Help! Acne is affecting my studies

Dear Dr Arusha Campbell-Chambers,

I am an 18-year-old girl who has been suffering from acne for two years. Earlier, my acne marks used to go away with some creams like Avene Clean-ac, etc. But now my acne has increased and the marks aren't going away. Day by day, the marks get darker. Please suggest any treatment for acne, medicines or creams. This problem is really becoming a trigger of my stress and I am not able to concentrate on studies. Please help me get rid of my acne.

Thank you.

Regards, S.I.

Dear S.I.,

Acne is a very common problem in your age group. It seems that, like many others, you have tried several over-the-counter (OTC) products which no longer help. The good news is that there are prescription-strength medications, both topical and oral, if necessary, to help you achieve better control of your acne and help fade dark spots.

Mild acne can be treated with over-the-counter products containing ingredients like benzoyl peroxide (2.5-5 per cent), sulfur and/or salicylic acid (0.5-2 per cent). It is best to choose gentle cleansers when using acne treatments. If tolerated, exfoliating (deep cleaning) cleansers and toners/astringents can be used.

Regular bathing soaps and blue 'cake' soaps are not recommended. Scrubs should ideally not be used more than once weekly. Oil-free (non-comedogenic) sunscreens should be used since acne treatments can make the skin more sensitive to the sun and since the sun can make dark spots darker. Oil-free moisturisers may be needed to counteract the dryness resulting from acne treatment. You should also avoid aggressive scrubbing, picking or squeezing the skin. Squeezing acne lesions can often cause them to go deeper, potentially causing dark spots and scarring.

If acne is not improving using only OTC medication, your dermatologist can prescribe medication suitable for you. These include topical retinoids (vitamin A derivatives), benzoyl peroxide and topical antibiotics. Some oral acne medications may be prescribed, if necessary. We always weigh pros and cons of treatment based on the individual. Acne treatment may take at least four to eight weeks to give good results.

Most teens outgrow acne in their 20s. Until then, there is no permanent cure, so maintenance treatment is required to keep acne controlled. Optional procedures include professional comedone extractions, chemical peels, microdermabrasion, injectable steroids (into deeper lumps), light therapy and lasers.

Dark spots can be treated using a medicated mixture of hydroquinone mixed with other ingredients prescribed by your dermatologist. There are other products which are used to treat dark spots but some may be irritating and most are not as effective as hydroquinone. The active ingredients in these include kojic acid, azelaic acid, soy, arbutin and licorice. Very strong topical steroids found in many 'black-market' bleaching creams should be avoided. Procedures such as microdermabrasion and chemical peels can also help treat dark spots.

Try not to let it stress you out and affect your studies. You can regain control of your skin's condition and you are stronger than you think!

Dr Arusha Campbell-Chambers is a dermatologist and founder of Dermatology Solutions Skin Clinics & Medi-Spas; email: yourhealth@gleanerjm.com