Biostatistical Analysis on the Combination Treatment Against Acne

Introduction: Acne is one of the commonest skin disorders. During Adolescence 70% to 80% of the population have some clinically evident acne [1]. This is commonly seen as oily face, obstructive horny plugs or inflammatory lesions like pustules. These may complicate into cysts, abscesses, scars, keloids, hyper-pigmentation and above all psychological damage to self-confidence. The striking feature of acne is greasy skin and severity of acne is directly proportional to sebum excretion rate SER [2]. Raised SER is often due to hyper sensitive end-organs i.e. Sebaceous glands (SG), mostly at normal levels of circulating androgens [3]. SG are larger and more permeable in acne skin [4]. Chemabrasion may be introduced as a surgical procedure with a new idea where microdermabrasion (MD) is combined with chemical peeling to achieve permanent partial destruction or shrinkage of target organs i.e. SG. This results in decreased number and size of SG. The MD produces controlled removal of superficial skin layers in successive sessions and the chemical peeler absorbed through abraded opened follicles selectively causes partial destruction of SG. This can be proved by measuring the SER before and after treatment [5-11]. So investigations of SER are very important for understanding the physiology of SG, pathogenesis of acne and the efficacy of this treatment ‘chemabrasion sheikhing’.

Methods: Every patient had 4 chemabrasion sessions for active acne and for those having scarring 2 additional sessions were done. Sessions were spaced 10 to 15 days. During each session MD was done followed by IMMEDIATE chemical peeling. MD was performed with crystal peel and vacuum system using aluminum oxide crystals. It was almost painless with complete evacuation of comedones and pustules. The abraded area was cooled with ice packs and chemical peel applied. For this study we used a medium strength chemical peeler jessner’s solution (JS), created by Max Jessner (having lactic acid, salicylic acid and resorcinol). Burning was controlled with cold saline wipes or ice packs. Topical antibiotic prescribed for twice daily use for five days. Most patients healed in 2 to 3 days.

Results: This combination treatment has proved very safe and effective against acne. All patients had remarkable improvement. We noted a decrease in number of new lesions, skin greasiness and open pores. There was an improvement in scars, hyper pigmentation and we also noted a decrease in vellus hair with more smooth skin.

Keywords:Acne; Sebaceous gland; Microdermabrasion; Chemical Peel; Chemabrasion; Jessner’s solution; Sebum excretion rate