Overactive sebaceous glands can cause acne. The sebaceous glands which secrete sebum (oil) are found
all over the skin but are most abundant on the face, especially the central portion (T-zone). The
glands become active during puberty as result of hormonal changes. In acne sufferers, sebaceous
gland activity tends to be higher and the lining of the pores in the skin is thickened, resulting in
blockage. This blockage together with the increased oil production results in the formation of the
earliest pimple spot called a white or blackhead (also known as a comedone).
Once the pore is blocked, a type of bacteria in the deeper parts of the hair follicle called
propionibacterium acnes increases and brings about a biochemical reaction in the sebum, irritating
the surrounding skin and causing red and yellow spots to form. These spots are what people generally
recognise as acne. If the glands swell greatly, cysts may form, causing discomfort and pain.
Prescribed oral and topical medicines such as topical retinoids, topical antimicrobials and oral
antibiotics have been a mainstay of treatment for acne. Today, however, there are new topical
medications and machinery like lasers (e.g.Smoothbeam®
laser) to treat acne, and fractional CO2
laser (e.g. MiXto
SX®) and intense pulsed
light (IPL) to treat the acne scars.
The current recommended standard of care for patients with acne is a combination of topical retinoid
and antimicrobial therapy as it can target multiple pathogenic factors. One example of a treatment
that fits the bill is Epiduo Gel, a fixed-dose combination of adapalene 0.1 percent and benzoyl
peroxide 2.5 percent which needs to be applied once daily to affected areas after cleansing and used
for long term maintenance after the acne is cleared. By streamlining the number of medications and
applications, patients are more likely to stick to their acne treatment regimes, thereby improving
Incorporating an appropriate skincare routine is essential too, as skincare products are important
in enhancing the penetration and efficacy of drugs and improving the healing of acne. For instance,
an acne patient would usually be advised to use a non-soap cleanser and a moisturiser (eg
Dermacontrol™) that provides oil control and/or is non comedogenic to prevent breakouts and clogged
pores. The role of dermatologists is vital in this regard as they can help patients choose the
correct products for their skin conditions.