Dr.Sayani Sainudeen
Medical Director at Signature Clinic

For this blog I am focussing on Active Acne, rather than Acne scarring. See my blog on Acne scarring and our views on treating scarring. Active Acne is often seen as a trivial condition and there is often a lack of understanding even amongst medical professionals about the psychological impact and the need for treatment. Unfortunately, not many treatments options are available on the NHS unless the acne is severe. It is important to treat active acne quickly as once scarring is developed, treatments options are not as effective and give modest results.

Options described below are low cost, minimally invasive to higher cost and more invasive treatments. Although more invasive treatments give better results overall, it is important to recognize that some treatments will be more effective for some people. Treatment Plans should be made to fit the individuals budget and attitude to invasive procedures.

Good skin care

This should be the base line for most people with or without active acne at all times. By good skin care, I mean using a medicated product for cleansing and toning every day. The Obagi range is a good range of products and requires a physician or Nurse Prescriber to be trained to be able to prescribe the range. Yes, I meant prescribed by a Doctor on a prescription.

PRODUCT APPLY COST
OBAGI FOAMING GEL CLEANSER ( 200ml ) CLEANSE MORNING AND NIGHT £45
OBAGI TONER (200ml ) APPLY MORNING AND NIGHT WITH AFTER CLEANSING £45
OBAGI HydrateMoisturiser (48 g) Apply once Morning and Night £40
OBAGI Sun Shield Matte Broad Spectrum SPF 50 (85 g ) Apply in the morning £60
OBAGI EXFODERM (57 g) ( mild chemical exfoliation ) Twice a week £75

This stock should last 3 months if applied correctly.

ISOTRETINION GEL

In my opinion this is one of the treatments that gives best value for money. Consult a doctor for Isotretinoin Gel as it is available only on prescription only after you have been assessed.

Isotretinoin actually can be used as an anti ageing cream as it tightens and firms the skin and also lightens the skin tone and areas of hyperpigmentation.

PRODUCT APPLY COST
ISOTREX GEL 0.025% Start with a small amount twice a week and then increase over a few weeks to applying daily. Can increase strength to 0.5% after a few months £25 to £50 per 30g tube

While there are multiple options for medicated creams such as Benzoyl Peroxide ( Duac ) and antibiotic creams prescribed by your GP, we are presuming that you have tried these and they have not worked for you.

HYDRAFACIAL

 

Microdermabrasion has been present for a very long time. Traditional microdermabrasion involved buffing the top layer of skin with a rough head pretty much like a sand paper application. This is not really an options for active acne as it can flare up inflammatory acne.

Here is where the Hydrafacial comes in. The Hydrafacial provides dermabrasion with targeted water jets. The skin is also then treated with Salicylic and Glycolic acid serums followed by LED light. This makes the Hyrdrafacial an excellent choice for active acne.

 

TREATMENT APPLICATION  COST
HYDRAFACIAL Undertaken  in Clinic byLevel 3 Qualified Therapist . Repeat monthly  as maintenance. £100 to £120 per session.

MILD CHEMICAL PEEL

 

I would recommend a light chemical peel such as the Obagi Blue Peel Radiance The chemical peel when applied removes the top layer of dead cells allowing newer layer of cells to grow.

TREATMENT APPLICATION COST
OBAGI BLUE PEEL RADIANCE Applied in Clinic by the Doctor / Nurse or Level 3 Qualified Therapist . Repeat every 3 months as maintenance. £100 to £120 per session

IPL  ( NON ABALATIVE )

Intermittent Pulse Laser or IPL is a good treatment to clear active acne and can give excellent results. The technology uses the IPL to reduce bacterial count and reduce oil production. A recent study showed a 50% reduction in Active Acne after 4 sessions of IPL. Non-Ablative means that the pulsed laser is delivered to under the skin without disrupting the top layer and hence less invasive. Ablative treatments affect the top layer of skin and are more effective.

PRODUCT APPLY COST
IPL Treatment Applied in Clinic by the Doctor / Nurse or Level 3 Qualified Therapist. 4 to 6 sessions required. £149 per session

PLEXR

 

PLEXR is a new technology that uses Plasma energy to deliver a small current (similar to lightning). It delivers the energy directly to the acne spot to remove it. It will require an application of local anaesthetic cream for 30 mins before the treatment

PRODUCT APPLY COST
PLEXR Applied in Clinic by a Doctor. Once off treatment but may need to be repeated once. £249 per session

LASER RESURFACING ( ABLATIVE )

Laser unlike IPL is ablative which means it causes disruption to the top layer of skin.
The laser light is very focused unlike the IPL and the doctor will often use a combination of topical anaesthetic along with a skin cooler device which blows cold air to allow treatment to be carried out with minimal discomfort.

TREATMENT APPLICATION COST
LASER RESURFACING Applied in Clinic by a Doctor . Once off treatment £449 per session

TO SUMMARIZE

Acne treatment vary in cost, efficacy and invasiveness. A thorough consultation to determine the overall cost and patients commitment is required. Majority of treatment failures occur due the lack of appreciation that acne requires a multi-modal approach to treatment is a logical manner. Commitment to a treatment plan is critical to treatment success.

So what option should I go for ?

Contact me for a face to face discussion and we can decide together what the best option is for you. I am likely to suggest that we start with an Obagi Blue Peel followed by Good Skin Care routine along side Isotretinoin Gel to start the treatment. Give it 4 weeks and on the first review we will discuss IPL, Laser or PleXr options get rid of the spots that are still persistent.

 

Here are the options again

TREATMENT COST PER SESSION SESSSION REQUIRED TOTAL COST COMFORT LEVEL
Skin Care £270 for 3 months suply *****
Isotretinoin      –         – £ 40 ( 1 to 2 months supply ) ****
Hydrafacial £120 Monthly £720 for 1 year *****
Mild Chemical Peel £120 3 monthly £ 480 for 1 year ***
IPL £149 6 sessions £900 ***
PLEXR £249 2 sessions £500 ***
LASER £449 1 session £449 **

***** = no discomfort.