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Understanding acne

How does acne develop?

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Oil Production: Your skin has small glands called sebaceous glands that produce an oily substance called sebum. This oil moisturizes your skin. 

Hair Follicles: Each hair on your skin grows out of a follicle, which has a tiny canal that connects to the surface of the skin.

Clogging Begins: Sometimes, the cells lining these follicles shed too quickly and mix with the sebum, creating a plug that blocks the follicle's opening.

Blackheads and Whiteheads: If the blocked follicle is open at the surface, you get a blackhead. If it's closed, you get a whitehead. These are both types of non-inflammatory acne.

Bacteria Enter the Scene: Bacteria on the skin, called Propionibacterium acnes, can start multiplying in the clogged follicle, leading to inflammation.

Inflammatory Acne: The body's response to this process can result in red papules, pustules, nodules, or cysts. These are examples of inflammatory acne.

What are the types of acne we treat?

We treat all the 4 grades of acne.​

Grade 1 - Mild : Mostly whiteheads and blackheads, occasional erythematous papules.

Grade 2- Moderate : Multiple erythematous papules and comedones with a few pustules.

Grade 3 - Moderately severe : Predominant erythematous papules and pustules, occasional nodules.

Grade 4 - Severe : Mainly cysts and nodules, widespread scarring.

What are the different Lifestyle and environmental factors that predispose to acne


Body mass index


Alcohol Consumption 

Psychological Stress


Prescription medicines

Anabolic and androgenic steroids

Seasonal factors


Lack of sleep/lnsomnia

What are the common causes of acne?​​

⦁    Familial tendency
⦁    Endogenous and exogenous androgenic hormones
⦁    Acne bacteria- Propionibacterium acne, Staphylococcus aureus
⦁    Hormonal causes like - Polycystic ovarian disease (PCOD)
⦁    Drugs: steroids, hormones, anticonvulsants and others
⦁    Application of occlusive cosmetics
⦁    High environmental humidity
⦁    Diet high in dairy products and high glycaemic foods- rice, chocolates, etc
⦁    Stress 
⦁    Dandruff 

What are the causes of acne specific to men?

Hormonal Changes: Androgens, which include testosterone, are male sex hormones that play a role in the development of acne. During puberty, there is a surge in androgen levels, leading to increased sebum (oil) production. Hormonal fluctuations can continue into adulthood and may be a contributing factor to adult-onset acne in men.

Increased Sebum Production: Sebaceous glands in the skin produce sebum, an oily substance that helps moisturize and protect the skin. Elevated levels of androgens can stimulate the sebaceous glands to produce more sebum, leading to clogged pores and the development of acne lesions.

Genetics: A family history of acne can increase the likelihood of developing acne. Genetic factors may influence the way the skin responds to hormonal changes, inflammation, and other acne-related triggers.

Sports and Physical Activities: Friction from helmets, hats, or sports equipment, as well as sweat and heat generated during physical activities, can contribute to acne development, especially if proper hygiene practices are not followed.

What are the causes of acne specific to women?

Hormonal Fluctuations:

Menstrual Cycle: Hormonal changes during the menstrual cycle, particularly in the days leading up to menstruation, can trigger acne in some women.

Pregnancy: Pregnancy-related hormonal fluctuations can lead to changes in skin conditions, and some women may experience acne during pregnancy.

Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder that can cause an imbalance in androgen levels, leading to increased sebum production and acne.

Skincare and Makeup Habits:

Use of Comedogenic Products: Certain skincare and makeup products may contain ingredients that can clog pores and contribute to acne. It's important to choose non-comedogenic products.

What is the science behind the E.N.D acne treatment plan ?

The E.N.D  acne treatment plan is the first plan in India that converges the power of three sciences - Endocrinology, Nutrition and Dermatology to target hormonal imbalances, brain-gut-skin connections, and precise skincare for holistic acne treatment.


By addressing hormonal triggers, emphasizing gut health, and offering personalized dermatological care, it aims to achieve clear, healthy skin through a comprehensive, multidisciplinary approach.

E.N.D. acne treatment plan

What is the aim of our E.N.D. acne treatment plan?

⦁    To first target the root cause 
⦁    Reduce severity 
⦁    Clear existing lesions 
⦁    Limit the spread of acne by preventing the formation of new lesions as well as scars
⦁    Avoid negative impact on the quality of life
⦁    Minimize emotional stress pertaining to cosmetic concerns

What could be the reasons for the poor response to acne treatment?

⦁    Consultation from non-professionals - quacks, neighbours, social media, etc.
⦁    Using poor quality of skin care products
⦁    Incomplete adherence to treatment protocols 
⦁    Using inadequate dosage to save money
⦁    Having unrealistic expectations of getting quick results

How do we design acne treatment ?

Our treatment plans are designed according to the US FDA guidelines and are fully personalized.
We classify acne into four grades: mild, moderate, moderately severe, and severe and plan treatment accordingly.


These plans encompass topicals, oral drugs, and supplements. We first plan a consultation with our dermatologist and depending on the root cause, we coordinate your consultation with a gynecologist, endocrinologist or nutritionist.

What does the E.N.D acne treatment kit include?

The treatment kit typically includes the following products-​

  1. Anti-acne face wash or cleansers

  2. Medicated gel and creams

  3. Moisturizer 

  4. Acnepads 

  5. Sunscreens 

  6. Oral medications

  7. Probiotics 

  8. Oral supplements 

  9. Anti dandruff shampoo

Please note that the products in the kit may vary as per the grade of acne. All topicals are non comedogenic.

What does the E.N.D acne treatment kit include?

Typically, it takes 2-4 weeks to begin noticing results. Nevertheless, the duration  may vary depending on the individual case.

It's important to note that consistent usage of all the products simultaneously, as  per the prescribed dosage, is crucial to achieve the optimal results.

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