An estimated 80 percent of people between 11 to 30 years of age will experience acne at some point.
In fact, adult acne is extremely common not only in Singapore but all around the world. The cause of adult acne is somewhat similar to the causes of puberty; with fluctuating hormone levels being the most common reason.
While cystic acne will affect far fewer people, this does not change the fact of its psychosocial impact to those suffering from it.
Before exploring the reasons as to why your acne treatment is NOT working, it is first critical to understand what causes acne:
The Main Culprit
Your skin is covered with innumerable hair follicles and pores. And just beside the base of each hair shaft, you have sebaceous glands – which generate sebum to keep your skin healthy and moisturized. That is, in healthy levels.
However, things start to change when a key player called Propionibacterium acnes, or P-acne bacteria for short, starts to inhabit the base of the hair follicle. They feed off on sebum, and when triggered by factors such as hormonal changes or stress – causes the over-production of oils that when combined with a proliferation of P-acne bacteria, causes inflammation and a clogged-up hair follicle – leading to unwelcomed acne.
Knowing this, if you are just one of the many who have tried countless of ways to treat those pesky acne scars – from topical and oral medications, completely changing your at-home skincare routine to signing up for a laser treatment for acne – it’s time to solve the mystery on why your acne treatment might NOT be working.
1. You aren’t giving the treatment enough time to take effect.
It is completely normal to still get pimples during the first few weeks of any acne treatment – even a laser treatment for acne needs to take at least a week or two for breakouts and acne scars to fade and heal. Typically, acne treatments can take anywhere from 8 to 12 weeks to start working, depending on the type and extent of your condition, as well as individual skin type and response.
In some cases (roughly 10%), your skin might breakout, or start peeling before it actually starts to recover, so don’t be disheartened immediately. A general rule of thumb we recommend is to wait it out for 8 to 12 weeks before deciding on your next move.
2. You are utilizing ONLY topical and oral medications.
Acne is actually a far more complex problem that requires a comprehensive plan. Cystic acne is even harder to treat, since it doesn’t respond well to topical treatments such as antibiotics and retinoids.
In order to treat deep acne scars or severe acne, you will need a solution that goes beyond the epidermis – this involves remodelling the scar fibres and replacing it with new collagen fibres in order to push up the scar to the skin’s surface. This is the reason why solutions such as laser treatment for acne, micro-needling and even fillers are fast becoming popular acne treatments in Singapore as they have been proven valuable in treating moderate to more severe cases of acne.
3. Your doctor has recommended the wrong acne treatment.
The truth of the matter is, no one suffers from a single type of acne.
Typically, a person will suffer from a combination of both active acne and acne scarring. For example, a patient may have some acne that are reddish, others that are brownish, and an ice-pick scar next to a boxcar. Since each type of treatment has its own pros and cons, each acne type will have a solution that is better catered to solve it.
There is a slew of acne treatments currently available in Singapore today, which can prove overwhelming for a typical consumer – this is why it is pertinent to work with a doctor that is able to tailor an extensive plan that matches your combination of acne with the ideal acne treatment.
4. You are working with an inexperienced doctor.
Laser treatments for acne are highly intricate procedures that aren’t just operator dependent, but settings dependent and machine dependent as well.
For example, the well-received Q-switch laser is a high-energy, intense laser light is used to eliminate the sebaceous glands and clear any harmful P-acne bacteria.
To do so, the different crystal rods in the Q-switch laser is able to produce different wavelengths (typically 1064nm), energy and work with different spot sizes – allowing an experienced doctor to set the perfect level and frequency to treat multiple skin issues. Only with the right settings can the laser energy be absorbed and penetrated into the skin structure to produce the desired effect.
Since the pores on your face are extremely tiny – this adds yet another dimension of difficulty and detail that not all doctors are able to pull off.
5. The clinic does not offer Vbeam laser.
Another laser that is effective in treating acne, and especially redness is Vbeam – otherwise known as Pulsed Dye Laser (PDL). According to the New Zealand Dermatological Society, Vbeam has been highly successful simply because the light emitted from the treatment has a toxic effect on P-acne bacteria.
By directly targeting specific areas, Vbeam is able to boost skin’s rejuvenation, while curing any redness, stubborn acne and acne scars. And from what we have learnt earlier, any method that can eliminate the presence of P-acne bacteria on the skin can help reduce acne substantially.
Delivered in micro-pulses, Vbeam Perfecta is a gold-standard laser offered in our clinic that can be programmed to zap away multiple issues – with amazing results. The best part about it? Zero downtime.
6. The oil glands are not being targeted correctly.
Eliminating sebum and P-acne bacteria in the acne equation is key to seeing a drastic improvement in your acne condition.
We do this at our clinic using AGNES, a permanent and long-term solution to acne breakouts and recurrent acne where a combination of both micro-needling and radiofrequency (RF) energy helps to shrink the sebaceous glands at its core. By destroying hyperactive sebaceous glands, less oil is produced, leaving no chance for pores to get clogged, inflamed and infected – and acne goes away for good.
In order to execute AGNES properly, the doctor needs to first correctly identify the oil glands under high magnification. Being able to accurately pin-point the minuscule pores to treat with the appropriate dose of radiofrequency (RF) energy is what will ultimately make or break your treatment results.
7. Your doctor is only recommending one type of treatment.
As mentioned earlier, treating acne is never as straight-forward as it seems. The best doctors will recommend the best type of laser treatment and pair it with other solutions to complement your specific needs.
Our acne solutions in Singapore is one of the signature treatments at our clinic – both Dr. Gerard and Dr. Chow are fully-trained and qualified in aesthetic procedures to competently treat acne problems, even for patients that have deemed their situation hopeless and untreatable.
We believe in following 4 critical steps for holistic acne treatment:
Step 1: Facial Treatments – to deep-cleanse pores, control inflammation and remove micro-blockages.
Step 2: Laser Treatments – Targets and kills the bacteria that contributes to acne breakouts, while reducing pigmentation and scars. Both our Q-switch laser and Vbeam laser are highly-effective solutions promising minimal downtime.
Step 3: Selective Follicle Treatment – Goes to the root of the problem by selectively shrinking the sebaceous glands to effectively reduce recurrent acne. We do this using our AGNES treatment for longer-lasting results.
Step 4: Topical and Oral Therapy – When you undergo treatment with us, we will also be taking care of your daily skincare regime – a range of clinic prescribed skincare products will be given to you to help you achieve an optimal balance of hydration according to your skin type. We also may recommend oral medication and supplements for those with cystic acne.
8. The doctor has poor knowledge of P-acne bacteria and the different methods available to eliminate it.
Having excellent knowledge of the P-acne bacteria and bacterial community of the skin is key to developing a plan to treat acne. P-acne bacteria tends to live in the oily regions of the skin’s pores, triggering immune responses that often lead to red and swollen bumps.
A good doctor would be fully aware of the conditions that P-acne bacteria thrives in, such as a low-oxygen environment – and proceed to choose the best methods to treat acne accordingly. Given that P-acne bacteria is sensitive to certain types of antibiotics, a good doctor should be able to correctly administer the best one.
A poor knowledge of the different types of antibiotics can also lead to ineffective acne treatment. More often than not, doctors prescribe an excessive dose of antibiotics for patients over a lengthy course of time, leading to a counterintuitive effect where the bacteria becomes even more stubborn and resistant. In fact, doctors should not be viewing antibiotics as an anti-microbial solution, but instead an anti-inflammatory one.
9. Your lifestyle has not changed since undergoing treatment.
It is important to make the right lifestyle choices before, during and after acne treatment – especially since acne can easily be triggered by lifestyle habits and hormonal fluctuations.
We recommend making a few healthy and beneficial lifestyle changes before treatment. If you are planning to get a laser treatment for acne, you might want to quit smoking for at least 2 weeks and stop taking any medication or supplements that can hinder healing.
Additionally, ensuring proper sun protection is extremely critical, both before and after laser treatment. Be sure to apply an even layer of oil-free, non-comedogenic sunscreen 10 to 15 minutes before heading out the door, ensuring that you do not over apply – this can cause your pores to get clogged, a precursor to the dreaded acne once more.
Of course, the best-case scenario is if you can keep up the habits for as long as possible. A great incentive to motivate you is that the greatest improvements and lasting results tend to be rewarded to those who are non-smokers and stay out of the sun.
10. You aren’t following your aftercare procedure meticulously.
After undergoing treatment with us, you will receive aftercare instructions on the medication and skincare products that you need to take and apply, when you need to take it and how often.
While you may be tempted to overdo the aftercare procedure – it may actually have a counteractive effect that can cause dryness, redness, peeling and irritation. On the other hand, patients who have attained clear skin may even decide to stop doing it altogether, which can be detrimental when trying to completely heal from acne.
You might also decide to “spot-treat” your acne – applying the acne medication only on active spots and blemishes. However, this is a common mistake that can easily be avoided – acne medication should be applied exactly as directed by your doctor and should never be taken lightly.
11. You aren’t a suitable candidate for your acne treatment.
Laser treatments may be effective in treating acne, but they don’t work for everyone. For example, if you have light sensitivity, or are currently taking any blood-thinning medications, you might not be a good candidate for laser treatments. In addition, you might want to avoid undergoing laser treatment if you currently have active acne or skin sores, as it might aggravate the situation.
It is also worthy to take note that it is possible to be allergic to certain ingredients in the medication and supplements that you are currently taking – causing a skin reaction and worsening your acne. Ultimately, it is best to communicate clearly with your doctor and dermatologist of any allergies and underlying conditions that you have before committing to any treatment.
12. You wait too long to start acne treatment.
Acne typically takes about 2 to 3 weeks before becoming visible on the skin, so the secret to controlling and “curing” acne is actually through prevention, and proper maintenance. Not doing so can eventually result in an acne problem that is harder and takes longer to treat. When treated early, depressed acne scarring can also be avoided.