Dr. Giuseppe Micali is a world renowned Dermatologist from Italy. During his visit to Mumbai to discuss the role of Dermocosmetics in Acne

Management at symposia organized by INVIDA in different cities of India, he clarified certain skin issues.

 1.    What are the different types of Acne people suffer from?
Mild acne with closed comedones (whitehead) and open comedones (blackhead) with few papules (skin colored red bumps) and pustules (pus-filled bumps). Moderate acne with predominant papules and pustules. Occasional nodules (deep, red, severely inflamed relatively hard, spherical structure) may be present. Severe acne with predominant nodules and cysts (fluctuant abscesses containing the debris from infected sebaceous glands, hair ducts, inflammatory cells, and surrounding dermal tissue).


2.    What are the various factors that cause them?
Acne is polygenic and multifactorial. There are 4 primary pathogenic factors, which interact in complex manner to produce acne lesions:
(1) increased sebum production by the sebaceous gland;
(2) P. acnes colonization;
(3) alteration in the keratinization process;
(4) release of inflammatory mediators into the skin.

3.    What are new treatments available to treat acne?
Pharmacological treatments for acne remain the principal approach (topical benzoyl peroxide, topical retinoids, topical antibiotics, systemic antibiotics and systemic retinoids) and the use of cosmetics, if correctly prescribed, may contribute to clinical improvement. The use of cosmetics plays an important role in the management of acne, and there are a growing number of scientific papers suggesting their in vitro and/or in vivo efficacy.
A cosmetics correct choice may enhance the therapeutic outcome as well as patient's compliance. 

4.    Can you get rid of acne by visiting a psychodermatologist?
Acne is a chronic disease which is regarded as having relevant impact on quality of life. Several studies have shown that anxiety, depression and compromised self-confidence can be triggered by such disease. Cortisol, a stress hormone, triggers the increased production of sebum which creates more oily skin. The excessive sebum can cause more breakouts: pimples, blackheads, whiteheads, and cysts in acne prone skin.
Social life of patients can be limited because of negative self-image, avoidance of personal contacts and stigma.
However, psychological consultation has no benefit in the management of acne. A correct therapeutic strategy is more effective.

5.    Some skin lightening products have mercury present in them. What are the effect they can have on your skin?
The use of mercury in any topical compound should be discouraged. There are several reports of systemic mercury toxicity after topical application.

6.    Which are the other harmful ingredients present in products that we must look out for?
The best way is to always choose products from trusted companies which in general provide ingredients list on the product package. Importantly, products prescribed for acne should be dermatologically tested, non-comedogenic, non-acnegenic, non irritating and non-allergenic.