acne derm Archives | Dr Anastasia Therianou

Subcision for scars

drmacli — Fri, 24 Feb 2023 15:47:27 +0000

One of the main reasons for scarring is acne, an inflammatory disorder of the skin which results in clogged pores and produces pimples. Acne doesn’t just cause a problem above the skin but below it, too. During a flare up, the deeper layers of the skin become inflamed, resulting in scarring.

What is subcision? Ηow does subcision work?

In some cases, acne may leave you with “rolling acne” scars; dips in the skin caused by the base of the scar being attached to deeper layers of the skin which pulls it inwards. Subcision is the best form of treatment for this type of scar.

Subcision is a minor in-office surgical technique used to treat acne scars. It involves the insertion of a needle beneath the skin to break up the fibrous bands of tissue that are causing the scarring. This way, it allows your skin to rise and diminish the acne scar.

Although subcision is most often used to treat acne scars, it may also help reduce scars caused by other conditions, like: chicken pox, wounds, surgery, scars or even cellulite.

Dr Anastasia Therianou and her team has extensive experience in the management of acne and acne scars. Recently, Dr Anastasia acted as a principal investigator in a large national study about an acne treatment known as Safa study.

What is the procedure?

Before surgery, you will be given a local anaesthetic. A hypodermic needle is inserted underneath the scar to cut the fibres which are pulling it downwards. Your body will then automatically increase collagen production to heal the wound and lift the skin, with the wound expected to heal in around six to ten weeks.

Immediately after the surgery, icepacks will be placed on the wound to help reduce any swelling, but you should expect a degree of bruising and swelling for a few days afterwards whilst our sterile technique minimises any risk of infection.

How long does it take to see the results from subcision?

The results of subcision can be immediately visible sometimes. Usually, there is quite a lot of swelling from the anaesthetic. This can take a day or two to settle. The results are usually seen within 1 to 3 months.

Subcision aftercare

We will discuss all aspects of aftercare with you. Some of the most important aftercare advices are:

For the first 24-48 hours after the procedure, it is normal to feel slightly sore in the treatment areas. Mild swelling usually lasts less than 48 hours, but in some rare cases, swelling may persist for up to a week.

Do not touch the treatment areas, as this may lead to infection.

Regular washing or shower activities may be resumed after 24 hours unless instructed otherwise.

For swelling and soreness, apply a cold, wet cloth to the treatment area in intervals of 10-15 minutes.

Do not wear makeup or other cosmetic products in the treatment areas for 24 hours.

Apply a thin layer of vaseline after showering.

Do not pick scabs that develop in the treatment area.

Is subcision treatment the best for acne scar treatment?

Subcision is often recommended alongside other medical treatments to diminish acne scarring. These treatments may include:

Dermapen Microneedling. It is a completely natural treatment that has both anti-ageing and restoration effects, and is used to significantly improve atrophic scars following acne, injuries, chicken pox scars or enlarged pores.

Dermabrasion. This procedure uses a wire brush or a diamond wheel with rough edges to remove and level the uppermost layer of skin.

Laser treatment. This treatment involves using lasers to remove your uppermost layer of skin and heal scarring.

How many sessions are needed?

One or two sessions should be needed, depending on the severity of the scarring.

What is the cost?

Between £200 and £700

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Benzoyl peroxide for acne treatment

drmacli — Wed, 01 Feb 2023 11:36:05 +0000

A big skin myth that is not spoken about enough, is that acne is often thought of as a skin condition mainly reserved for teenagers. This is, in fact, not true, acne can occur at any age. In fact, one recent study found some degree of facial acne in 54% of women and 40% of men older than 25 years.

So, if you’re struggling, you’re not alone, but that doesn’t mean you shouldn’t seek treatment.

What is acne?

Acne occurs when the sebaceous (oil) glands begin to overwork. The purpose of these glands is to secrete sebum to keep your skin moist and protect your skin’s barrier, however, when a raised level of sebum is released, it can begin to clog pores and trap bacteria and dead skin cells that are present, creating – potentially painful – spots.

Treating acne with benzoyl peroxide

The good news is, acne can be treated. Though it can be tempting to try and pop or scratch spots, this should be avoided to prevent any acne scarring or the spreading of bacteria to other parts of your face or body.

One super-effective treatment is benzoyl peroxide, a potent chemical compound that normally comes in the form of a gel or face wash. Though severe acne might need stronger, professional treatment, many people who suffer with mild to moderate acne find that this over-the-counter cure helps to minimise redness.

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How does benzoyl peroxide work?

Benzoyl peroxide works as an antiseptic to reduce the number of germs on the skin. Also it peels away the skin to get rid of dead cells and excessive oil. There are gels that combine benzoyl peroxide with antibiotics or retinoid creams. These come only under prescription.

How to use benzoyl peroxide

The most common products contain 1- 5% of benzoyl peroxide and should be used once or twice a day, or as directed by the medical professional you are working with, and can take up to four months to completely clear acne. Make sure to apply to the entire infected area, rather than simply dabbing on individual spots.

During this time it is best to avoid strong sunlight and use an oil-free sunscreen of SPF30 or above on a day-to-day basis.

Take care to avoid your clothing and hair while applying as the benzoyl peroxide gel or face wash can discolour them, and be aware that initial use can cause skin irritation. If this happens, reduce the amount of gel or wash you are using and let your skin gently build up to a higher concentration. Consult your doctor or the medical professional you are working with if skin irritation persists or worsens.

What types of acne is benzoyl peroxide good for?

Benzoyl peroxide products are usually used to treat mild to moderate acne. More specifically, these products are commonly used to treat the following types of acne:

Blackheads and whiteheads: These can be both apparent in blemish-prone skin. Blackheads look like black dots on your skin and whiteheads look like white dots. They are caused by plugged pores, and benzoyl peroxide can remove oil and dead skin cells that clog your pores, so it helps to clear the skin from back and whiteheads.

Acne pimples (pustules): Pimples are small applies on the surface of the skin, which are inflamed and contain pus at their tips. Benzoyl peroxide works to treat acne pimples by killing the bacteria called P.acnes underneath the skin, as well as helping the pores shed dead skin cells.

Cystic acne: Cystic acne is a severe form of acne that results in large, pus-filled cysts forming underneath the skin’s surface. Over-the-counter products may help mitigate the inflammation and bring it down a bit, but dermatologists typically recommend a combination of oral and topical prescriptions in these cases.

Can you use benzoyl peroxide when pregnant?

The good news is that you can use benzoyl peroxide if you are suffering with acne while pregnant or breastfeeding as it is applied to the skin in small amounts and so shouldn’t cause any complications, even if passed through to the baby.

If you’re breastfeeding just make sure that the baby doesn’t come into direct contact with the gel or face wash and avoid using it down your neck or chest area, or take care to thoroughly wash it off these areas before feeding.

If you’re actively trying for a baby, or hope to in the near future, there are no known effects on fertility caused by use of benzoyl peroxide.

Can benzoyl peroxide work for severe acne?

Though you can try a benzoyl peroxide gel or face wash as a first treatment, more severe acne cases might need further, more intensive, treatment, carried out by a dermatologist. The good news is, there are other options available that Dr Anastasia and her team would be more than happy to discuss with you, you can contact them here.

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How can you fix acne scars with injections?

drmacli — Mon, 13 Dec 2021 15:24:54 +0000

Injections are one of the options for treating scarring, and especially atrophic scars. It is produced by the patient’s own blood cells.

Blood cells have various growth factors and proteins which accelerate healing. These growth factors have the potential to stimulate stem cells to produce collagen, to grow new tissue and improve scars.

During the appointment, a small sample of blood, less than 20ml is taken from the patient. The blood sample is placed in a centrifuge and a specific blood component is extracted. Then, it is injected into the areas that have atrophic scars with a very small needle.

In our clinic this method is usually combined with medical needling (Dermapen) and you can return to your activities straight after the treatment.

Who might be a good candidate?

Individuals with atrophic scars on face. But remember: we never treat scars when acne (spots and pimples) are still present. We first treat the acne and then focus on the treatment of scars.

How many sessions are needed?

We recommend treatments every 4-6 weeks for around 5-6 sessions, but everyone has different needs so we individualize our treatment according to the each patient.

Are there any risks?

It is generally a well-tolerated treatment. Mild pain at the sides of the injections is not uncommon. Also mild swelling, bruising or numbness might occur. A very rare side effect can be getting an infection and we minimise this risk by using a sterile technique.

How long does each session last?

It takes around 45 minutes as we combine it with medical needling (Dermapen) for
better results. We have in our team a great qualified nurse who performs the
treatment.

What is the cost?

The cost is 200 pounds per session.

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Dermapen: Microneedling for treating scars

drmacli — Mon, 13 Dec 2021 14:29:03 +0000

Dermapen is the industry-leading medical needling device, which works as a skin repair treatment to significantly improve atrophic scars following acne, injuries, chicken pox scars or enlarged pores and is an effective acne scar treatment.

What is Micro Needling?

Micro needling or medical needling is a wonderful, completely natural treatment that “helps the skin to help itself”. Micro needling has both anti-ageing and restoration effects.

How does Dermapen work?

Instead of injecting any substances into the skin, Dermapen treatment only involves an advanced automatic needle pen which is equipped with sterile, ultra-fine needles.

Dermapen and medical needling in general, mechanically mimics the effects of fractionated laser technologies by creating microscopically small punctures in the dermis, where our collagen and elastin live.

This mini-injury induces thousands of tiny, controlled wound-healing responses in this deep layer of the skin. Consequently, growth factors are released, and fibroblasts are stimulated into synthesizing new skin matrix such as collagen. In time, this will lead to a better skin surface.

But always remember:

Acne (active spots and pimples) has to be treated before considering any scarring treatment!

Dermapen is an effective treatment for the following concerns

How many sessions are needed?

Usually, we recommend a course of three to six sessions at four-to-eight-week intervals. The procedure is performed by our qualified test after application of an effective numbing cream for pain prevention as it is well tolerated by all of our patients.

Sometimes we combine this technique with injections or subcision based on each patient’s type of scarring and needs.

You also may have heard of needle-rollers for use at home. The high quality, sterile micro-needles that we use in clinic go much deeper. Not surprisingly, they’re much more effective than home rollers in all respects. In fact, home rollers don’t actually reach the collagen containing dermis.

Are there any risks?

It is generally a well-tolerated treatment. Mild pain at the sides of the injections is not uncommon. Also mild swelling, bruising or redness might occur. A very rare side effect can be getting an infection and we minimise this risk by using a sterile technique. In patients with dark skin there is a risk of leaving some darker marks called post inflammatory hyperpigmentation, that is why we always offer a test prior to the actual treatment to be able to check how the skin responds.

Is Dermapen safe for everyone?

Dermapen is not suitable for women who are pregnant or breastfeeding and people who have keloid scarring or are immunocompromised with delayed wound healing.

How long does each session last?

It takes around 30 minutes and when we combine it with injections it takes up to 60 minutes. We have in our team a great qualified nurse who performs the treatment.

How long do the results last?

If Dermapen is used to treat scars or stretch marks, the improvements are permanent. If it is used for rejuvenating, the results last for approximately 12 months.

What actions should I take after my Dermapen treatment?

Use the aftercare products as recommended by our team.

Avoid intense sunshine for 2 weeks after the treatment. During this period you must always use high factor sunscreen (30+) SPF.

Avoid hot water or any other extreme temperature (eg saunas, etc) for 48 hours.

Avoid any unnecessary contact with the treated area for 2 days.

What is the cost ?

The cost for Dermapen is 180 pounds per session.

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Acne: 10 great tips will change your life

drmacli — Mon, 22 Nov 2021 15:00:56 +0000

What is Acne?

Acne is a common skin condition where comedones (blackheads and whiteheads) and pus-filled pimples (pustules) cover various parts of the body (face, upper chest, back, under arms, and/or buttocks).

The face and trunk are the most common affected areas. In the past it was thought that acne appears only in teens and young adults. Nowadays we know that it can also affect older age groups. 1 in 5 women between the ages of 25 and 40 have breakouts.

Acne is a result of sebaceous glands becoming over productive, so they produce more sebum than usual and the pores become clogged with oil and dead skin, creating the unsightly red bumps.

Acne can vary from a few spots on the face to severe, deep spots (cysts) which cause pain and scarring.

For many individuals, mild acne can be treated with topical, over-the-counter products such as creams and gels, and the acne will subside in their mid-20s.

Many more though will need creams under prescription or even tablets to get rid of it. When acne develops in mid-to-late 20s and even 30s, triggers can be lifestyle changes, hormonal changes, stress, and/or pregnancy (in women).

Myths and facts about acne

Genetics

It is true that genetics play a role. Your DNA controls how much keratin your skin produces and how large and productive your sebaceous glands are. This is why acne often runs in families.

Sebaceous glands are also more concentrated in the skin on your face, chest, and back. This is why these are the areas where acne most often appears.

Cosmetics

A popular myth about acne is that makeup causes acne. The truth is, if makeup isn’t properly removed, that can result in acne.

Wearing non-oily cosmetic products, wearing non-comedogenic makeup (makeup which doesn’t clog pores), and always properly cleansing the skin free of make-up help the skin to not have acne.

People with pimples should never put any products which contain any types of oil on their face.

Hygiene

Acne is not caused by dirty skin. Actually, if skin is overly washed or scrubbed too hard, this may fracture the skin, resulting in acne.

Medications

Certain medications may also cause the skin to break out, for example, the use of steroids. Also, hormone replacement therapy for women and steroids that are taken to increase physical performance and build muscle, can also have the same effect on the skin’s oil glands, as can some progesterone based contraceptive medications.

Diet

Consuming certain food like chips or burgers and generally, greasy food may worsen the acne. The small studies that have been conducted to look at the effect of a low-glycemic diet on acne suggest that a low-glycemic diet may be helpful.

This happens because when your blood sugar is high, it causes inflammation everywhere on body, so the skin it is also affected.

More studies though are needed to confirm all these. Moreover dairy products, for instance cow’s milk (whole and low-fat), which is a low – glycemic product, found to be associated with acne only in some patients, so it is important to look at the history of each individual.
There is no evidence that cheese or yogurt can worsen the spots.

Stress

Stress does not cause acne, but if you have acne already, stress may make it worse. There is anecdotal and observational evidence (meaning that it has not yet been confirmed in rigorous scientific studies) that suggests that stress can influence an acne outbreak.There is no evidence that cheese or yogurt can worsen the spots.

Friction

Rubbing, caused by tight clothing and repetitive pressure can also cause acne. For example, if you work out and wear a tight bra, this can block hair follicles and create a warm, moist environment for bacteria to multiply in.
This combination of blocked hair follicles and multiplying bacteria can lead to acne forming. This type of acne also called ‘sports acne’, is common amongst athletes due to the repetitive heat, sweat, and friction that their skin is exposed to.

Top tips & treatment

[1]

Over-the-counter products with ingredients such as benzoyl peroxide and salicylic acid can help with acne. Stick to a skincare routine with ingredients and products which are designed to treat acne. Use a cleanser and oil-free moisturizer. Spot treatments can also assist with reducing breakouts. No matter if your skin is oily, you still need to use a moisturiser preferably cream or gel, as it improves the skin barrier which subsequently helps with pimples.

[2]

Always use oil-free products on your face, for instance oil-free foundation.

[3]

Ingredients such as retinoids which can be found in various skincare products can also help diminish the size of pimples and can fade acne scars. Be careful to start from lower percentage and increase slowly the percentage to avoid burning, flaking and redness.

[4]

Life style changes such as quitting smoking, drinking less alcohol, wearing sunscreen, drinking water, showering daily, and properly removing make-up all are essential in making acne go away.

[5]

Never exercise with makeup on. Also, if you have spots on your back, always have a shower straight after your work out or change t-shirt if a shower is not an immediate option. (You are at the park for example). Sweat can block the pores more and worsens the acne.

[6]

Therapies with blue light treatment and chemical peels (glycolic or salicylic acid) can assist with light acne.
At-home peels and chemical exfoliants with AHAs and BHAs are also effective in treating acne. BHAs are more effective for acne while AHAs have a more anti ageing effect. Avoid physical exfoliators such as scrubs as it is likely to be harsh for your skin.

[7]

Topical antibiotics can also be used to kill the excess bacteria which cause acne (P.Acnes). Antibiotics are also helpful in reducing the redness in the skin and any inflammation. Oral antibiotics are also an option for those with severe acne.

[8]

In certain cases, a steroid injection may be required for deep, cystic acne lesions in order to promote rapid skin healing and to decrease the pain.

[9]

Try not to pick, squeeze, or irritate your acne with your fingernails, or with other tools. Acne should be treated with medication and with the instructions of your doctor. If you pick them, you increase the risk of permanent scar at a later stage.

[10]

If your acne does not improve after the above tips, consult with a qualified dermatologist for a treatment plan which is best for you, your skin type, and needs.

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Why you have adult acne and what to do about it ?

drmacli — Wed, 12 Aug 2020 17:40:03 +0000

Adult acne is common

Acne is the eighth most common skin disease worldwide* and one study found that 85% of females and 15% of males have adult pimples*. You may have had spots since your teenage years, or it may be a new skin problem even if you’re in your 30s, 40s or 50s. This is known as adult-onset-acne. The good news is that if you are an adult pimple sufferer you don’t have to just live with it. First, you need to identify the cause of your adult spots, before seeking appropriate treatment.

Types of adult acne

Mild adult acne usually consists of small pustules, whiteheads, and blackheads. It may also include papules – raised areas of skin or lesions – covering up to three-fourths of the face or body. Symptoms of severe adult spots include swelling, extreme redness, irritation, and deep cysts. Acne is not to be confused with rosacea, which is a different skin condition.

What causes acne?

There are many potential causes of adult pimples. Read on for the factors that trigger this condition:

Hormones

Fluctuating or excessive male or female hormones can lead to adult spots. Hormonal fluctuations are often experienced by women around pregnancy, breastfeeding, perimenopause, and menopause as well as around their periods. Hormone levels can also fluctuate after starting or discontinuing taking birth control pills.

Genetics

If a close blood relative has suffered from adult spots, you may be more genetically predisposed to get it. Research has shown that having a parent, brother, or sister who has (or has had) pimples will make a person more likely to have this problem.

Products

Certain toiletries can trigger adult spots. A protective reaction can lead to inflammation if harsh cleansers or razors are used against dry skin. Check the ingredients of products like sunscreen, moisturizer, hair conditioner, etc. Only use products whose ingredients are described using one of the following terms: “non-comedogenic”, “non-acnegenic”, “oil-free”, or “won’t clog pores”.

Emotional stress

Adult pimples have been found to be connected to high levels of emotional stress. Research has identified a relationship between stress and acne break-outs, as stress causes our bodies to produce more male hormones. Oil glands and hair follicles in the skin are stimulated by male hormones, resulting in acne.

Physical stress

Hormonal changes, weakened immunity and inflammation can all be triggered by physical stress. This can arise from factors including lack of sleep, dehydration, environmental irritants, pollution, and extreme weather. People who have allergies and migraines and those who smoke are more likely to have adult acne.

Medication for acne

If you are taking medication and experiencing spots, it’s important to find out if acne is one of the side effects of what you are taking. If so, your doctor can hopefully prescribe a different medication. If this is not possible, a dermatologist can treat the resulting pimples. Medications that can trigger adult acne include antidepressants, epilepsy treatments, and certain corticosteroids.

A medical condition

Acne can be a sign of an untreated underlying medical condition. It’s important to see your GP to find out if you have a medical condition and get a full diagnosis. If so, once the condition has been treated, the spots may well clear up without further treatment.

Skin hygiene

Excessive oil can clog the pores and a build-up of skin cells can cause blocked hair follicles, resulting in acne. Exfoliation to remove dead skin cells and appropriate skin hygiene are essential for preventing this and removing bacteria that lead to acne development. Use a gentle chemical exfoliant rather than a harsh scrub or other physical exfoliants.

Diet

While there is no consensus on dietary factors, some experts believe that white flour, dairy, nuts, sugar, and fast food may be contributing factors to the problem of adult pimples. It is also believed that chocolate can worsen pimple in some sufferers.

If you have persistent acne that you have been unable to treat effectively, I can help. An expert in dermatological care for hair loss, mole problems, and skin conditions, I can provide you with advice via online video consultation and offer face-to-face consultations when necessary. Contact me, Dr. Anastasia Therianou on 0203 464 4884.

* Source: PubMed Central.

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