Ask The Experts

Pop goes the pimple? No, do a chemical peel

Squeezing a pimple may push the infection deeper, making it worse and causing permanent scarring.
Squeezing a pimple may push the infection deeper, making it worse and causing permanent scarring.PHOTO: ISTOCKPHOTO

Q I am a 15-year-old girl. I have had acne since I was around 12 years old and it does not seem to go away.

When one pimple disappears, at least two more will appear.

I have tried creams, face washes and masks, but none of them seem to work. Can you suggest any other methods to keep acne away?

A Acne may be classified as mild, moderate or severe, depending on the number of comedones (whiteheads and blackheads) and inflammatory lesions on your face.

On top of the severity and extent of the acne, dermatologists would tailor the acne treatment based on the patient’s age and sex, duration of the acne problem and response to previous treatments.

When you are a teenager, it is not unusual to have a pimple or two.

Mild acne usually responds well to topical anti-acne creams such as benzoyl peroxide and salicylic acid. If these over-the-counter creams fail to work, you should see a dermatologist to obtain prescription creams and skincare products.

These usually include an oil-control facial wash, oil-free facial moisturiser, antibiotic cream and a night cream containing retinoids.

Topical retinoids are vitamin A derivatives that unclog pores, reduce oil production, prevent comedones and pimple formation, and speed up cell turnover to improve acne scars and even out skin discoloration.

If you have one or two huge painful pimples, a dermatologist can inject a diluted corticosteroid directly into the painful pimple in a procedure called intralesional corticosteroid injection, also known as steroid shot, or cyst injection.

Within hours to two to three days, the pimple will start to heal and flatten.

If you have break-outs that are not well controlled with creams alone, you would need one of the following oral medications.

Oral antibiotics help to kill bacteria and reduce inflammation of the skin.

Birth control pills regulate the female hormones and would be helpful for women and girls with acne problems.

Isotretinoin is approved to treat moderate and severe acne that may potentially cause severe acne scarring.

It is an oral retinoid that works by reducing the production of sebum (an oily substance produced by the skin) and the production of keratin (outer scales of skin) that blocks the pores of the hair follicle and cause acne.

Other than creams and oral medications, there are procedures to treat acne and improve acne scars.

Chemical peel is performed by applying an acid solution to the skin. The acid solution causes the skin to peel over a period of several days.

As the skin peels, fresh new skin replaces it. This exfoliation reduces comedones, improves pigmentation and superficial scars. However, multiple treatments maybe needed.

There are a variety of lasers used for acne treatments. Some help by decreasing the bacteria that cause acne. Some work by closing the pores and shrinking the oil glands.

Deep acne scars can also be improved by resurfacing lasers or radiofrequency.

And finally, get enough sleep and exercise regularly. In fact, do this regularly before you see a dermatologist.

Research has shown that a low glycemic diet, which limits sugar intake and where the carbohydrates eaten are less likely to cause large increases in blood sugar levels, helps to control and prevent acne.

Try not to pick the pimples or comedones, or squeeze them. You may push the infection deeper, make it worse and cause permanent scarring.

Dr Tan Siew Kiang

Specialist in dermatology and consultant at Raffles Skin & Aesthetics.

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A version of this article appeared in the print edition of The Straits Times on October 11, 2016, with the headline 'Pop goes the pimple? No, do a chemical peel'. Print Edition | Subscribe