What is acne?
Acne is a disorder of the pilosebaceous unit (follicle and oil gland). Acne usually occurs whenpores are blocked by oils, skin cells and normal bacteria. This usually leads to the development of a comedone. A comedone can be opened to the surface (a blackhead) or closed (whitehead). Bacteria and oil surrounding the pilosebaceous unit causes inflammation which can lead to red bumps (papules) and pustules. These lesions can increase in size to cause red painful nodules and cysts. The greater the inflammatory response the more likelihood hyperpigmentation (dark spots) or acne scars can develop.
Acne is usually a disorder of adolescent but post adolescent acne is increasingly more common. 40% of women with acne reports that their acne occurred after the age of 25. Adult acne tends to be more hormonally related and is distributed more commonly in the lower 1/3 of the face (lower cheeks, jawline, neck). Lesions usually consists of inflamed lesions but can present with black heads and whiteheads. If acne is associated with excessive hair, abnormal menstrual cycles or significant flare with your menses, or deepening of your voice, lab work may be needed to test for androgen excess or abnormal hormones. Non traditional acne treatments utilizing anti-androgens may be necessary.
Is diet related to acne?
Recent studies revisited the link between diet and acne. There is now evidence to suggest that a “Non-Westernized Diet” may help to improve acne. This type of diet can consist of a low glycemic load (virtually no processed foods/refined sugars), high Omega-3 (seafood and fish), minimal dairy, high in antioxidants, and high in fibers. A diet similar to the “South Beach Diet” has a low glycemic load.
Dairy appears to be weakly associated with acne. Skim milk is most strongly correlated with acne. Alternative suggestions include almond or soy milk.
There may be a possible role for antioxidants in the treatment of acne. Useful oral and/or topical antioxidants include green tea, lycoprene, reservatrol (found in the skin of red grapes, red wine, peanuts, mulberries, etc.), Vit C, Vit A, Vit E or nicotinamide. Selenium and zinc supplements may be of value in acne. As with any balanced diet, excessive ingestion of any of the times should be avoided secondary to detrimental side effects.
How can acne and acne scarring be treated?
Treatments for Acne:
- Treat excessive oil (salicylic acid, sulfur/sulfacetamide, Clinac OC and other oil absorbing ingredients)
- Treat comedones with retinoids (tretinoin, retin-A, Tazorac, Differin, Atralin) or combination products (Epiduo, Ziana, Veltin). Clarisonic home care system for deep pore cleaning.
- Treat bacteria and inflammation (antibiotics, benzoyl peroxide, Aczone)
- Accutane (oral isotretinoin) suppresses sebaceous (oil) gland activity and is very effective for acne but has many potential serious side effects. Monthly visits and labs are recommended.
- Photodynamic Therapy (PDT) involves a topical medication applied to acne prone skin. This medication is activated by a light source (blue light, red light, IPL Photofacial, Vbeam Pulse Dye Laser) to target the pilosebaceous unit. This treatment improves acne by inhibition or destruction of sebaceous glands. PDT may induce anti-microbial and anti-inflammatory effects. PDT is considered as a treatment option in individuals who do not want to take oral antibiotics or Accutane.
- Treat post inflammatory hyperpigmentation (hydroquinones, azelaic acid, kojic acid, arbutin, soy, vit C, Melaplex/Perle, oligopeptide/Lumixyl, chemical peels, microdermabrasion, Silk Peels)
- Treat scarring with non ablative and ablative fractional resurfacing (Fraxel laser, Nd:YAG laser or CO2RE CO2 fractionated laser).
Many of these products and procedures can treat one or more causes of acne or its sequelae. Usually a combination of treatments gives the best results.
Successful treatments aim to target inflammatory lesions (nodules, cysts, papules or hard bumps) and non-inflammatory lesions (blackheads or whiteheads). Post inflammatory hyperpigmentation can cause skin discoloration or if the lesions are deep can cause significant scarring.
Our professional staff will work with you to develop a comprehensive program to treat your acne, post-inflammatory hyperpigmentation and scarring.