The severity can vary from a self resolving very mild disease consisting of few black heads to a very severe nodulocystic form which tends to leave permanent disfiguring scars. Appearance is an important factor in social and emotional functioning. Appearance, particularly facial appearance, represents an important aspect of one’s perception of body image. Though it is a cosmetic problem but its early treatment is very important not only to prevent permanent scarring but also to boost self confidence and esteem in the productive years of life.
Now a days successful medical treatment is possible which can significantly limit the disease duration, clear the acne and prevent recurrences. Treatment options include not only topical and oral medications but also anti acne peels, phototherapy and lasers for the faster results.Case -1
The treatment can be with the help of UVB Phototherapy, PUVA Phtotherapy and Melanocyte Transplants.
3) Botox Treatment: Botulinum Toxin is a protein and neurotoxin, normally synthesized by a bacterium, Clostridium Botulinum. This bacterium sometimes grows in improperly preserved meat products and when consumed, leads to poisoning, which results in paralysis by blocking neuromuscular transmission of acetylcholine. In 1960s, therapeutic effects of botulinum toxin were discovered and first used in ophthalmology. The cosmetic effects of Botulinum Toxin A were first described for wrinkles in 1989. Gradually, the indications became more defined and presently, it is used routinely for dynamic facial and neck lines and wrinkles, excessive sweating, hidradenitis in early stages, masseteric hypertrophy, blepharospasm and strabismus (squint), cervical dystonia, upper motor neuron syndrome such as cerebral palsy and chronic migraine.
For face and neck, the Botox injections are used to get rid of crow’s feet (around the corner of eyes, especially on laughing), forehead lines (horizontal lines, formed on raising eyebrows), vertical forehead frown lines, marionette lines (radiating from corners of mouth), in combination with other treatments such as fillers.
The treatment is carried out as OPD procedure and takes 10-15mins. It involves injection of Botulinum Toxin A using very fine needles, into previously determined points. The full effects are evident in 5-7 days and last 4-6 months.Case -9
4) Medical Tattooing: Medical Tattooing is the process of uniform implantation of very fine inert skin color matching pigment granules into the skin , so as to artificially create a permanent cosmetic camouflage using manual or electrically driven needles.
Over the years this technique has attained many advancements and with the help of modern colours and equipment a good colour matching is usually obtainable. The most important advantage of tattooing is, instant result with no downtime.
Tattooing is commonly used for small size patches of vitiligo ( leucoderma) affecting lips, nipple, areola etc. It is also sometimes used as decorative tattooing for creating permanent eyeliner, lipstick and moles.
The tattoo pigment once implanted and well accepted by the body usually does not undergo any further major change, after the initial 3-4 months. However, sometimes the tattoos fade a little with aging. Therefore touch tattooing is required in some cases.Case -12
5) Lasers: The word Laser is an acronym for ‘ Light Amplification by Stimulated Emission of Radiation’. Depending on wavelength, the laser light is selectively absorbed by the target tissue such as melanocytes, hair follicles or blood vessels. On absorption it gets converted into heat energy and causes selective destruction of the target component.
Lasers have widened the scope of efficient treatment for certain indications which were in the past either untreatable or required extensive surgery over a prolonged time. These can now be treated with less down time and much better cosmetic results. Laser treatments are mostly office procedures.
Lasers in dermatology and cosmetic surgery are of various types. Different lasers are used for different indications. The common indications are:
Proper patient selection and judicious use of laser technology along with certain precautions yields good cosmetic result without any side effect. Generally multiple sittings are required for consistent and substantial results.
6) Cryotherapy: Cryotherapy is an important treatment modality in the field of dermatology , in which local freezing is used for controlled destruction of the tissue. It has very high safety profile, easy to perform and high cost effectiveness. Being an office procedure it does not require any special patient preparations.
There are many cryogens which can be used for this purpose but Liquid Nitrogen is the cryogen of choice today as it is the coolest cryogen, easily available and decreases temperature of the tissue to -196°which can even destroy the malignant lesion as well.
Cryotherapy is commonly used for benign lesions like warts, molluscum contagiosum, seborrhoeic keratosis, granuloma pyogenicum, skin tags and mucoid cyst. It is also effective in conditions like actinic keratosis, leukoplakia and basal cell carcinoma.