Arggggh Acne!


By Professor Des Fernandes and Dr Ernst Eiselen

There is a great deal of information online about how to treat acne and there are even more products for sale that purport to do the job quickly and efficiently. The reason for this is probably that it is such a common condition and so many people are embarrassed by it.

We need to find a scientific and proven way to deal with the problem and, strangely enough, this might not be the most complicated or expensive one!

During the initial consultation, it is good to tease out all the lifestyle matters that may excarcerbate the problem before deciding on the final action plan. Hormones, allergies, diet, stress levels, genetics, medications, skincare products and many other things can all contribute to both its arrival and departure.

Dr Ernst Eiselen

  The Skin Science Authority's own Skin Analysis System provides a very sound guided client consultation that helps you to document  all the most important information you need to understand what is happening in your client's skin.It is during the skin consultation that trust is formed and a clear treatment plan agreed, with clear expectations set to ensure the client understands that the skin may get worse before showing signs of improving .

 What is happening?

 Acne is hormone-driven condition of sebaceous glands in skin. Misbehaving testosterone receptors create excessive sebum production and inner surface cells of the sebum conduits to the skin surface called follicles. The combination of events creates sticky plugs obstructing the follicles. This is an inflammatory complex, which then invites lipid-loving bacteria to colonise the fatty plugs, ramping up the inflammation to the ugly visible lesions known as pimples.  Severely inflamed lesions create tissue damage and scarring so well known to acne sufferers. 

Dr Ernst Eiselen



What to do about it


Vitamin A in many forms is able to alter the behaviour of the sebaceous glands and follicles to prevent the sequence of events that lead to acne. It does need to get to the target cells and receptors in an increased concentration for the therapeutic benefits to occur. Vitamin A occurs in several molecular forms in the body but to unlock receptor activity it needs to be in the acid forms. Vitamin A is the normalising vitamin for most skin conditions.

Dr Ernst Eiselen


The big problem for people in their late teens is the development of acne.This girl shows the oily skin with large pores, blocked follicles, blackheads, and acne typical of this problem. She should have lovely skin, and that is what she got after using a very simple regime of cleaning her skin gently with a gel cleanser and toning with a stronger alpha-hydroxy acid toner. She then used a gel formulation of vitamin A, betacarotene, and the antioxidants only once per day.

The patient reported that the change took about two months, while the photograph shows the result five months later.

To date I have found that this regime works on more than 70 per cent of cases. Other cases that are not responding as well require either better cleansing of the skin prior to washing by using mineral-oil-derived oil cleansers and make-up removers, more alpha-hydroxy or beta-hydroxy acids, or antiseptics like Australian tea tree oil and other ingredients that reduce sebum production. If that fails, then one needs to consider the advantages of skin peels. Diet generally does not play an important part, but by increasing the daily oral intake of vitamin A by 5000 to 10,000 IU or even 40,000 IU per day, acne may also improve. Failing that, special forms of oral vitamin A should be used like cis-retinoic acid.

No one today should have uncontrolled acne and get permanent scars and pits on the face. In recent years my approach has been refined to using the light peels right from the beginning. I teach patients to have one or two peels with a therapist and then very short ten-minute daily home peels followed by the application of the vitamin A, C, and E oil.

Professor Des Fernandes



Ongoing maintenance

 Acne is a permanent condition, which once in remission, can be ignited again if circumstances in the skin and hormonal systems conspire; usually at a time of hormonal changes. Better then to view cleared skin as being in remission and not cured. Acne skin in remission needs ongoing management to prevent recurrence.

Effective, practical and affordable long- term strategies that maintain remission of acne are not in abundance. 
Most doctors and therapists appear to ignore this reality. They simply wait for recurrences and then treat again. This is a curious thing! Especially as a very well designed and formulated treatment approach to both the primary problem and long term maintenance has existed for over two decades, but has not become recognised as the solution. Understanding that, with appropriate and effective vitamin combinations combined with weak organic acid treatments to control bacterial colonies and inflammation locally in the skin, acne can be kept at bay indefinitely in the majority of people. Maintaining and, in most cases, improving skin quality in the process is a great added bonus.  

 Dr Ernst Eiselen