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A Professional's Guide To Treating Acne

Do you suffer from acne?

We are delighted to be an Acne and Rosacea Association UK (ARA UK) Accredited Treatment Centre. Professor Tony Chu is the national leading acne expert and Dr Elsmore has undergone his rigorous training to allow The Courtyard Aesthetic Clinic to deliver the optimal acne treatment service. This allows us to provide sufferers with correct and accurate information, help and support in achieving the best results in their treatment.

Acne is not just a teenage problem. Many people suffer in silence into their 30s and 40s; in fact, 20% of women and men continue to have acne beyond their teens.

If we understand acne properly, we can treat it more successfully and even prevent it from occurring.

There are 4 main steps in the pathway to inflammatory acne:

1. Increased sebum secretion

2. Build up of dead skin cells forming a partial blockage of the hair follicle (follicular hypercornification) and development of the blackhead (micro comedone)

3. Overgrowth of the bacterium p. acnes which is present on all our skins

4. Inflammation and development of pus or cysts

In the acne sufferer, sebum production is abnormally high and the risk of forming blackheads much higher. It is this micro-comedone which is the primary lesion of acne and for successful treatment it is essential to target this lesion. We can of course target each of these 4 steps and more besides.

Exacerbating Factors

A number of factors can lead to a break out of acne or may encourage it in a susceptible person.

Hormonal Changes: The onset of acne often coincides with puberty with the first bursts of androgens. In women, acne is often worse premenstrually.

Contraceptives: Second generation progesterones are the commonest in contraceptives including oral and depot contraceptives and are also in the Mirena coil. These have androgenic effects and can exacerbate acne. In an acneprone woman, changing to a third generation progesterone is often helpful eg Marvelon or Cilest. There are also some directly anti-androgenic pills such as Dianette and Yasmin.

High Humidity: With sweat retention against the skin or high humidity, the dead skin cells on the surface of your skin absorb water and swell. This can cause an acute blockage of the hair follicle and an intense inflammatory response and acne occurs.

Stress: Physical or mental stress stimulates the adrenal gland leading to production of adrenaline and steroids but also androgens. Unrecognised stress to the body may be responsible for acne flare ups in people who have a low level, non-clinical sensitivity to certain foods including gluten and lactose. It is not unusual for people to report that when they go on a gluten or milk free diet their acne improves. Stress in modern life may also be responsible for the persistence of acne in older age groups.

Drugs: A number of drugs may exacerbate acne such as corticosteroids, lithium, anabolic steroids and anti-convulsants.

We understand that acne often has a significant psychological impact on the sufferer. We only offer treatments which have strong evidence of their effectiveness. Alternative medical treatments e.g. long term oral antibiotics, are available via your GP. Not all acne is the same; it is important that the treatment your skin receives is appropriate for you and your acne subtype. Your skin consultation will ensure you receive a tailored program individual to your needs.

Example of Courtyard ZO Acne Protocol

1. Week 1 - Skin Care - ongoing daily home treatment


Exfoliating Cleanser

Exfoliating Polish

or Dual Action Scrub (escalation)

Complexion Renewal Pads

or Oil Control Pads (escalation)

Acne Control Cream

Correct and Conceal camouflage

Daily Power Defense

Daily Sheer SPF50

EVENING routine

Exfoliating Cleanser

Complexion Renewal Pads

or Oil Control Pads (escalation)

Daily Power Defense

Complexion Clearing Masque

2. Week 1- Zenii Pro Clear Supplement – ongoing daily supplement

Advanced micronutrient formula with vitamins, minerals, zinc, turmeric, and antioxidant support targeting acne skin, blackheads, oiliness and rosacea.

3. Week 4 – Start monthly Facials to maintain & optimise skin health

HydraFacial Platinum Bespoke with lymphatic drainage, deep cleanse, exfoliation and extraction with infusion of personalised booster (ZO Rozatrol booster for calming of inflamed active acne, or Murad Retinol booster for acne scarring), Blue LED light therapy face/chest/back.

4. Week 6 and Week 10 - Lumecca Intense Pulsed Light

Not only will the Lumecca IPL help with acne skin discolouration, but it also kills surface bacteria and decreases pore size helping to minimise trapping of oil. You will also benefit from overall skin rejuvenation with increased collagen, improved skin tone and radiance. Lumecca can also assist in reducing acne scarring.

5. Week 8 and week 16 – Morpheus8 or Microneedling

Acne scarring can be improved with microneedling treatments which tighten the skin through micro injuries with or without radio frequency which induce repair systems to be triggered in your skin. The resurfacing changes can be assisted with the addition of our award-winning supplement Zenii Skin Fusion which provides your body with the amino acids & peptides that are essential for collagen production.

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