Acne, commonly known as spots or pimples, is a skin disease that appears in everyone, particularly during adolescence. It arises when the ducts of the sebaceous glands on the skin surface (follicles) become blocked by a thicker layer of oil, so that the oil (sebum) secreted by the sebaceous glands cannot be released onto the skin. It can be seen in almost everyone at certain periods. The body clears it up over time without any outside intervention, but when it cannot, the problem becomes chronic and negatively affects the person’s quality of life. In such cases acne treatment is needed.

After acne, red marks and scars may remain on the skin. If acne does not recur in the same area, the red marks fade within 2–4 months. If a spot is deep and long-lasting, it is more likely to leave a red mark. Spots that keep recurring in the same place can turn their marks into scars. For this reason acne should be treated early.

In addition, picking or squeezing spots can further increase the likelihood of permanent scarring. If a red acne mark persists in the same place for more than 6 months, a pitted scar may remain in that area. For this reason it is worth treating long-lasting red marks. Early treatment can prevent scarring.

How Does Acne Develop?
Sebaceous glands take their name from sebum, the oily substance they produce. Under normal conditions sebum travels along the hair follicle and reaches the skin surface. When acne forms, the sebum stays inside the follicle and cannot get out. Acne forms mostly in areas where sebaceous glands are more concentrated, such as the face, neck, back, upper arms and shoulders. Blackhead-type acne lesions are called comedones, while red, swollen and pus-filled lesions are called papules, nodules and pustules.

To Prevent Acne
* Fatigue and stress affect hormone balance and indirectly increase oil production. Try to stay away from fatigue and stress as much as possible.
* The skin is nourished and renews itself during sleep, so make sure you get good sleep.
* Exercise is, above all, very beneficial for general health. It speeds up blood circulation and delivers more oxygen to vital organs, including the skin. After exercise, always carefully wash off the oil and sweat that build up on your face and create an environment for bacteria. Otherwise your acne may get worse.
* Water makes up a large part of the cells of the body and skin, makes it easier to eliminate toxins from the body and helps transport nutrients around the body. Drinking water will not get rid of acne, but it helps keep the skin healthy.
* Even if you sometimes feel a very strong urge, do not squeeze spots or pick off the skin or inflamed parts over them.
* Wash your hands often. Take care to keep your hands away from your face while thinking, reading, watching television or studying.
* Wash your hair at least twice a week and your face at least twice a day with a soap recommended by your dermatologist.
* Because a damp towel is a very suitable environment for bacteria to grow, change the towel you use for drying every day.
* Try to keep your hair away from your face while sleeping. During the day, tie your hair back so that it does not touch your face.
* Take care to avoid excessive exposure to sunlight.

What Causes Acne?

1. Genetic Factors
Acne is a condition with a genetic component. In fact, anyone can experience acne to a certain degree, but some people have a genetic predisposition to certain types of acne. If the mother or father had acne in adolescence or at any time in their lives, their children are more likely to have acne.

2. Hormones (Androgens)
Acne usually forms when the body starts producing more androgen hormones. Acne increases when androgen production peaks between the ages of 11 and 14. In young women, changing hormone levels due to the menstrual cycle also cause acne flare-ups. These changes also affect the sensitivity of the sebaceous glands to androgens.

3. Bacteria
A blocked follicle is a suitable environment for bacteria to grow. The bacterium that lives in this environment in particular is P. acnes. This bacterium feeds on sebum and is found on everyone’s skin, whether or not they have acne. When the sebaceous gland is blocked and fills with sebum, P. acnes multiplies much more quickly. The chemicals produced by the bacterium cause inflammation inside the follicle and on the skin surface.

4. Increased Sebum Production
After the sebaceous glands are stimulated by androgens, they start producing more sebum. The oily sebum accumulates inside the follicle and moves upwards. As it moves upwards it combines with normal skin bacteria and dead skin cells. As sebum production increases, so does the likelihood of the hair follicle becoming blocked and causing comedones.

5. Changes Inside the Follicle
As androgen production increases and the sebaceous glands enlarge, the structure of the hair follicle extending beneath the skin also changes. Normally dead cells are shed gradually and move away from the skin surface. During adolescence cells are shed more often and are more prone to clumping and sticking together; when they come into contact with sebum they can block the follicle. In this case the sebum and dead cells form a plug in the follicle.

Acne Treatment
Acne is a treatable disease. The psychological impact of acne should be assessed separately in each patient, and acne treatment should be planned accordingly.

The aim of acne treatment is to remove the follicular plug, reduce sebum production and treat bacterial colonisation. In acne treatment, a range of topical medicines and gels, vitamin A derivative medicines and antibiotic medicines that kill the microbes causing spots on the skin can be used.

Different treatment options are available depending on the severity and grade of the acne. Achieving effective acne treatment can take up to 4–6 months.

Acne Treatment Methods
* Topical (Cream) Treatment
* Medication
* Mesolifting (Skin Mesotherapy)
* Chemical/Herbal Peeling
* Medical Skin Care Treatment
* CO2 Fractional Laser

Topical (Cream) Treatment
Topical treatment is the direct application of medicines to the skin by various methods. Acne seen during adolescence (physiological acne) and spots usually respond well to topical treatment.

Medication
When topical treatment does not work, oral medication can be used. Oral medication is recommended for patients with moderate and severe acne. Such medicines often give better results when used together with topical treatment.

Mesolifting (Skin Mesotherapy)
Creams that you apply externally mainly moisturise and nourish the upper layer of the skin. However, the cells that provide the skin’s real vitality and support, and that need nourishment and moisture for a good cosmetic appearance, are located in the lower skin. Because mesolifting bypasses the skin’s barrier function by injection and reaches the lower layer, it achieves more effective results in acne treatment.

Herbal Peeling
The superficial peels used for acne are peels with salicylic acids (BHAs). This substance acts more superficially on the epidermis (the uppermost layer of the skin). It is preferred mainly for treating acne, blackheads and whiteheads and, secondarily, for treating marks. Herbal peeling is carried out in 6–10 sessions at 2–3 week intervals. It is also applied as a complement after mesolifting (skin mesotherapy).

Medical Skin Care Treatment
In skin care, professional products containing vitamins and antioxidants are used to balance the skin’s moisture level and protect it from acne and external factors. It is also applied as a complement after mesolifting (skin mesotherapy).

CO2 Fractional Laser
An effective treatment used to improve the appearance of acne scars and pits, wound and burn scars and stretch marks.