Acne/ Breakout

(Acne vulgaris, Pimples ,तारुण्यपिटिका, युवान-पीड़िका, कील-- मुंहासे या पिटिका)

Acne or Pimples is aggravating condition which can appear as small blackheads and whiteheads, pustules (close pus containing pockets) with large cysts or nodules. Severe acne can result in permanent scarring.

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells due to increased sebum production or due to disharmony of hormones. . It causes whiteheads, blackheads or pimples. Acne is most common among teenagers, though it affects people of all ages. Effective acne treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems. Acne is extremely common and can affect people of all ages. Adolescents and young adults between ages 12 and 24 tend to be the most affected group. It usually begins during the start of puberty, affecting girls earlier than boy

About 3% of adults have acne over the age of 35. Treatments for acne are available, including lifestyle changes, medications, and medical procedures. Some rural societies report lower rates of acne than industrialized ones. More than 10 million cases per year (India). Treatable by a medical professional. Requires a medical diagnosis.

Lemon + water cure pimples.

Introduction

Acne vulgaris is a medical name for common acne. Acne is a long term skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads and scarring. It usually affects the oily skin. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back . Effective acne treatments are available, but acne can be persistent. Usual onset is puberty. Risk factor is genetic.The hormonal shifts affect the oil glands and sebaceous glands in the skin,

The difference between acne and pimples is that acne is a disease and pimples are one of its symptoms. Acne is a condition affecting the skin's hair follicles and oil glands. Under your skin, your pores are connected to glands that make an oily substance known as sebum. If your parents had acne as teens, it's more likely that you will, too. The good news is that, for most people, acne goes away almost completely by the time they are out of their teens.

Acne otherwise called pimples present as an inflamed blackheads to pus filled pimples or large red and tender bumps. For some teens it is an occasional incidence, for girls it can occur right before each menstrual cycle. This situation may persist for longer duration to manifest a chronic condition known as acne vulgaris. Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying ). Acne can present as noninflammatory lesions, inflammatory lesions, or a mixture of both, affecting mostly the face but also the back and chest.

Acne vulgaris

It can appear all over the body, but its most common on the face, neck, chest, and back. Acne is usually caused by hormonal imbalance and hyper sensitivity to the robust hormonal activity going in the body during puberty, but stress related with this age also an associate cause.

Acne or pimples is a disease of adolescent. It is due to hormonal changes at this age resulting in more oily secretions. Although a healthy diet and a clean skin are desirable for all children. Do not nag a child having acne about personal hygiene and food all the time. There is no evidence that fried foods or chocolates are the cause of acne. However, if we explain to the child the basic cause of acne he is more likely to listen to our advise about avoiding junk food as far as possible. Just share the information about acne with the child as a friend.

Acne affects the face and upper chest or back.

Washing the face once in the morning and once at night with an ordinary bath soap is enough. Instruct the child not to keep touching the pimples and not to squeeze them. He will listen, especially if we explain that pinching the pimples can lead to permanent scarring.

Regarding medication, it is better to take he advice of a doctor or a skin specialist. Application of milk of magnesia to the pimples before going to sleep may help. Fortunately most cases improve with age.

In this vata, kapha, rakta gets vitiated and produces shalmali kantake (small rashes) on the face.

"Avoid dairy for acne."

Ayurvedic view on Acne

Acne has very interesting name in Ayurveda i. e "Tarunyapitika" तारुण्यपिटीका . Tarunya means young age and pittika means small leisions. The life science pours belief in " Prevention is better than cure". In Taruny avastha Pitta is more predominated and vitiated pitta gives lesions on face hence its name is according to phase of life, One should avoid sour, salty, spicy, fried food. Especially pickles fast and junk food, bakery products. Late night awakening, day sleeping, over eating should be restricted. Proper diet and lifestyle is half treatment. Ayurveda offers proper treatment for acne as cleansing tropical application and internal medicine.

Cleansing with Triphala decoction (normal skin). Argvada (cassia fistula) bark decoction (oily skin) Rose water (acne with burning sensation). Tropical applications in form of lepa (mask). Apply mild fomentation to acne with cloth soaked in warm water or suitable decoction till cloth gets cool. Apply the mixture of Dhania, Lodhra, Vacha (4:2:1) and water. Wet it than and wash it . Use this preparation till acne subsides (5-7)days. Any facial mask should be used before sunset for better results and to avoid harm to complexion.

Internal medicines

Avipathikara churana (5 gms) at bed time with warm cow milk. Manjishtadi kashaya (dry and normal skin) 2 tsf twice a day after meal. Arawadhadi Kashaya (oily skin) 2tsf tab twice in a day after meals.

Nimbadi guggul one tab twice in a day after meal. Take this medication for 7-14 days.

Oily Skin

Acne and oily skin are closely related, some teens suffer from oily skin alone. Oily skin hides grace and complexion of an individual. To overcome from this there are two treatment routes available, use tropical applications to "mop up the oils", regularly or finding out the root cause of oil production and shut it down. For second option one should be ready for heavy expenses for laser, where oil glands are suppressed to be less active for up to a year, so oil production is dramatically reduced. After one year this problem may arise and further treatment may be needed. Best and easy option is mop the oil regularly by using oil control face pack and face wash.

Best herbal oil control face pack

Take 2 tsf of Yava (Hordeum vulgare), add 1 tsf of Aargavadh (cassia fistula) bark powder add 200 ml of water cook it till it become fine paste. Use this freshly prepared paste for massage or as a lepa (facial mask 5-7 minutes wet it first and than wash it.

Acne scars are caused by inflammation within the dermis . hypertrophic scar are uncommon and are characterized by increased collagen content, Keloid scars from acne occur more often in men and people with darker skin, and usually occur on the trunk of the body

Pigmentation

After an inflamed nodular acne lesion resolves, it is common for the skin to darken in that area, which is known as post-inflammatory hyper-pigmentation (PIH). The inflammation stimulates specialized pigment-producing skin cells (known as melanocytes) to produce more melanin pigment, which leads to the skin's darkened appearance. PIH occurs more frequently in people with darker the color. Daily use of SPF 15 or higher sunscreen can minimize such a risk.

Grading of acne

The presence of clogged skin follicles (known as comedones) limited to the face with occasional inflammatory lesions defines mild acne. Moderate severe acne is said to occur when a higher number of inflammatory papules and pustules occur on the face compared to mild cases of acne and appear on the trunk of the body. Severe acne is said to occur when nodules (the painful 'bumps' lying under the skin) are the characteristic facial lesions, and involvement of the trunk is extensive.

Hormones : Hormonal activity, such as occurs during menstrual cycle, puberty and pregnancy, may contribute to the formation of acne. During puberty, an increase in sex hormones called androgens causes the skin follicle glands to grow larger and make more oily sebum. The androgen hormones testosterone are linked to acne. High levels of growth hormones and insulin are also associated with worsened acne.

Medical conditions that commonly cause a high-androgen state, such as poly cystic ovary syndrome, congenital adrenal hyperplasia, and androgen secreting tumors.

Acne can be a side effect of estetorone replacement therapy or anabolic steroids used. Over-the-counter body building and dietary supplements often contain illegally added anabolic steroid.

Hormonal acne typically presents itself in women over the age of 20 with very tender, red, inflammatory papules around the chin and jawline, “The pimples seem to last forever, and if there is any attempt to squeeze or pick, nothing will come out and only scarring will occur. Hormonal breakout is its location on the face. If you're noticing inflamed cysts around your lower face—especially your chin and jawline area. The hormone also has the effect of increasing sebum production at the base of hairs. This is because the glands that secrete the oil are sensitive to testosterone.

Acne at the back

Facial acne

Facial Acne erupt after doing facial. All the pore of face are opens due to steaming, and the dirt deposit on them . due to inflammation acne's are formed.

Pathophysiology

Acne vulgaris is a chronic skin disease of the pilo-sebaceous unit and develops due to blockages in the skin's hair follicles. These blockages occur as a result of the following four abnormal processes: increased oily sebum production (influenced by androgen), excessive deposition of the protein keratin leading to comedo formation, colonization of the follicle by Cutibacterium acnes (C. acnes) bacteria, and the local release of pro-inflammatory chemicals in the skin.

The main hormonal driver of oily sebum production in the skin is dihydrotestoterone Another androgenic hormone responsible for increased sebaceous gland activity is DHEA-S . The adrenal glands secrete higher amounts of DHEA-S during adrenarche (a stage of puberty ), and this leads to an increase in sebum production. In a sebum-rich skin environment, the naturally occurring and largely commensal skin bacterium C. acnes readily grows and can cause inflammation within and around the follicle due to activation of the innate immune system. acnes triggers skin inflammation in acne by increasing the production of several pro-inflammatory chemical signals (such as IL-1a, IL-8, TNF-alpha , and LTB4) ); IL-1α is essential to comedo formation.
C. acnes' ability to bind and activate a class of immune system receptors known as toll-like receptors (TLRs), especially TLR2 and TLR4, is a core mechanism of acne-related skin inflammation. Activation of TLR2 and TLR4 by C. acnes leads to increased secretion of IL-1α, IL-8, and TNF-α. The release of these inflammatory signals attracts various immune cells to the hair follicle, including neutrophils, macrophages, , and Th1 cells IL-1α stimulates increased skin cell activity and reproduction, which, in turn, fuels comedo development. Furthermore, sebaceous gland cells produce more anti microbial peptides , such as HBD1 and HBD2, in response to the binding of TLR2 and TLR4

This inflammatory cascade typically leads to the formation of inflammatory acne lesions, including papules, , infected pustules, or nodules, If the inflammatory reaction is severe, the follicle can break into the deeper layers of the dermis and subcutaneous tissue tissue and cause the formation of deep nodules. The involvement of AP-1 in the aforementioned inflammatory cascade activates matrix metalloproteinases, which contribute to local tissue destruction and scar formation.

Along with the bacteria C. acnes, the bacterial species Staphylococcus epidermidis (S. epidermidis) also takes a part in the physio-pathology of acne vulgaris. The proliferation of S. epidermidis with C. acnes causes the formation of biofilm , which blocks the hair follicles and pores, creating an anaerobic environment under the skin. This enables for increased growth of both C. acnes and S. epidermidis under the skin. The proliferation of C. acnes causes the formation of biofilms and a biofilm matrix, making it even harder to treat the acne

Types of Acne

Whiteheads :"Whiteheads form in the follicle and appear to be just under the topmost layer of the skin, due to the collection of Sebum (oil) and dead skin cells collecting in the pore.The earliest pathological change is the formation of a plug (a microcomedone ), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle. In healthy skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle. In people with acne, the increased production of oily sebum causes the dead skin cells to stick together. If the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).
Blackheads : The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone. The C. acnes biofilm within the hair follicle worsens this process. If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo) Blackheads (open plugged pores)
Papules : These look like Small red, tender bumps
Pustules : If you notice a white bulb with a red and inflamed blemish, then that is most likely a pustule, another form of acne.
Nodules : Large solid painful lump under the skin is nodule.
Cysts : Cysts are commonly increased in thirties. as this is when the skin is most susceptible to the hormonal changes.

The last four types papules. pustules, nodules and cysts are types of inflammatory acne that can be harder to treat.

Cause

Hormones : In both sexes hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum. Hormonal imbalance ( hormonal changes seen in premenstrual syndrome, or at the time of pregnancy)
Oily skin contributes to the formation of acne.
Constipation
Make up
Stress : Increased acne severity is associated with high stress levels, for example at the time of board examination, or at the time of marriage.

Stress Acne

Infections : The anaerobic bacteria Cutibacterium acnes excessive growth of the bacterium Cutibacterium acnes, which is present on the skin
Sleep deprivation : Acne can flare up when you aren't getting enough sleep. In fact, sleep deprivation is considered one of the three main acne triggers, along with stress and sweating.
Beauty palour: While doing facial, opening the pores of skin, which further get infected. And acne erupt on face.

Post Facial Breakout

Cigarette smoking
Diet
Inadequate hydration
Junk food
Fried food
Excessive use of drugs
Others : Mechanical obstruction of skin follicles with helmets or chinstraps can worsen pre-existing acne.
Several medications can also worsen pre-existing acne. Examples of such medications include lithium, hydantoin, isoniazid, glococorticoids, iodides, bromides, and testosterone.
Genetic
Excessive washing of face.
Avoid friction from tight clothing and bag-packs
Not taking shower after exercise.
According to Ayurveda Kapha and pitta type are more prone for acne formation.

Signs & Symptoms

Rash and discoloration
Itching . burning
Discharge, crusting and smell
Pain and tenderness.
A growth or lump

Diagnosis

Medical history, family history of acne

Excessive production of androgen hormones, cortisol, and growth hormone. worsening the week before a woman's period;

Avoid

Lifestyle

Adequate hydration : Drinking ample water balances the oil and water content on the skin of your face. This helps to prevent excess oil and sebum secretion, which means fewer clogged pores and acne. Adult acne is getting more common these days due to busy lifestyles and lack of hydration.
Reduce stress : Minimize stress as stress can also cause acne. Stress is one of the most common causes of acne. That's because it causes the body to produce excess cortisol and other hormones in response, and these hormones trigger the overproduction of sebum in the skin. While sebum is important for keeping the skin hydrated and youthful, an excess will clog pores quickly.
Avoid friction from tight clothing and backpacks.
Shower after exercise to clean the clogged pores.
Exfoliating the skin : Apricot facial scrub For Oil Control and to remove dead cells.

Get plenty of sleep. Give your skin time to rest and breathe.
Avoid using soap.
Moisturize : DON'T wash your face too much. While it may seem counter intuitive, washing too much can further irritate or dry out your skin, leaving it cracked and open for bacteria to sneak in. Washing your face twice a day is a good amount to aim for. DO moisturize every day.
Eat Yogurt : Yogurt has natural anti-bacterial and anti-fungal properties, that can help prevent breakout of acne and ensure a glowing and healthy skin. All you need to do is rub a dab of the creamy yogurt onto acne-prone areas.
Sweat it out.

Exercise

Exercise has many benefits for the skin, such as increased blood flow and reduced stress-related acne.

Pranayama

Yoga
Apart from its health benefits, you'll be surprised to know that regularly practicing yoga for acne and pimples can help improve the condition of your skin ten folds.

●    Fish Pose Matsya asana (मत्स्यासन )
Benefit :

The stretched upper body allows unrestricted airflow, thus providing extra oxygen into the lungs.
It expands the bronchial tubes to permit easier breathing. This is especially useful for asthma patients.
Stretching of the neck and spine stabilizes the functions of the parathyroid, pineal, pituitary, and adrenal glands, thus regulating the hormonal functions within your body. This means increased improvement in skin conditions, and your facial and throat muscles.
It improves metabolism, which makes it a great pose for those who wish to shed weight,
It removes soreness of the muscles and bones in your spine and neck.
It greatly improves posture, flexibility, digestion, thus reducing constipation.
Practicing certain advanced variations of this pose will help you acquire perfectly toned glutes.
This pose also allows you to de-stress and detoxify with ease, therefore improving your overall health and happiness.
This is the best exercise for stomach. It activates the intestine and cures constipation.

● Shoulder Stand pose   Sarvangasana  ( सर्वांगासन  )


Technique :  Lie down fixed on your back in the Shavasana – The Corpse Pose. Breathe in by your nostrils slowly and put your palms facing in downward direction flat on the floor. Holding the hips fixed on the floor slowly curve your knees and get them upward towards the abdomen through breathing out. Breathe in by the nostrils, pressing your hand in downward direction try to raise your body from the waistline upwardly away from the floor, curving the backbone backwards and unbending the arms, your hips should be on the floor. Breathe in, and then whilst breathing out, raise your legs directly upward perpendicular to the floor. You can support your hips with your hands making sure that your legs should be united, knees straight and toes pointed straight up. Keep your head straight, don't turn it to any side. The chin should be compressed against the chest Holding the posture for a while breathe softly through the nostrils. Reverse the steps to come back to the Shavasana– The Corpse Pose
●
Benefit :
It provides good circulation to the head region. It also relieves the stress and calms down the mind.
Calms the brain and helps relieve stress and mild depression.
Stimulates the thyroid and prostate glands and abdominal organs.
Stretches the shoulders and neck.
Tones the legs and buttocks.
Improves digestion.
Helps relieve the symptoms of menopause.
Reduces fatigue and alleviates insomnia.
It activates the thyroid and pituitary glands.

  ●  Cobra pose  Bhujangasana  (भुजंगासना )



Technique :  Lie down on your abdomen by taking legs apart. Keep the palm beside the chest. Breathing in, lift the upper part of your body, up to naval region. Hold it for 10 seconds by feeling the stretch on your abdomen. Repeat this for 3-4 times.
Benefit :
This asana is beneficial in diabetes, bronchitis, asthma and spondylitis.
This asana is very useful in relieving stiffness in upper back and also boost flexibility in lower back while strengthening our core muscles
Opens up the shoulders and neck.
Tones the abdomen.
Strengthens the entire back and shoulders.
Improves flexibility of the upper and middle back.
Expands the chest.
Improves blood circulation.
Reduces fatigue and stress.
Useful for people with respiratory disorders such as asthma. (Do not practice this yoga pose during the attack though).
Flexibility of the dorsal spine, strengthens the spinal muscles. Prevent back pain. Reduces abdominal fat.
Wheel Pose Chakrasana (चक्र आसन )

Benefit :
Stretches the chest and lungs.
Strengthens the arms and wrists, legs, buttocks, abdomen, and spine.
Stimulates the thyroid and pituitary.
Increases energy and counteracts depression.
Therapeutic for asthma, back pain, infertility, and osteoporosis.
. ...

● Lotus Pose Padmasana  (पदमासन )


Technique : Sit erect with both legs placed straight forward. Bend the right leg on the knee joint. place the right foot at the left groin with right sole turned upwards and the heel in front of the pelvic bone. Place the left foot on the right groin in the same fashion. Straighten up with both hands placed on thighs. close the eyes and meditate. maintain this posture for one minute.
Benefit :
Opens up the hips.
Stretches the ankles and knees.
Calms the brain.
Increases awareness and attentiveness.
Keeps the spine straight.
Helps develop good posture.
Eases menstrual discomfort and sciatica.
Helps keeps joints and ligaments flexible.
Opens up the hips. Stretches the ankles and knees. Keeps the spine straight. Relieves menstrual pain. Cultivates calmness, awareness and focus. Awakens the energy centers (chakras).

  ● Plow Pose Halasana  (हल आसन)


Technique:  Lie on your back with your arms beside you, palms downwards. As you inhale, use your abdominal muscles to lift your feet off the floor, raising your legs vertically at a 90-degree angle. Continue to breathe normally and supporting your hips and back with your hands, lift them off the ground. Allow your legs to sweep at a 180-degree angle over your head until your toes touch the floor. Your back should be perpendicular to the floor. This may be difficult initially, but make an attempt for a few seconds. Do this slowly and gently. Ensure that you do not strain your neck or push it into the ground. Hold this pose and let your body relax more and more with each steady breath.
Benefit :
Calms the brain.
Stimulates the abdominal organs and the thyroid gland.
Stretches the shoulders and spine.
Helps relieve the symptoms of menopause.
Reduces stress and fatigue.
Therapeutic for backache, headache, infertility, insomnia, sinusitis.
It stimulates the pancreas spleen and activates the immune system by massaging all the internal organs such as the pancreas.
Strengthens the neck, shoulder and back muscle. Reduce stress and fatigue. Provides relief from the symptoms of menopause. Stimulates the thyroid gland. Boost the immune system.

Neem Leaves

Chewing Neem leaves every morning is considered a treatment for acne as it helps in purifying blood. It also help in reducing the appearance of dark spots and scars. However, intake of large number of neem leaves for a long time can cause side effects.

Food

Do's

Eat a diet high in natural fibre. .
Dermatologists also recommend a diet low in simple sugars as a method of improving acne.
A well-balanced diet. If you are looking for a clear skin detox, your diet should emulate the same. ...
Cucumber Infused Water. ...
Coconut Water.
Aloe Vera Juice
Fruits : Yellow and orange fruits,
Vegetables : Spinach and other dark green and leafy vegetables, broccoli, guava, kiwi fruits, oranges, papaya, strawberries and sweet potatoes.
Vitamin C is needed to produce collagen that strengthens the capillaries that supply the skin

Don't

Dairy Products : Milk contains whey protein and hormones such as bovine IGF-1 and precursors of dihydro-testosterone. Studies suggest these components promote the effects of insulin and IGF-1 and thereby increase the production of androgen hormones, sebum, and promote the formation of comedones.
High-glycemic load diets have been found to have different degrees of effect on acne severity. There is weak observational evidence suggesting that dairy milk consumption is positively associated with a higher frequency and severity of acne.
Restrict Sugar. Sugars, which we consume as refined white sugar in our homes and in other forms like sodas, tetra pack juices, honey, etc. ...
Vitamin B 12 may trigger skin outbreaks similar to a acne (acneiform eruptions), or worsen existing acne when taken in doses exceeding the recommended daily intake.
Restrict Chocolate.
Whey Protein Powder.
Refined Grains.
Foods Rich In Omega-6 Fats.
Foods such as milk chocolate, French fries, and sugary drinks are among those that can increase acne risk.

"Consult a dermatologist."

Neem Leaves

Treatment

"Acne generally improves between eight and twelve weeks after starting therapy."

Dermatologists advise against Popping a pimple as it can cause infection and scarring, and it may

make the pimple more inflamed and noticeable. It also delays the natural healing process. Due to this,

it is usually best to leave pimples alone.

Skin care
Drink lot of water
Do yoga

In general, it is recommended that people with acne do not wash affected skin more than twice daily The application of a fragrance-free moisturizer to sensitive and acne-prone skin may reduce irritation. Skin irritation from acne medications typically peaks at two weeks after onset of use and tends to improve with continued use. Dermatologists recommend using cosmetic products that specifically say non-comedogenic, oil-free, and won't clog pores.

Acne treatments work in at least four different ways, including the following:
Reducing inflammation,
Hormonal manipulation,
Killing C. acnes, and
Normalizing skin cell shedding and sebum production in the pore to prevent blockage
.
Benzyl peroxide

Retinoids are medications that reduce inflammation, normalize the follicle cell cycle,, and reduce sebum production. They are structurally related to vitamin A Topical retinoids

include adapalene, retinol, tazarotene, trifarotene, and tretinoin.

Isotretinoin is an oral retinoid that is very effective for severe nodular acne, and moderate acne that is stubborn to other treatments.Contraindicated in pregnancy. Medical professionals typically reserve isotretinoin pills for severe acne, due to greater potential side effects

Antibiotics

People may apply antibiotics to the skin or take them orally to treat acne. They work by killing C. acnes and reducing inflammation.tetracycline (e.g., doxycycline ) and macrolide antibiotics (e.g., topical erythromycin Commonly used antibiotics, either applied to the skin or taken orally, include clindamycin , erythromycin, metranidazole, sulphacetamide, , and tetracycline (e.g., doxycycline or minocycline ). Doxycycline 40 milligrams daily (low-dose) appears to have similar efficacy to 100 milligrams daily and has fewer gastrointestinal side.

Hormonal agents

combine oral contraceptive pill

In women, the use of combine birth control pill can improve acne. These medications contain an estrogen and a progesterone They work by decreasing the production of androgen hormones by the ovaries and by decreasing the free and hence biologically active fractions of androgens, resulting in lowered skin production of sebum and consequently reduce acne severity

Spironolactone is an effective treatment for acne in adult women. spironolactone can successfully treat acne, especially in women with signs of excessive androgen production, such as increased hairiness or skin production of sebum, or baldness.

Azelaic is effective for mild to moderate acne when applied topically at a 20% concentration. Treatment twice daily for six months is necessary.

Salicylic acid is a topically applied beta-hydroxy acid that stops bacteria from reproducing and has keratolytic properties. It is less effective than retinoid therapy. Salicylic acid opens obstructed skin pores and promotes the shedding of epithelial skin cells. Dry skin is the most commonly seen side effect.

Alternate medicine

Ayurveda

Triphala: Taking 1 tsf Triphala powder at night with warm water.

Tea Tree Oil

For Pigmentation : Daily use of SPF 15 or higher sunscreen can minimize such a risk.

Keratolytic soaps

light therapy and laser therapy
Ayurvedic
Trikatu
Its a combination of three herbs. Dry ginger, black pepper and long pepper ratio 1;1;1`Take powder with water.