When you wash your face gently, and over-the-counter products do not clear the skin of blemishes, it may be time to see a board certified dermatologist. Although acne is more common during the teenage years, it can strike during adulthood. Adult acne can be embarrassing and cause men and women to feel self-conscious about their appearance. Acne can appear on the face, shoulders, back, chest, and neck. The Integrated Dermatology team takes the time to explain how acne develops and the treatments available.
LEARNING ABOUT ACNE
Acne affects millions of people. Signs and symptoms vary depending on the severity of the condition. Acne can include whiteheads, blackheads, papules, pustules, and cystic legions. Whiteheads are closed plugged pores. When the oil in the pores is exposed to air and turns brown, the open plugged pores are called blackheads. Papules are small red, tender bumps. Pustules, often called pimples, are papules with pus at their tips. Severe acne includes red bumps beneath the surface of the skin called nodules and pus-filled lumps (cystic lesions). Severe acne can be painful and leave scars.
Acne leads as the most common skin condition. It usually develops during puberty, but many adults also live with acne. The pores become clogged when dead skin cells mix with oil in the skin. This mixture leaks into nearby tissues and can lead to redness, swelling, and pus. Patients may experience anything from a few red spots to large, red lumps. Anybody is susceptible to developing acne; from newborns to adults. The skin condition often will develop on the face, chest, shoulders, and back.
THE CAUSES OF ACNE
The main factors that cause acne are oil production, dead skin cells, clogged pores, and bacteria. Other factors can trigger or aggravate an existing case of acne including hormones, certain medications, and diet.
Hormones that increase during puberty can cause the sebaceous glands to enlarge and make more sebum, which is an oily substance that keeps the skin and hair lubricated. When sebum and dead skin cells mix, the pores can become clogged and infected. This results in skin inflammation. Hormonal changes related to pregnancy and the use of oral contraceptives can affect sebum production. Contrary to popular belief, cosmetics and eating greasy foods have little effect on acne.
ACNE TREATMENTS
Acne affects 40 to 50 million Americans at any time, according to the American Academy of Dermatology. Fortunately, there are many safe and effective treatments. Some patients in Quincy, MA ask, “Is there a dermatologist near me who treats acne?” The Integrated Dermatology team is comprised of board certified dermatologists and physician assistants who provide acne treatments that can reduce, control, or eliminate acne. We understand not every acne treatment works for everyone; however, we can tailor plans to meet the individual needs of our patients. Our treatments include:
TOPICAL MEDICATIONS
Medications such as retinoid cream or gel work best when applied to clean, dry skin 20-30 minutes after washing. We recommend applying a pea-sized amount of the cream or gel on the end of the index finger and apply it evenly around the face, to include areas there is no acne. Retinoid medication works by preventing plugging of the hair follicles.
ORAL MEDICATIONS>
Oral medications may be recommended for moderate to severe acne to reduce bacteria and fight inflammation. As symptoms improve, we will likely recommend tapering off of these medications, which helps prevent antibiotic resistance.
LIGHT THERAPY
Our Quincy office has the largest phototherapy center in Boston. We offer various light-based therapies to reduce acne and improve its symptoms.
CHEMICAL PEELS
Chemical peels involve applying a chemical solution to the skin. The outer layer will eventually slough off; revealing fresh, rejuvenated skin. Chemical peel treatment can be ideal for acne scarring.
DETERMINING THE RIGHT TREATMENT
Whether you have adolescent, hormonal, or adult acne or rosacea, effective treatment is available. During our acne visits, we explore possible causes of acne, treatment options, and general skin care.
The severity of acne will help us provide an accurate diagnosis and treatment. We will carefully examine the skin and ask about current medications patients may take. Then, we tailor a treatment plan that can include a skin care regimen suited to their needs. It is important that patients gently wash their skin to prevent the acne from becoming worse.
At Integrated Dermatology we are not only skilled in treating acne, but are experts in repairing the scars that can result from blemishes. There is no need to continue to suffer from acne with the medications now available.
RETIN-A (TRETINOIN), DIFFERIN (ADALPALINE), OR TAZORAC (TAZAROTENE)
These creams/gels should only be used at night, since they are inactivated by sunlight, and can cause your skin to become sensitive to the sun while they are on your skin. The best thing to do is apply it to your skin before you go to bed, and then wash it off in the morning. Here’s how to apply it…
Before you go to bed, wash your hands and face. Wait 20-30 minutes after washing your face to apply the medicine. Then, take just a pea-sized amount of the cream (or gel) and put it on the end of your index finger. Take that pea-sized amount, and dot it evenly all over your face (even to places where you do not have acne), concentrating more on the problem areas. Then, go back and rub all the little dots into your skin. After you have done this, if there is still some cream/gel showing on your face, then you have used too much! Using more than a pea-sized amount for your entire face can actually make your acne worse, not better.
If your back and chest also break out in acne, you can apply one pea-sized amount to your chest, and another pea-sized amount to your back. Follow the same application directions as above.
In the beginning, your skin may actually become more irritated from this nighttime cream/gel because your skin is not used to it. That’s O.K. If this happens, then instead of using it every night, try every-other-night, or even every-third-night. Gradually, over the course of a month or two, you can try building back up to every night, as your skin starts to get used to it. If by the time of your next visit your skin is still irritated, we can change your medicine to a different one.
If you experience some dryness on your skin during the course of using these medicines, you can certainly use some over-the-counter moisturizers that are “non-comedogenic” (i.e., “non-acne forming”). Examples are Cetaphil, Aveeno, and Eucerin, among others.
It usually takes about 6-8 weeks of using these medicines regularly until you start to see improvement. Be patient!
These medications should NOT be used during pregnancy.
