Acne


Acne is the most common skin condition in the United States. Though common, accurate information about acne can be scarce. Today, virtually every case of acne can be successfully treated. Dr. Groysman can help treat existing acne, prevent new breakouts and reduce your chance of developing scars.

Why treat acne?

Dermatologists know that letting acne runs its course is not always the best advice. Here’s why:

  • Without treatment, dark spots and permanent scars can appear on the skin as acne clears.
  • Treating acne often boosts a person’s self-esteem.
  • Many effective treatments are available.
  • Acne signs

Many people think that acne is just pimples. But a person who has acne can have any of these blemishes:

  • Blackheads
  • Whiteheads
  • Papules
  • Pustules (what many people call pimples)
  • Cysts
  • Nodules

Who gets acne?

If you have a bad case of acne, you may feel that you are the only one. But many people have acne. It is the most common skin problem in the United States. About 40 to 50 million Americans have acne at any one time. Most people who have acne are teenagers or young adults, but acne can occur at any age. Newborn babies can get acne. Men and women get acne. Some women get acne well into 20’s, 30’s, 40’s and even 50’s.

What causes acne?

Causes of Acne Acne is caused by several factors:

  1. Abnormal maturation of the skin
  2. Hormonal influences
  3. Bacteria
  4. Diet
  5. Oil overproduction

Acne appears when a pore in our skin clogs with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (oil), that normally keeps our skin from drying out, the dead skin cells can stick together inside the pore.

Hormonal fluctuations that happen during puberty, menstrual cycle or pregnancy many influence the sebum production.

Diet plays a role as well, since diet high in carbohydrates and dairy raises glycemic levels which in turn raises insulin levels. This contributes to higher male hormone and oil production. Higher male hormone production contributes to increase levels of sebum or oil production. Sebum makes the cells sticky, so the cells become trapped inside the pore.

Sometimes bacteria that live on our skin, p. acnes, also get inside the clogged pore. Inside the pore, the bacteria have a perfect sticky environment for multiplying very quickly. With loads of bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears.

How does Dr. Groysman treat acne?

Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be controlled.

Since acne is caused by multiple factors, treatment of acne will require both topical and oral medications.

Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Dr. Groysman, may call this topical treatment. There are many topical acne treatments. List of Topical Treatments:

  • Benzoyl Peroxide cleansers are available over the counter (Panoxyl) These cleansers will bleach fabrics, so be careful with towels and wash cloths and collars of clothes.
  • Topical antibiotic (clindagel, clindamycin foam, Cleocin-T solution, Erythromycin 2% gel) - apply a thin layer to acne areas once or twice daily as prescribed.
  • Combination benzoyl peroxide and topical antibiotic (such as Benzaclin, Duac, Acanya) - apply a small amount to clean skin once daily. These can be applied morning However, these will bleach fabrics, so make sure they are completely dry before pulling on a shirt. If you are applying this medicine at night, use an old pillowcase since it will bleach any fabric.
  • Topical retinoid (Differin lotion or gel, Retin-A Micro, Atralin, Tazorac cream or gel, tretinoin cream or gel, Veltin, Ziana, Epiduo) - Wash your face and let it dry. Then apply a pea-sized amount to your entire face, except right around the eye area, corners of the mouth and nose. This medication is usually used at night unless you have been instructed otherwise by your doctor. Start by using this product three times a week, then every other night and increase to nightly use as tolerated. If your face is irritated or dry, make sure that your face is completely dry before you are applying the medication. You may apply an oil free moisturizer first then apply your retinoid product, if your face is dry.
  • Topical Dapsone (Aczone gel)- Wash your face and let it dry completely Then apply a small amount to your entire face (and/or chest and back as directed). You can apply a moisturizer and make-up after the medication dries (about 5 minutes). Use twice a day unless otherwise directed.

Acne treatment that works throughout the body:

Medicine that works throughout the body may be necessary when you have red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these oral treatments:

  • Antibiotics (helps to kill bacteria and reduce inflammation).
  • Spironolactone (decreases male hormone production).
  • Birth control pills and other medicine that works on hormones (can be helpful for women).
  • Isotretinoin (the only treatment that works on all that causes acne).
  • Zinc supplementation (decreases inflammation responsible for acne).

Procedures that treat acne:

Dr. Groysman may treat your acne with a procedure that can be performed during an office visit. These treatments include: Lasers and other light therapies:

  • Photodynamic blue light therapy. This requires and application of a medication followed by exposure to blue light. You must stay out of the sun for 48 hrs. IPL treatment may also be helpful with acne reduction. First yours skin will be numbed with topical anesthetic and then a laser is applied. You should experience redness for 3-5 days after the treatment.
  • E-matrix facial rejuvenation - decreases acne scarring
  • Chemical peels: You cannot buy the chemical peels that dermatologists use. Dr. Groysman uses chemical peels to treat 2 types of acne - blackheads and papules. Please ask us at your appointment what chemical peel would work best for you. At Cahaba Dermatology we have glycolic, salicylic and TCA peels. Peels come in different strength and must be applied by a professional for best results.
  • Acne removal: If a lesion gets large, we may perform extraction of the lesions. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.

What outcome should you expect?

Waiting for acne to clear on its own can be frustrating. Without treatment, acne can cause permanent scars, low self-esteem, depression, and anxiety. Your acne will most likely get worse before it gets better. You should expect 50% improvement by 3 months of treatment! Treatment of acne is not easy. So please be patient and use your medicine as prescribed. When the skin clears, treatment should continue! Which means you shouldn’t stop any treatments without instruction by your physician. Treatment prevents new breakouts. Your dermatologist can tell you when you no longer need to treat acne to prevent breakouts.

You can reduce your acne by following these skin care tips from Dr. Groysman.

  1. Wear oil-free sunscreen everyday
  2. Wash twice a day and after sweating. Perspiration, especially when wearing a hat or helmet, can make acne worse, so wash your skin as soon as possible after sweating.
  3. Use your fingertips to apply a gentle, non-abrasive cleanser such as Purpose face wash, Cetaphil or Cerave facial cleanser.
  4. Be gentle with your skin. Use gentle products, such as those that are alcohol-free. Do not use products that irritate your skin, which may include astringents, toners and exfoliants. Dry, red skin makes acne appear worse.
  5. Scrubbing your skin can make acne worse. Avoid the temptation to scrub your skin.
  6. Rinse with lukewarm water.
  7. Don’t use pre-moistened clothes, they can make your face more sensitive.
  8. Shampoo regularly. If you have oily hair, shampoo daily.
  9. Let your skin heal naturally. If you pick, pop or squeeze your acne, your skin will take longer to clear and you increase the risk of getting acne scars.
  10. Keep your hands off your face. Touching your skin throughout the day can cause flare-ups.
  11. Wear mineral based make-up such as Jane Irendale, Color Science, Bare Minerals.
  12. Stay out of the sun and tanning beds. Tanning damages you skin. In addition, some acne medications make the skin very sensitive to ultraviolet (UV) light, which you get from both the sun and indoor tanning devices.

If you have questions or concerns about caring for your skin, you should make an appointment with Dr. Groysman to discuss treatment. Call us 205-214-SKIN.

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