Medical & Surgical Dermatology


Acne is the most common skin problem in the United States. It occurs in the form of blackheads, whiteheads, pimples and lumps, sometimes called nodules. Acne results when a pore in your skin is clogged with dead skin cells or bacteria cause inflammation inside your pores.


Common causes of acne:

  • Bacteria causing inflammation within pores 
  • Environmental factors, such as humidity, causing swelling of the skin
  • Certain medications
  • Genetic factors
  • Hormonal changes
  • Oil glands producing more sebum (an oil that prevents skin from drying out)
  • Pores clogged with dead skin cells


Most acne appears on the face, but it can also be on the shoulders, upper arms, chest, neck and back. 


Adult Acne


Acne dermatologists classify acne before treatment; it varies from mild to moderate in most cases. Mild acne is classified as having a few to several blemishes, and moderate acne consists of several to many blemishes. Severe acne is classified as many or extensive blemishes, including acne cysts.

Untreated acne can be emotionally damaging, especially in the teenage years. Acne scarring, low self-esteem, depression and anxiety can result from untreated acne, so talk to a Water’s Edge dermatologist and get serious medicine for your skin.

Acne Scarring

Acne scarring is a frustrating problem for both patients and physicians. It has a high prevalence in acne patients and can be psychologically devastating to patients with severe cases. The causes of acne scarring are complex and each patient needs to be approached on an individual basis.


Water’s Edge Dermatology offers comprehensive treatment of acne scarring. Treatments offered include: subcision, Fractional CO2 laser, chemical peels, fillers injected underneath scars, and mini-excisions of large scars. During your consultation your specific scars are categorized (rolling, boxcar, icepick, etc.) and a treatment plan is tailored for your specific skin tone and scars, which can significantly improve the appearance of your skin.


Acne Scarring Treatments
Adult Acne

Teenage Acne

Fractional CO2 Laser (DOT Laser)


Fractional ablative lasers have revolutionized the treatment of acne scarring. The procedure involves the delivery of a laser beam that is broken up into hundreds of very small columns, which put tiny holes in the skin. As these small wounds heal, new collagen is laid down underneath the skin (a process called “collagen remodeling”), which can smoothen out the surface of the skin. Advantages over traditional CO2 resurfacing include faster healing time and a lower risk of complications. As part of a comprehensive acne scarring treatment plan, fractional laser resurfacing can improve skin which has been damaged by prior severe acne.



Subscision is an excellent treatment for “rolling” or “boxcar” type acne scars, which often have fibrous attachments holding the base of the scar down to the underlying deeper tissue.  After the surrounding skin is numbed with a local anesthetic, a small needle is carefully inserted under the skin to cut and release these attachments beneath the scar.  During the healing process, collagen remodeling occurs and new collagen is laid down underneath the scar, further improving the smoothness of the skin.  Occasionally a filler substance can also be injected under the scars after subscision to make the scar look less visible and to produce the results wanted. 


Chemical Peels

Chemical peels work by producing a controlled injury to the top layers of the skin, which is followed by a healing response that produces smoother, softer, more youthful skin. Superficial chemical peels are useful for decreasing the signs of aging such as fine lines, but can also be used to treat brown spots, melasma, acne, acne scarring, and keratoses. Superficial chemical peels are safe in all types of skin, including ethnic skin. There is virtually no downtime after such peels.


Chemical peels are used in two ways for acne scarring:

1) The first method is the CROSS technique, in which a small amount of high concentration of trichloroacetic acid (TCA) is placed directly into an acne scar, creating a wound. The collagen remodeling and healing process that ensues can smoothen out the skin at the site. Usually multiple treatments are required.


2) The second method is a total face chemical peel, in which a lower concentration of TCA, Jessner’s solution, salicylic acid, or glycolic acid. The skin is rejuvenated as it heals.



Dermabrasion is an excellent technique for improving skin damaged by acne scars. Different from “microdermabrasion,” dermabrasion is a procedure in which layers of skin and underlying scar are precisely contoured with a small, hand-held medical-grade sander. The procedure requires local anesthesia for comfort, and the skin usually heals in 7 to 10 days.


Mini-Excision of Scars

Certain scars such as very deep scars or scars that project outward from the skin are often best removed surgically. The scar is cut out completely and the skin edges are carefully brought together with sutures. The final scar is much less visible than the original acne scar.


Filler Injections

Injectable filler substances such as Restylane, Juvederm or Belotero can be injected under acne scars to smoothen out the skin. The improvement in the appearance of the skin is immediate and lasts for many months as the material slowly degrades. Some of the improvement may be permanent.


Comprehensive Acne Scar Treatment

Often a combination of procedures is required to provide the maximum amount of improvement in acne scarring. Fractional laser therapy may be combined with chemical peels, subcision, and/or fillers to provide you with the best improvement to your scarring as possible. A treatment plan is organized for each patient’s specific scars. This comprehensive acne scarring therapy will give the highest chance for improvement in acne scarring.


Acne Treatment

Unfortunately, acne is not a curable condition, but your Water’s Edge acne dermatologist can treat your acne and help prevent new breakouts from occurring. Water’s Edge offers several treatment options, and your acne dermatologist will determine the right treatment for you.


Acne treatments include:

  • Topical prescriptions
  • Acne surgery
  • Microdermabrasion
  • Oral antibiotics or birth control pills
  • Photodynamic therapy

Acne Prevention

Acne treatments prevent new breakouts from occurring, but you must let existing blemishes heal. This is why acne treatments can take a few weeks to make noticeable improvements.


Tips for acne prevention:

  • Wash your face twice a day and after perspiring
  • Use your fingers to cleanse your face, anything else could cause irritation
  • Use gentle, alcohol-free cleansers that don’t dry out your skin
  • Do not scrub your skin
  • Use lukewarm water, not hot water
  • Do not pop or pick at your acne
  • Try to keep your hands away from your face
  • Protect your skin from sun overexposure
  • Use only oil-free, water-based moisturizers and cosmetics


Click here for more tips to prevent acne.


Learn what your Water’s Edge acne dermatologist can do to help you with your acne. Click here to schedule an appointment for serious medicine for your skin.

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