackhead or whitehead is
not removed, an inflammatory reaction develops wherein there is an involvement
of the deeper layer of skin, rather than just the opening of the pore. Moderate acne now becomes red and swollen. Bacteria produce pus in some inflamed lesions.
Unfortunately, untreated patients
may progress to severe acne wherein some lesions evolve into cystic acne as
these develop thickened walls, while others have nodular acne that can be
palpated as deep, hard bumps that stay on in the skin for several weeks or
more. Nodulo-cystic acne can be painful
and is notoriously known to cause permanent scarring.
“Cleaning” is actually the layman’s term for
what we scientifically refer to as acne surgery. A small incision is made using a fine needle
or blade and the contents of the acne lesion are extracted with a sterile
extractor. Once a pore is cleared of a
plug or the purulent discharge of a pimple is expressed, the skin definitely heals
faster. Cleaning can be performed as a stand-alone procedure or may be
incorporated as an important part of facials or diamond peels.
A deep cleansing facial treatment is a procedure
involving gentle facial massage strokes with application of a cleansing cream, scrub,
gel and solution. This is ideal for cleansing of the outermost layer of skin
for those who use make-up or are exposed to much dust or the elements. Steaming the face opens the pores and
facilitates extraction of comedones after facial massage which enhances blood
circulation. After cleaning, a facial
mask is applied to soothe the inflamed skin.
Various masks are infused with necessary ingredients such as anti-acne
treatments, collagen, vitamin C or whitening actives.
A diamond peel is a machine
treatment wherein an abrasive wand with vacuum is used to microdermabrade the
upper layer of skin. Controlled exfoliation of the damaged upper layers of skin
is achieved, superficial pigments and fine lines are sloughed off, and
comedones or pustular acne are unroofed.
This makes extraction of comedones definitely easier and cleaning seems
to be less painful. This procedure has
the added benefit of modifying acne scars.
A cold hammer is then applied to soothe the skin at the end of the
treatment.
Whether one goes just for
cleaning, or has a facial done or undergoes a diamond peel, I always remind my
patients that all these are just adjunctive treatments for acne and can be
performed every month, more frequently if necessary. Medical treatment must still be given to
achieve clear, acne-free skin.
