In one of the more bizarre fashion statements ever, Malasyian designer Moto Guo sent his models down the Mens Fashion week runway in Milan last week, with pimples on their faces, not covered up with tons of make up, but highlighted as a fashion accessory.
Apparently the designer wanted to remind people its okay to be human. Reaction to Guo’s fashion statement has been mixed, with some commentators applauding his efforts to normalise taboo skin conditions like acne, others saying, trying to make acne “cool” trivialises a condition that causes many of those who have it significant emotional trauma.
I believe highlighting acne as a real problem, even in this somewhat unusual way, is a good thing. Acne is the commonest health problem experienced by young adult women and men and young adult women in particular are four times more likely to suffer from chronic treatment resistant acne.
We all need to speak about this more, so that those with acne don’t feel isolated and alone in their struggle to get clear skin. Everyday I receive a dozen photographs of young adult women and men with acne who come to our Clinics for help. I am so pleased that we now have a solution to offer them.
This month will mark 3 years since I found SGA during a trip to a conference in Asia. I am constantly amazed at how few patients are referred to me by our Clinics, because SGA is not working for them. So far this year I have helped with 2 or 3 whose acne has not settled with 6 – 10 SGA treatments. Given we are treating thousands of patients with acne and breakouts, this is pretty remarkable. I have spent most of this year working out how to take SGA to the world as there are so many people who have chronic treatment resistant acne. I am hoping to launch a new website in the New Year which will offer online consultations, advice on where in-Clinic SGA is available and home based treatment in some countries.
In the meantime, here are a few more examples of the great results we are achieving with SGA.
I have read four articles in the past week describing research into bacteria and viruses that interact with the P acnes bacteria on the skin and their potential to deliver a future “Acne Cure”. I can’t help feeling like Sallah in Raiders of the Lost Ark..”Indie, Indie, they’re digging in the wrong spot”. Too attention is paid by researchers, inaccurately in my opinion, to P acnes, which is not the cause of Acne. The role of P acnes in the Acne story is secondary to the malfunctioning of the sebaceous gland. If the sebaceous glands are functioning properly, P acnes is never a problem. After all, it is part of our ” normal” skin flora, the bacteria and viruses that live on our skin that act to help protect the skin from infection. In the malfunctioning sebaceous gland however, P acnes goes haywire, causing inflammation that leads to the formation of pimples and cysts.
Therefore, all our attention needs to be focussed on getting rid of the malfunctioning sebaceous glands. Enter Sebaceous Gland Ablation- SGA. SGA is the only treatment that focusses on eliminating the cause of Acne, the malfunctioning sebaceous gland, leading to permanently breakout free skin. In the Acne puzzle, SGA is the answer.
There are thousands of products on the market that claim to be effective in controlling or eliminating Acne and breakouts. One thing I have learned treating thousands of people with Acne prone skins is that almost all products deliver some short term improvement in breakouts, but there are very few products that are effective long term in controlling Acne and breakouts for most clients.
Mild breakout is often readily controlled with a daily routine of cleansing and toning with a mild salicylic acid solution ( 0.5 – 2% ). Salicylic acid is very effective for controlling mild Acne and breakouts as it is oil soluble and therefore able to penetrate the sebaceous glands and help dissolve the mixtures of oil and dead skin cells that block the pores. Salicylic acid also assists in reducing the appearance of post acne marks. Other mild acids like glycolic acid and trichloracetic acid can also be helpful in exfoliating the excess dead skin cells and clearing the pores. These should always be used in low concentrations.
Benzyl peroxide is also a very commonly used medication for Acne and breakouts. All the best known advertised Acne treatments are benzyl peroxide based and it can also be found in combination with some prescription Acne medications. Benzyl peroxide does work well for many clients and can be effective for long periods of time. It is less effective for moderate and severe breakouts and it can be very drying for the skin, particularly in higher concentrations. It is also a bleaching agent and will bleach clothes and bed clothes.
Topical antibiotics are often prescribed by doctors for Acne. They are also combined with topical retinoids in a small number of prescription medications. In my opinion, topical antibiotics are the least effective Acne treatments on the market. They promote the growth of antibiotic resistant bacteria and should be avoided.
Topical retinoids ( tretinoin ) are the most effective skincare products for breakout prone skin. Unfortunately, they have significant side effects ( sun sensitivity and skin dryness and cannot be used during pregnancy ) which has made them unpopular with many doctors. An alternative topical retinoid adapelene is more commonly prescribed by doctors but in my opinion, is not as effective as tretinoin. It has the advantage of not causing sun sensitivity but can be very drying to the skin. It is important to use tretinoin in low dosages to start with, to allow the skin to adapt to it ( 0.025% is recommended). It treats all parts of the Acne cycle and is also helpful for treating Acne scarring. In my practice, I combine tretinoin with a mild bleaching agent to help resolve the pigmented scarring that is so common with Acne. I also like my patients to use a 2% salicylic toner, preferably daily.
Before you buy any more skincare products for your Acne, read the ingredient list and make sure they contain something that will actually help your skin.
One of the things I like most about posting up these results from SGA is knowing how happy these clients are with their new, clear skin. Here are some more happy clients:
I have written earlier posts about what a big problem Adult Acne and Breakouts are. It is difficult to determine how common Adult Acne is, but a study published in 2008 ( which attempted to measure the prevalence ( how many people are affected ) of Acne in adults 20 years and over ), reported 42.5% of men and 50.9% of women continue to have problems with acne and breakouts in their 20s. Although the peak prevalence of Acne is the teenage years, the mean age at presentation for treatment is 24 years.
This is certainly our experience and the majority of people we are treating with SGA are adults. I believe the majority of teenagers put up with mild to moderate Acne, waiting to “grow out of it”. But young Adults affected by Acne are quickly frustrated when the common Acne creams fail to reduce their Acne and are looking for a permanent solution. The hardest part of this search is wading through the myriad of “fixes” advertised online and in magazines and trying to evaluate the claims.
I hope, over time, the weight of evidence of the effectiveness of SGA will make this process much easier.
Here are some more great results we are achieving for our clients with SGA. We have now been performing SGA for six months and our client base is building exponentially with word of mouth. When I introduce a new treatment into our Clinics, I always expect a stream of emails from my therapists with all the clients the treatment hasn’t worked for. I was expecting the same with SGA. We have treated over 1500 clients in the past six months with SGA and I have received one email about a client whose acne has not improved after 3 SGA treatments. We know now that some clients with particularly stubborn can take up to six treatments to start to see improvement and we have revised our recommendations so that new clients can expect to have 6 to 10 treatments to clear their Acne and breakouts.
One email from 1500 clients undergoing a brand new treatment, I am astonished. I would have expected a 10% “problem with the treatment” rate and many, many more emails.
It’s still early days for us, and we are currently undertaking a massive follow up of all 1500 clients to determine our success so far. But most importantly, the feedback from all my therapists is that our clients are really happy with SGA and really happy with their progress.
We have a long journey to introduce SGA to all those people who could benefit from it and have it recognised as the effective Acne treatment it is, but we’ve made a great start.
I am posting a number of photographs today of some of our clients who are currently having SGA treatments. All the clients are woman over the age of 20, who have persistent, treatment resistant acne. I have always felt this was a significant subgroup of Acne affected adults and I came across a Spanish study,, published in 2009, which also proposed recognising this subgroup, as the incidence of adult Acne is thought to be increasing and it is twice as common in women than in men. What is so important for this group of adult females, who are affected by chronic Acne, is that they do not respond to antibiotics and are less responsive to topical treatments ( like medicated creams ). The authors of this study proposed using intermittent low dose isotretinoin ( Roaccutane ) to treat these women but admitted the relapse rate following this treatment was 40%!
I know for my group of female adults with chronic acne, SGA is a godsend. A quote from the Spanish study summarises my view exactly:
“It is important to dedicate time and energy to these patients as the impact on their quality of life can be even greater than that seen in adolescents, and sensitivity is required in offering medical solutions to their skin problems”.
I have seen so many young adult woman over the past 12 years who have been so distressed by their chronic Acne, that it becomes a barrier to them enjoying their lives. To be able to offer them a permanent solution that does not involve ongoing drug therapy is profoundly satisfying.
Please note, all of these clients have only had 1-2 SGA treatments and will require several more treatments to be permanently breakout free. It can also take another 6 to 9 months for all of the red scarring ( post inflammatory hyperpigmentation ) to fade.