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Acne Vulgaris

What a name... just this term conjures up such negative connotations or traumatic memories. Usually this condition affects those at their most vulnerable times, teenagers, mid life, perimenopause and does nothing for self esteem. So many skin treatments and over the counter products don't seem to work. At Tonic Medical, with a holistic assessment of the patient, a tailored skin care regimen can be formulated. With consistency and support, great improvements in skin appearance can commonly be achieved.


To understand what treatments work in acne management, it is first best to have an understanding of what the reasons are behind why acne occurs.

Skin is a wonderful organ. If we take a cross section through our skin it can be diagrammatically represented as below.


The pilosebaceous unit is where it all goes a bit wrong in acne. This is made up of the hair follicle and it's grease gland. Under the influence of factors including hormonal changes, the sebaceous gland can enlarge and become over active. This leads to swelling of the follicle and increased pore size. These pores can become plugged and inflammed and sometimes bacteria can get in worsening the inflammatory process. Acne is a combination of open and closed comedones - medical terms for blackheads and white heads. In more severe cases deep inflammation can occur producing tender cystic nodules. It is these lesions that can lead to scarring.


When treating acne successfully reasons for the development of acne need to be explored. It is important to think about lifestyle and diet as there is some evidence showing high dairy and refined sugar diets exacerbate skins prone to acne.


Good topical treatments exfoliate and cleanse pores, gentle removing debris that may block the hair follicle. Products containing salicylic acid, are particularly good at this. Salicylic acid is a Beta Hydroxy Acid (BHA). It works by removing dead skin debris and dissolving keratin plugs. It also calms the sebaceous glands oil production subsequently shrinking the size of congested pores. It is naturally found in willow bark and some vegetables. When used as part of an acne treatment regimen it can prep the skin for additional treatments including benzoyl peroxide and topical retinoids.



Benzoyl peroxide can be used alongside salicylic acid to kill bacteria on the skin and within hair follicle, it also decreases oil production and has an anti inflammatory action. These skin treatments form the back bone of a skin care regimen for patients with acne. Additional treatments can be added in dependent on the severity of acne.


Obagi offer the CLENZIderm system which includes three great products with good evidence base for benefits behind them.


When this system is utilised alongside potential additional treatments great results can be seen. Commitment and consistency will produce the desired outcome.




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