Acne, a common skin condition among adolescents, is caused by the excess production of sebum by sebaceous glands, blocked hair follicles, propionibacterium acnes bacterial infection and inflammation of hair follicles.
The problem did not afflict primary school pupils before. But due to more affluent lifestyles and changes in eating habits, even Primary 5 or 6 students are showing blackheads and whiteheads on their foreheads.
Unlike whiteheads, which are completely closed spots, blackheads block hair follicles only partially and are more likely to get infected; this leads to further inflammation.
Since most cases afflicting primary school pupils do not involve propionibacterium acnes bacterial infection or inflammation of hair follicles, they are advised to keep their skin clean, increase intake of vitamins C and E, and sleep early.
When children enter puberty, the growth and secretion of sebaceous glands are facilitated by hormonal changes in their body.
If they fail to observe proper care of their skin, follicles on their forehead and around the nose could get clogged and infected by propionibacterium acnes bacteria. If that happens, medical treatment will be required.
Doctors used to prescribe topical antibiotic cream such as erythromycin, clindamycin and tetracycline. In recent years, however, researchers have found that topical antibiotic cream is losing effectiveness as propionibacterium acnes bacteria develop tolerance and resistance.
Gels or creams with benzoyl peroxide or retinoic acid do not pose such a problem as they are not antibiotic.
Benzoyl peroxide topical could be used to treat mild to moderate acne as they could help unclog pores, reduce inflammation and kill bacteria.
The medicine comes with a range of concentration from 2.5 percent to 10 percent. Patients are advised to start with 2.5 percent, making sure it does not result in burning, itchiness or redness of the skin, before increasing the dosage.
Retinoic acid has to be prescribed by a doctor. The cream could unblock or prevent blocking of pores and its effectiveness could be seen after one or two weeks of use.
It is also good for clearing whiteheads, blackheads and smaller spots. But it could have side effects such as mild irritation and stinging of the skin.
It is suitable for nighttime application only as it is photosensitive. Pregnant women or those planning for pregnancy should avoid both oral and topical retinoic acid.
This article appeared in the Hong Kong Economic Journal on June 10
Translation by John Chui
[Chinese version 中文版]
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