Medical & Surgical Dermatology
AcneAcne is a skin condition which has plugged pores (blackheads and whiteheads), inflamed pimples (pustules), and deeper lumps (nodules). Acne occurs on the face, as well as the neck, chest, back, shoulders and upper arms. Although most teenagers get some form of acne, adults in their 20’s, 30’s, 40’s, or even older, can develop acne. Often, acne clears up after several years, even without treatment. Acne can be disfiguring and upsetting to the patient. Untreated acne can leave permanent scars; these may be treated by your dermatologist in the future. To avoid acne scarring, treating acne is important.
Types of Acne and How Acne FormsAcne is not caused by dirt. Testosterone, a hormone which is present in both males and females, increases during adolescence (puberty). It stimulates the sebaceous glands of the skin to enlarge, produce oil, and plug the pores.
Whiteheads (closed comedones), blackheads (open comedones), and pimples (pustules) are present in teenage acne.
Early-age acne occurs before the first onset of menstruation and is called prepubertal acne. When acne is severe and forms deep “pus-filled” lumps, it is called cystic acne. This may be more common in males.
Adult acne develops later in life and may be related to hormones, childbirth, menopause or stopping the pill. Adult women may be treated at menstruation and ovulation when acne is especially severe, or throughout the entire cycle.
TopicalsYour Water’s Edge Dermatology practitioner may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. Before starting any medication, even topical medications, inform your practitioner if you are pregnant or nursing, or if you are trying to become pregnant.
Special TreatmentsAcne surgery may be used by your Water's Edge Dermatology Practitioner to remove blackheads, and whiteheads. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result.
Microdermabrasion may be used to remove the upper layers of the skin improving irregularities in the surface, contour, and generating new skin. Light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin growth. Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly.
Birth Control PillsBirth control pills may significantly improve acne, and may be used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills. This is uncommon, but possible, especially if you notice break-through bleeding. As a precaution, use a second form of birth control.
CleansingAcne has nothing to do with not washing your face. However, it is best to wash your face with a mild cleanser and warm water daily.
DietAcne is not caused by foods. However, if certain foods seem to make your acne worse, try to avoid them.
CosmeticsWear as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used.
A flesh-tinted acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation is also good cover-up. Shield your face when applying sprays and gels on your hair.
Control of acne is an ongoing process. All acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own, therefore, improvement takes time. If your acne has not improved within two to three months, your treatment may need to be changed.
Occasionally, an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help your Water’s Edge Dermatology practitioner by providing an updated history of what you are using on your skin or taking internally.
Many non-prescription acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully. Oral antibiotics taken by mouth such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed.
In cases of unresponsive or severe acne, isotretinoin may be used. Patients using isotretinoin must understand the side effects of this drug. Monitoring with frequent follow-up visits is necessary. Pregnancy must be prevented while taking the medication, since the drug causes birth defects.
Women may also use female hormones or medications that decrease the effects of male hormones to help their acne. Photodynamic therapy using the blue wavelength of light can be helpful in treating acne as well.
Treatment of Acne Scarring
Your Water's Edge Dermatology practitioner can treat acne scars by a variety of methods. Skin resurfacing with laser, dermabrasion, chemical peels, or electrosurgery can flatten depressed scars. Soft tissue elevation with collagen or fat-filling products can elevate scars. Scar revision with a microexcision and the punch grafting technique can correct pitted scars, and combinations of these dermatologic surgical treatments can make noticeable differences in appearance.
Proper Care is NecessaryNo matter what special treatments your Water’s Edge Dermatology practitioner may use, remember that you must continue proper skin care. Acne is not curable, but it is controllable; proper treatment helps you to feel and look better and may prevent scars.
Moderate Acne Severe Acne