Acne Treatment
Acne is the most common dermatological condition and is not limited to adolescent skin as it appears in later years, especially in women. The primary cause of acne is a disorder in the secretion of the sebaceous glands, most often caused by the sensitivity of receptors to androgen hormones. In teenagers, androgen hormones are not stabilized, leading to acne related to the general secretion of excess sebum and oily skin. However, tests may show a normal level of androgen hormones in the blood, but acne is still present. The cause is an oversensitivity of receptors in the sebaceous glands to androgen hormones or their disproportion, thus stimulating excess sebum secretion. This is why acne appears in later years in women and is not limited to oily teenage skin. Of course, there are many other factors that contribute to acne, such as diet, stress, inadequate hygiene, and care.
Ultimately, blocked sebaceous glands, bacterial colonization, and hyperkeratinization collectively create conditions for inflammatory content formation. Acne treatment should be carefully planned, considering that acne is a chronic disease and often leaves post-treatment changes like erythema, pigmentation, and scars, especially in people who were not treated on time or were treated improperly.
Juliette Armand has paid particular attention to acne therapy and home care. Clarifying, Lipocontrol, or Retinoid line? It depends on skin type, acne type, and selected professional treatments.
Acne treatment depends on the severity of the clinical picture, where we classify acne into:
Comedone or blackhead, namely closed or open non-inflammatory comedone as the mildest form.
Papulopustular acne, painful inflammatory red nodules turning into pustules with whitish purulent content, are a moderately severe form.
Conglobate acne, the most severe form, where the inflammatory process affects deeper tissue parts around the follicle, leading to nodules and cysts, resulting in severe scars. Continuing home care is an integral part of planning acne therapy and supplements the results achieved by professional treatments.
Treatment
The natural process of sebum secretion, along with many internal and external factors, make mechanical facial cleansing the first step in preventing the occurrence of severe acne forms. Oily and combination skin, due to increased sebum secretion, needs to be cleaned more often than normal and dry skin. Before a facial cleansing treatment, it is necessary to assess the client’s skin type and condition, and to view facial zones as a projection of the body’s health condition. Indeed, the appearance of comedones and acne in certain areas is sometimes a warning sign of an imbalance in the body, which should definitely be taken into account when planning acne therapy. Classic facial cleansing consists of several steps and lasts about 90 minutes:
- Exfoliation – removes dead cells
- Vaporization – opens pores
- Mechanical extraction
- Toning and disinfection with high frequency
- Application of a soothing mask
- Application of a soothing cream and sun protection factor
If the face does not require mechanical cleaning, or if a pleasant pore-cleansing treatment from excess sebum, toxins, and bacteria is desired, the choice is Aqua Peel from the *Hydrocool platform, a water microdermabrasion where skin pores are rinsed with cleaning, disinfecting, and moisturizing solutions. Juliette Armand Cleanser Wash, Sensitive Cleansing gel, Clarifying gel, AHA Cleanser are available for all skin types.
Seborrheic (oily) skin and enlarged pores, besides more frequent cleaning, are indications for a chemical peel with salicylic or azelaic acid, especially in the case of inflammatory acne when mechanical face cleaning is not preferred.
Chemical peeling is done in several steps:
- Prepare the skin by applying Pro Peel
- Apply the peel and assess its duration
- Neutralize the peel with Post peel to return the skin’s pH to normal
- Finally, apply Calming Bliss and Repair gel to soothe and epithelize the skin, and Sun Film 30+ to protect the skin from the sun
The chemical peel treatment lasts 30 minutes.
For improperly treated acne and inadequate home care, in addition to existing acne, we often see dehydrated and sensitive skin and post-inflammatory pigmentation. Skin Booster Apocalypsis, a phytopeel treatment combined with 20% AHA acids, is an excellent solution for removing skin imperfections and damage.
The treatment is carried out in several steps:
- Apply the phytopeel and massage for a few minutes until the face turns red, after which we leave the face under a vaporizer for another ten minutes.
- After gently removing the phytopeel, apply a 20% AHA acid and leave it for 1 minute. Neutralize the acid, and then apply the extremely pleasant Clarifying mask by Juliette Armand, which will soothe, cool, and disinfect the face.
- Finish the treatment with Sun Film SPF 30+, which contains sunblocks, hyaluronic acid, and antioxidants.
The Apocalypsis treatment lasts about 60 minutes.
In acne treatment, we also use Dr. Platon’s cold plasma. A special device technology and ceramic attachments transform air gases between the device’s tip and the patient’s skin (mainly oxygen and nitrogen) into non-thermal plasma at a temperature of 35-40°C. Cold plasma enhances skin immunity, reduces inflammation, strengthens the barrier function, increases epidermis permeability, increases skin resistance, and has an antiseptic and antibacterial effect.
Cold plasma treatments by Dr. Platon in acne treatment are effective for:
- Combating acne and balancing sebum production
- Soothing skin inflammation and associated spots
- Whitening skin pigmentation caused by acne
- Improving the absorption of active substances by the skin
We often see acne scars after recovering from acne conglobata, and we divide them into atrophic (below skin level) and hypertrophic (above skin level). In addition to chemical peels, microneedling, Plasmage, and CO2 fractional laser are excellent choices for scar treatment. With microneedling, small vertical stabs induce the creation of new collagen, thus regenerating damage, while Plasmage generates plasma, ionized gas that, when in contact with the skin, sublimates the surface tissue, making it ideal for hypertrophic scars.
Of course, the best results for post-inflammatory pigmentation and scars are achieved with a CO2 fractional laser. The CO2 fractional laser is an ablative laser that rejuvenates the skin by remodeling collagen, evens out the complexion, improves texture, removes pigmentation, scars, and other unwanted changes, and strengthens the skin’s tone. The synthesis of new collagen and improvement of the skin’s appearance continues up to 6 months after treatment.
Before the mentioned treatments, we apply anesthetic cream to make the treatment more comfortable. Microneedling facial treatment lasts 45 minutes and is often combined with a mesotherapy cocktail for better effectiveness. The treatment is completed with Calming Bliss and Repair gel and a protective factor. The Plasmage treatment lasts from 10-30 minutes depending on the number of scars and is targeted at scars. The treatment is completed by applying a protective factor. Before the CO2 fractional laser treatment, we apply anesthetic cream, and during the performance of the treatment, we additionally cool the skin with cold air at -25 degrees, making the treatment more pleasant and the skin redness less pronounced. Depending on the appearance and condition of the skin, the number of treatments is defined. Sometimes just one treatment gives excellent results. The treatment can be repeated after 30-45 days.
Candidates
Facial cleansing treatment is intended for everyone and all age groups, starting from the teenage years, whether it’s about mechanical or Aqua peel cleaning. The oilier the skin or the more it’s exposed to pollution, the more frequently cleaning is carried out. For teenagers with oily skin and acne, cleaning should be done twice a month to avoid inflammatory changes. Inflammatory acne at any age is an indication for a chemical peel with salicylic and/or azelaic acid, and Dr. Platon cold plasma, while the Apocalypsis phyto-peeling is the choice for individuals with post-inflammatory pigmentation and scars. Atrophic and hypertrophic scars usually appear later as a result of inflammatory acne and/or inadequate treatment, so people with such scars are candidates for Plasmage treatment, microneedling, and CO2 fractional laser, which is also the best choice for all skin irregularities, in this case, post-inflammatory pigmentation and scars.
Results
After medical facial cleansing, the results are immediately visible in terms of cleaner skin and reduced acne. For teenagers with oily skin, continuous cleaning is needed to maintain results and achieve a final result. The results after Aqua peel are clean, fresh, and hydrated skin right after the treatment. Chemical peeling and Apocalypsis phyto-peeling initially show results after a few days when exfoliation is complete, and the final result is seen after a month as the skin fully regenerates. The skin becomes cleaner, complexion more even with visibly fewer inflamed and non-inflamed acne, pores narrowed, and post-inflammatory pigmentation noticeably reduced. Multiple treatments are needed for a full result. Usually, 3 to 5 treatments yield excellent results.
Dr. Platon cold plasma needs to be repeated several times, depending on the skin condition and existing inflammations/hyperpigmentations.
For scar treatments from acne, multiple microneedling and Plasmage therapy sessions are required, depending on the type of scars and the damage done.
The CO2 fractional laser gives excellent results with just one treatment. Initial results are visible after 2-3 weeks, and then they keep improving as collagen fully regenerates over the following months. If necessary, the treatment can be repeated after 30-45 days.
Recovery
After mechanical facial cleansing, the skin may be slightly red and sensitive for 1-2 days. It’s essential to avoid touching the face, smoky environments, saunas, tanning beds, and sun exposure for a few days after facial cleaning. After a facial chemical peel, the skin is slightly red for 1-2 days, followed by exfoliation. The intensity of peeling depends on the type, concentration, and pH of the acid and the application duration, or the desired effect. It’s forbidden to expose oneself to the sun, use tanning beds, saunas, and aggressive products until the skin is renewed. Applying high SPF is mandatory. The Apocalypsis phyto-peeling treatment requires special care afterward. For the first two days, the face is red with a burning and tightening sensation, followed by intense exfoliation lasting 3-5 days. Until the exfoliation ends, it’s strictly forbidden to touch the face in any way, wash, apply cleansers, serums, and creams. Only sunscreen application is allowed. Sun exposure is prohibited. We recommend Juliette Armand Sun Film SPF 50, which also contains antioxidants. After exfoliation ends, it’s essential to do a Recovery skin renewal treatment. We recommend home care with Dermaheal gel and Dermaheal cream for faster skin renewal. Dr. Platon is entirely non-invasive and painless, so no special recovery is required. For acne scar treatments, recovery depends on the chosen treatment. For more information, see SCARS.