Acne can be an incredibly distressing experience that many of you may have already encountered. Some people describe it as a rite of passage—an inevitable journey during puberty that naturally resolves as we mature.
But what happens when acne persists?
For some individuals, acne lingers longer than expected, continuing well into adulthood. Research conducted in Singapore found that 41% of adults seeking treatment at the National Skin Centre had experienced acne since their adolescent years, with the majority suffering from adult-onset acne.
Don’t worry!
Thanks to technological advancements, modern medicine offers numerous solutions for various acne conditions. I’ll guide you through essential information about acne removal treatments, including medication types, in-clinic procedures, costs, and much more.
Understanding acne and available removal treatments can provide valuable insights on managing even the most severe outbreaks effectively.
What is acne?
Acne is a chronic or long-term skin condition affecting the hair follicle and sebaceous gland, both components of the pilosebaceous units in the skin.
The sebaceous gland naturally opens into a hair follicle to release sebum—a complex mixture of oils that protects the skin from dehydration, bacteria, and performs other important functions.
Read more: FAQS About Acne Scar Treatments In Singapore
Acne develops when hair follicles become clogged with oil and dead skin cells. They appear on the skin as comedones or inflamed, red, irritated bumps with or without visible pus.
What are the common types of acne?
Acne conditions can be divided into two broad categories:
- Non-inflammatory acne
- Inflammatory acne
Non-inflammatory acne
- Closed Comedones — usually <0.5mm and skin-colored bumps.
- Open Comedones — <0.5mm, skin-colored bumps with a black pore opening
Inflammatory acne
Inflammatory acne occurs when bacteria C Acnes infect the comedones, resulting in inflammation, redness, and swelling.
Inflammatory acne can be further classified into 4 other groups based on their appearance and diameter:
Papules
These are between 0.5mm to 0.5cm red, swollen, firm bumps which may be tender.
Pustules
These are between 0.5mm to 0.5cm red, swollen, and tender bumps with a white or yellow pus tip, pointing and ready to burst.
Nodules
These are over 0.5 cm red, firm, and tender bumps.
Cysts
These are over 0.5 cm bumps filled with pus ready to discharge, red and painful. They occur when blockage and inflammation develop deep in the hair follicle.
Common sites of acne are the face, forehead, chin, chest, upper back, and shoulders as these areas have the most oil glands.
Read more: 5 Easy Ways to Get Rid of Hormonal Acne Scars
What causes acne?
Acne is caused by a series of issues that affect the pilosebaceous units in the skin. The direct factors impacting acne formation include a list of physiological events in the skin, namely:
Main causes of acne
- Excessive sebum production — Sebaceous glands produce too much sebum or oil compounds which accumulate at the hair follicles.
- Improper exfoliation — The dead cells of the hair follicles do not exfoliate properly due to inadequate vitamin A in the follicles, thus plugging them with dead cells, sebum, and other debris.
- Bacterial growth — A rise in C. Acnes bacterial activity within the clogged follicles, potentially leading to inflammation in the form of acne outbreaks.
Looking deeper, there are some underlying factors within your own body that could be the root cause or exacerbate your acne outbreaks.
Underlying factors contributing to acne
- Genetics — If one or both parents have had acne conditions, then it increases the likelihood of their children having acne.
- Pubertal years — Acne occurs mostly between 12 and 30 years old. In fact, 80-85% of people with acne fall into this age group, where there is an increase in androgens, or male hormones, in the body.
- Hormonal changes in midlife — Hormonal changes can result in acne especially in women when the balance between the estrogens and androgens is disrupted.
- Stress — Stress can aggravate acne as well due to the resultant hormonal imbalances.
- Medications — Certain antidepressants, steroids, and lithium may worsen your acne conditions.
- Medical conditions — Some medical conditions may result in an overproduction of androgens such as polycystic ovarian disease syndrome (PCOS).
How is acne diagnosed?
As with any medical condition, a diagnosis involves a physical examination of the exhibited symptoms and taking note of the patient’s medical history.
The physical examination for an acne diagnosis will cover the areas of the body which contain the most oil glands such as the face, jawline, shoulder, neck, chest, and back.
The doctor will take note of the different types of lesions or acne formations which can possibly be a combination of comedones, papules, and pustules.
How is acne treated?
Acne treatment is administered based on the severity and types of lesions observed during the examination.
General treatment options for acne include topical and oral medication. An exhaustive list of the possible treatment options are as follows:
Treatments that can be administered at home
- Topical medication — Such as acne creams, gels, lotions, and washes. However, proper application of medication should be advised or they may irritate the skin and aggravate the condition further.
- Oral medication — Such as oral supplements, antibiotics, contraceptives or isotretinoin
Treatments that are administered in-clinic
- Acne Removal energy devices — Such as Acne Clear Laser treatment, Intense Pulsed Light (IPL) treatment, Light-emitting diode (LED) treatment and fractional radiofrequency treatment
- Therapy treatments — Ultrasonic extraction, Plasma treatment, Acne hydra peel, Chemical peels
Depending on the severity of acne, different treatments can be recommended. Usually, a combination of treatments can result in a synergistic effect and faster control of the condition.
The most effective treatment approach will target the main causes of acne by reducing sebum overproduction, normalizing the hyperkeratinization of the cells to improve skin exfoliation, reduce bacterial growth on the skin and hair follicles and prevent inflammation.
We can work to resolve the acne condition, minimize scarring as the acne heals, manage skin globally to prevent new acne from developing, and prevent future scarring.
What do I do for acne removal if over the counter creams do not work?
Generally, counter creams would work if your acne is mild. Mild acne means that there are less than 5 small acne bumps and should resolve quickly within the week without scarring.
Mild acne usually occurs only once in a few months.
Aside from that, anyone who has acne cyclically or persistently requires medical help.
For instance, premenstrual acne would be most effectively treated by oral contraceptives to overcome the heightened androgen levels.
If your acne condition consists of a combination of papules and pustules, oral antibiotics and topical treatments should be sufficient for acne removal.
Beyond that, if the above treatments prove ineffective, you may need to progress to in-clinic options which could involve laser treatments, extractions, chemical peels, and oral isotretinoin.
What are the complications of untreated acne?
Untreated acne can lead to a range of different problems that can have a lasting effect on the patient.
- Scarring — Untreated acne can lead to scars that are potentially permanent such as ice pick scars, box scars, rolling scars, or atrophic scars.
- Blemishes — There could also be darkened spots due to hyperpigmentation or post-inflammatory redness that can take a long time to fade
- Psychological issues — With these long-term changes to your appearance, it may result in reduced self-confidence and self-esteem. In some cases, people may deal with depression with the potential impact it has on their social life.
Acne removal treatment is recommended if you have:
- cyclical acne
- continually-active acne
- aggravated acne
Depending on how large the scars are, the continual production of acne will possibly result in large or small scarring.
Even though effective treatments for acne scars are available, if the scars are too deep, the complexion cannot revert completely to the pre-acne smoothness, scarless and poreless condition. Acne scar treatments also tend to be more costly.
It is advised to seek professional medical advice if your acne condition seems to be persistent despite self-administered treatment, to prevent permanent damage to your skin.
What are the specific topical prescription medications for acne removal?
Topical medication such as salicylic acid, lactic acid, and glycolic acid can improve the exfoliation of dead cells so that the sebaceous glands are not clogged up. Their drying properties help to reduce oil production as well.
Benzoyl peroxide has antibacterial properties which can be combined with topical antibiotics to reduce the antibiotic resistance effect.
Topical medication also includes Retinoids, Tretinoin, Differin and Epiduo which can come in different strengths and mediums such as gel, lotion, or creams.
They reduce the overproduction of dead cells and prevent the clogging of the hair follicles. This leads to a reduction in comedone formation.
These topical medications are applied over the active acne areas and other acne-prone areas of the skin. With regular use in low doses, they can reduce fine lines and improve the texture of the skin too.
Topical antibiotics such as Erythromycin and Clindamycin work to reduce bacterial growth on the face to prevent any inflammation of comedones.
There are also new supplement formulations available from doctors’ clinics that include combinations with vitamin B3, zinc, green tea (epigallocatechin) antioxidants, triethyl citrate, ethyl lanolate, GT peptide, and honokiol.
These have a combined effect in:
- reducing sebum production
- normalizing keratinization of the skin
- conferring anti-microbial properties
- helping with inflammation symptoms and improving the skin healing process.
What are some side effects of using medication for acne removal?
Some topical medications such as acid-based products like alpha hydroxy acid (AHA), beta hydroxy acid (BHA), tretinoin, and salicylic acid have a drying effect and can cause irritation if they are not used properly.
This is especially so for people with sensitive skin which can result in redness and irritation after usage.
Topical antibiotics, if overused beyond 6 months, may lead to antibiotic-resistant bacteria which make using further antibiotic treatments ineffective in dealing with acne.
Oral antibiotics may cause stomach upset with prolonged use, which can also cause antibiotic resistance.
In rare cases, using oral contraceptives may result in weight gain or depression.
Oral isotretinoin is unsuitable for females who are trying to or already are pregnant as it may affect the health of the fetus.
Cholesterol levels may also be increased but the occurrence can be detected during the doctor’s pre-treatment examination to check your cholesterol levels in the first month.
Across the board, depending on the type of medication and patient’s physiology, side effects of medication for acne removal may manifest in the form of:
- skin irritation
- redness
- peeling
- itching
- stinging
The best way to avoid this is to partner with your medical professional to ensure optimal results and minimize the side effects.
What are the common acne surgical procedures?
Acne surgery is the use of various surgical procedures for the adjuvant treatment of active acne and post-acne scarring.
Common clinical treatments for acne removal
1. Acne laser treatment
Laser light energy has indeed been shown to be effective in the treatment of acne. It can reduce inflammatory lesions, resolve the acne quickly, reduce bacterial activity, control oil balance by reducing sebaceous gland activity, improve exfoliation and, decrease blemishes and potential scarring.
2. Fractional radiofrequency (RF) treatment
Fractional RF devices are able to transmit thermal energy deep within the skin to help reduce inflamed acne lesions and improve acne scars as well. It is effective and safe to treat acne scars.
3. Chemical peels
Chemical solutions containing salicylic acid or glycolic acid are applied to the face much like a face mask. The procedure is able to unclog the hair follicles, reduce inflammation and improve pores and blemishes.
The more superficial scars can also be improved.
4. Steroid injections
For cysts and nodules, steroid injections can be administered to reduce the swelling and inflammation. Ultimately, it can help to resolve the lesion quickly.
5. Acne hydrapeels
A specialized facial treatment applied to the surface of the skin to help exfoliate it, reduce comedone formations, and cleanse pores deeply to remove dirt, sebum and dead cells.
6. Acne extraction
Done manually or with the help of an ultrasonic medical instrument, comedones can be cleared of sebum accumulation.
7. Plasma acne treatment
It helps to reduce inflammation and redness of more serious lesions to hasten their healing and resolve the condition.
8. Rejuran injections
The next stage of acne removal treatment when your skin has achieved acne control is the repair and restoration of skin texture and smoothness.
Rejuran is a special combination of salmon extract and polynucleotides which can be injected when the larger acne areas have improved. It has powerful anti-inflammatory and regenerative properties.
Rejuran takes your global skin improvement to the next level. This injection can help to:
- Further improve the acne condition
- Reduce post-inflammatory redness, hyperpigmentation, and discoloration
- Reduce enlarged pores
- Reduce acne scars
- Achieve smoothness in the skin
- Improve skin elasticity
- Improve oil control
- Enhance skin hydration
- Restore original complexion
What are possible side effects to in-clinic acne removal treatments?
After most of the treatments including laser procedures, there might be a temporary redness in the skin which should subside quickly.
Acne extraction procedures should not have any side effects if done by an experienced therapist.
Generally, most in-clinic acne removal treatments are non-invasive and have no downtime which means you can undergo a procedure and meet your friends for a lunch date right after!
What is an acne removal procedure like?
Most of the in-clinic acne removal treatments are comfortable, safe, effective, and have minimal to no downtime. The doctors and staff are experienced, skilled, patient, and attentive, to ensure the patient experience is smooth and pleasant.
Laser treatments
For laser treatments, your face would first be cleansed and then you would wear protective eyewear. The process would take about 10 to 15 minutes. After the laser treatment, we will proceed with ultrasonic and plasma acne treatment to clear your acne.
Fractional radiofrequency treatment
Fractional radiofrequency treatment would first involve a numbing cream that is applied for 20 minutes. After cleansing of the numbing cream, the procedure will be administered by the doctor.
This procedure might result in a slight downtime of 1 to 2 days where there may be slight redness in the skin. You would be advised on post-treatment skincare and to avoid direct exposure to the sun for a week.
Chemical peels
Chemical peel procedures similarly involve the follow steps:
- Facial cleansing
- The chemical solution is applied to the face for the main part of the treatment.
- A neutralizing agent is used to remove the chemical peel afterward.
This procedure may result in temporary redness of the skin for 3 to 4 days and possibly dryness and skin peeling for 4 to 5 days. Within a week, all these post-treatment symptoms should subside.
After most acne removal procedures, you would also be prescribed some skincare products and sunblock for self-application. You may also receive healing and calming cream to help reduce the redness that comes after treatment.
Rejuran injection
Rejuran injection will be the next stage of their treatment. It involves the following steps:
- Application of numbing cream for 30 minutes
- Cleansing of face to remove the numbing cream
- Injection of Rejuran for skin healing and repair.
How much does acne removal cost in Singapore?
Depending on the type of acne removal treatment, the cost to pay will vary. Most in-clinic acne removal treatments will certainly be more expensive than prescribed medication or self-administered treatments.
Do note that these prices may vary between clinics and health retail stores.
| Treatment | Cost |
|---|---|
| Most topical medication | $40-$80 per bottle |
| Oral medication | more than $60 a month |
| Oral contraceptives | $35 a month |
| Isotretinoin | $180 a month |
| Manual acne extraction | $60 per session |
| Laser treatments for acne removal | $180 per session |
Generally, acne removal procedures would range between $150 to $500 per session depending on the treatment. Usually, there should be a number of regular sessions performed over intervals ranging from bimonthly to monthly.
It would be performed until improvements to the acne condition are sustained, then a modified maintenance regime can be adopted.
Are acne removal procedures Medisave claimable?
Unfortunately, they are not Medisave claimable.
How can I manage acne after an acne removal procedure?
Maintenance of the health of your skin is essential. It all comes down to paying attention to your skin and taking good care of it.
This means adopting a suitable skincare routine. Ensure that you hydrate your skin with water-based products and continue the usage of homecare topicals, especially with the appropriate application of anti-acne skincare on vulnerable areas of the face.
On top of that, you can make use of products that help to control sebum oil on your skin and also avoid excessive exposure to sunlight.
For some acne conditions, it is important to keep to the regular monthly laser treatment appointments to prevent further acne outbreaks and regular anti-acne medi-facials to help keep the skin clean and clear.
What are some home remedies for acne removal?
There are some home remedies available that may help to deal with mild acne problems.
- Tea tree oil — It has anti-inflammatory and anti-microbial properties to curb some acne causes
- Green tea extract — It also has anti-inflammatory and anti-microbial properties. Additionally, it contains antioxidants as well.
- Witch hazel — It has anti-inflammatory properties and can treat acne effectively.
- Aloe vera — It also has anti-bacterial properties that make it effective for topical use to treat acne.
However, do remember that these are only home remedies and may work for those who have the occasional and sporadic one or two pimples but may not be sufficient for more serious cases of acne.
Summary
Acne can be frustrating to deal with but with the proper acne removal treatments and medical advice, you can resolve the problem. Try not to squeeze pimples. With a proper skincare routine and help from a trusted aesthetic doctor, your acne will be managed in no time!