acne vulgaris on face

Acne Vulgaris

Early intervention of your acne helps to prevent potential acne scarring.

Discover how we can help to not only treat acne but also maintain a healthier skin.

best acne vulgaris treatment singapore
Inflammatory acne along cheeks and jawline

OUR APPROACH

HOW DR.NG TREATS ACNE

As a clinician with more than 15 years of experience, Dr Ng. understands the impact of how acne can affect an individual. Acne knows no boundaries, afflicting a wide range of age groups and affecting both genders for varying lengths of time. Dr. Ng provides a patient-centric approach that is backed by the latest scientific evidence as well as his own wealth of experience to create a care plan for the best acne treatment that is unique to your skin type. Early intervention can help prevent acne scars, restore your skin and confidence.

How Common Is Acne Vulgaris or Acne?

Acne Vulgaris is the eight most common disease affecting individuals worldwide. Acne vulgaris can affect children and adults although most cases begin during the adolescent period. The clinical presentation can vary in severity and is often linked to psychological distress, embarrassment and low self-esteem. The relentless effects of untreated acne vulgaris can lead to pigmentary (hypopigmentation and hyperpigmentation) changes and permanent (atrophic, hypertrophic and keloid) scarring.

What Causes Acne Vulgaris?

What causes acne vulgaris breakouts can differ from one individual to the next. It may be triggered by stress, food, hormones, and even certain skin care products.

Inflammatory acne vulgaris is one of the most common forms of acne, and often causes significant discomfort. They mainly take the form of red spots (papules) and pus filled spots (pustules). It can occur at many locations including the face, jaw, neck, chest, shoulders and back. It often arises from comedomes (blackheads and whiteheads). Did you know that Whiteheads compared to Blackheads are especially prone to inflammation as the pores are clogged within the skin?

Inflammatory acne can quickly progress to more severe forms of acne such as nodules or Cystic Acne if not treated early. Quite frequently, inflammatory acne vulgaris breakouts can leave behind acne marks, acne pigmentation and acne scars due to the underlying inflammatory process.

Acne vulgaris or acne is more than just unwanted spots on the skin. The impact of acne extends beyond physical burden, it can affect mental health, social interactions and work performance. Additionally, the direct and indirect costs of dealing with chronic acne is always a consideration in your treatment care plan.

what affects sebum production?

sebum production in acne

Sebum production is influenced by various receptors found in the sebaceous gland. Research has shown that the sebaceous gland and sebum production can be activated by hormones, stress and diet. 

  • DHT-receptors: Activated by the androgen hormones.
  • Neuromodulator receptor: Activated by stress. Acne is more common during stressful periods such as before examinations.
  • Leptin receptor: Leptin is released by fat cells, which help to regulate body weight and metabolism of lipids.
  • Insulin-like growth factor (IGF) 1 receptor: Increased sugar intake can increase sebum production.
  • Peroxisome proliferator activator receptor (PPAR): This is activated by free fatty acids and cholesterol.

Why do I get inflammatory Acne Vulgaris?

Acne vulgaris breakouts are common in both teenagers and adults alike. It can present itself rather quickly and may persists over weeks, months and even years.

Genetics, hormones, diet and stress can be factors that contribute to what causes acne breakouts. In addition, the use of certain cosmetic products, diets and lifestyle habits may make you more prone to acne. Over washing the face worsens the problem as the protective skin oils are stripped away from the skin’s surface.

What Skin Products Should I Use?

A well-balanced, simple and effective skin care regime is a fundamental step at maintaining skin health. The number of skin care products in the market can be overwhelming, but a general guide is as follows:

  • Use a gentle non-alkaline facial cleaner
  • Oil free skin care products
  • Non-comedogenic skin care products
  • Power based foundation (to soak up excess oil)
  • Sunscreen that contains Zinc oxide and Titanium dioxide to lessen risk of skin irritation.
  • Remove make up at the end of the day

Using products that are not oil-free, comedogenic, and applying thicker formulation skin care products can clog pores. These products may be what causes acne breakouts in the first place.

A healthy skincare regime is essential

Should I Pop My Pimple?

Generally, you should refrain from popping or squeezing onto your pimple or acne. This may lead to the rupture of inflammatory contents deeper within the skin. Consequently, this can lead to deep and permanent acne scars. Although atrophic acne scars are the most common, too much skin trauma can lead to hypertrophic and keloid scarring. Therefore, if you find that your acne has not gone away within 2 weeks, please seek professional help.

Role of Diet and Acne Vulgaris

diet and acne
Glycaemic Index of different food groups

In general, a healthy well-balanced diet is recommended.

Although there is some evidence that low-glycaemic index diets may improve acne, a measured and sensible approach must be taken. The glycaemic index groups food on a scale of 0-100 based on how fast and how much they raise the blood glucose after eating. Factors such as amount and type of sugar, amount of soluble fire and cooking processes affects the glycaemic index.

While the number of studies remain small, some food stuff that may be implicated include dairy products (especially skim milk), chocolates and whey products.

Types of Acne Vulgaris

Mild AcneMild Acne

Mild

Acne Vulgaris
Many papules, pustules, comedomes in a limited area
Moderate AcneModerate Acne
Moderate
Acne Vulgairs
Numerous papules, pustules, comedomes affecting more than half of the affected area
cystic acnecystic acne
Severe
Acne Vulgaris
Entire area covered with papules, pustules, comedomes. Acne cysts and nodules may appear.
Colored skin acne anatomy composition with types of acne pimples before and after vector illustrationColored skin acne anatomy composition with types of acne pimples before and after vector illustration

What Are The Treatment Options for Inflammatory Acne Vulgaris?

Topical therapy

The treatment depends on the severity of your acne, your medical history, allergies, skin type and skin sensitivity. Often, combining treatments are more effective at targeting the different processes of acne to give a better outcome.

Prescription topical acne therapy is effective for mild to moderate acne vulgaris. Modern day topical therapy is effective at treating papules, pustules and comedomal lesions of acne. Moreover, many topical acne therapies can also help with pigmentation and scarring caused by acne. Early treatment will lead to better results, while maintenance therapy is needed to prevent relapse.

  • Retinoids e.g. tretinoin, adapalene, trifarotene
  • Benzoyl peroxide
  • Azeliac acid
  • Antibiotics
  • Fixed Combination: Retinoid+Benzoyl peroxide (e.g. Epiduo gel), Antibiotic+Benzoyl Peroxide  (e.g. Clindoxyl gel).

Oral therapy

  • Oral Antibiotics

Antibiotics are a mainstay of treatment for inflammatory acne, and work by reducing bacterial load and inflammation. Antibiotics have proven to be safe and effective in many studies to treat acne. A course of treatment may last about 3 months. First line treatment include Doxycycline, however there is an emerging trend of antibiotic resistant acne worldwide. Consequently, oral antibiotics are often combined with topical therapy to combat resistance and improve acne clearance.

  • Hormonal therapy

Combined oral contraceptive pills and/or oral spironolactone can help reduce inflammatory and comedomal acne lesions. They are helpful for moderate to severe acne vulgaris where long-term management is the goal for adult women.

  • Oral Retinoids

Oral Isotretinoin is a form Vitamin A medications that work extremely well in acne and are currently the most effective treatment for severe acne. It reduces oil secretion by 90% within 6 weeks of treatment, reduces whiteheads and blackheads by 90% within 3 months and has an anti-inflammatory effect.

A consultation is necessary to discuss about the side effects, suitability and precautions before starting oral retinoids.

100% Drug Free Acne Vulgaris Treatments

The hydrodermabrasion Hydra Plus Facial treatment is a non-invasive, multi-step treatment that uses a unique delivery system to cleanse, exfoliate, extract and oxygenate your skin. It performs multiple effect of clearing away impurities, dead skin cells, blackheads and whiteheads; and infusing essential nutrients  to restore your skin back to health.

ADVATx laser is clinically effective to target the inflammatory component of active acne vulgaris and improve the appearance of acne scars simultaneously. The 589nm laser targets inflammation, redness and post-acne erythema, while the 1319nm laser targets the sebaceous gland to reduce oil production and remodels the dermis to resurface acne scars. 

The Carbon Peel Laser is delivered using laser energy to improve pore size and acne vulgaris breakouts. This form of acne treatment is 100% drug free and utilizes laser energy to reduced inflammation, pore size, sebum production and stimulates collagen.

Early intervention of acne vulgaris breakouts will reduce unwanted acne scarring and help you achieve healthier skin. Evidence-based treatment that takes into account your grade of acne, medical history and treatment preference are pivotal at APAX Medical & Aesthetics Clinic. During consulation, Dr Moses Ng, with more than 15 years of clinical experience and having provided quality care to thousands of patients will determine the best acne vulgaris treatment for you.

When can I start to see improvement?

Every individual is different in his or her genetic make up and response to acne treatment. Acne vulgaris treatment is usually slowly responsive in the beginning stages as you are getting used to and incorporating the treatment into your routine. 

On average, you may notice some improvement in your skin condition within 6-8 weeks. Most patients require treatment for at least 4-6 months and maintenance thereafter.

It is important that acne vulgaris breakouts are treated. Appropriate treatments reduce skin scarring, acne marks and pigmentation. Thereafter, maintenance therapy is vital to keep acne at bay and lessen the chance of a breakout.

How can I improve my Acne Scars?

Acne scarring is an unfortunate but common complication of acne. It often results from acne that has been left untreated and resultant damage done to the dermal layer of the skin. Severe forms of acne such as cystic acne have a much higher risk of scarring. 

There are many types of acne scars, and acne scar revision will depend on the type or types of acne scar you have.

Dr. Ng uses various techniques including TCA CROSS, Subcision, INFINI , Genius, Fractional lasers acne scar resurfacing and fillers to improve your acne scars.

Frequently Asked Questions About Acne Vulgaris

Yes, certain lifestyle changes can help manage acne vulgaris, including maintaining good skincare habits (such as gentle cleansing and avoiding harsh products), keeping the skin moisturized, avoiding picking or squeezing pimples, managing stress levels, and following a balanced diet low in refined sugars and high in fruits, vegetables, and whole grains.

In some cases, untreated or poorly managed acne vulgaris can lead to long-term effects such as acne scarring, hyperpigmentation, and psychological distress. However, with proper treatment and management, these risks can be minimized.

No, acne vulgaris is not contagious. It cannot be spread through contact with someone who has acne, and it is not caused by bacteria that are contagious like the common cold or flu viruses.

Yes, severe cases of acne vulgaris, especially if not properly treated, can lead to permanent scarring. This is more likely to occur with deep cysts and nodules, which can cause inflammation and damage to the surrounding skin tissue.

Yes, hormonal changes, such as those that occur during puberty, menstruation, pregnancy, or when starting or stopping birth control pills, can contribute to the development or exacerbation of acne vulgaris. Hormonal fluctuations can increase oil production and lead to clogged pores, making breakouts more likely.

The duration for acne vulgaris to clear up varies greatly depending on factors such as its severity, the effectiveness of treatment, individual skin characteristics, and adherence to treatment regimens. Mild cases may improve within a few weeks to months with proper treatment, while severe cases may take several months or even years to fully resolve. Consistency with treatment and patience are key.

schedule a consultation for acne vulgaris treatment in singapore

We treat a range of acne and acne scars at both our clinics in Woodlands and Kovan. Contact us today to schedule a consultation, so that Dr. Ng can develop a personalized treatment approach for resolving your skin concerns and helping you to achieve long-term improvements in the health and appearance of your skin.

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Get in touch with us with any questions, pricing, or bookings.

Or give us a call at +65 6769 6007 | WhatsApp us +65 9855 3022

Dr Moses Ng dermatologist

acne vulgaris

My immediate concern whenever I see a case of acne vulgaris, whether it is mild or severe, is to assess how it is affecting your health. Acne that is not treated can lead to great emotional distress. This is quite unnecessary in this day and age, where effective acne treatments are readily available.

Related Information:
References:
  1. Jeremy AH, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol. 2003 Jul. 121(1):20-7.
  2. Barnes LE, Levender MM, Fleischer AB Jr, Feldman SR. Quality of life measures for acne patients. Dermatol Clin. 2012 Apr. 30(2):293-300, ix.
  3. Acne Vulgaris Management: NICE guidelines (2021). Click here.
  4. Oon, H. H., Wong, S. N., Aw, D., Cheong, W. K., Goh, C. L., & Tan, H. H. (2019). Acne Management Guidelines by the Dermatological Society of Singapore. The Journal of clinical and aesthetic dermatology12(7), 34–50.
  5. Dréno B. What is new in the pathophysiology of acne, an overview. Journal of the European Academy of Dermatology and Venereology. 2017 Sep;31:8-12.