Acne Vulgaris

Acne Vulgaris, usually simply called Acne, is a very common skin problem, usually more pronounced during teenage years, though it does happen often enough in adults, too. While it is very common, and it sometimes clears without medical treatment, left untreated it may also become serious enough to cause permanent scarring.

Teenagers are at an especially worrisome time for their appearance to be less than ideal: there are enough other changes going on to worry about.  Acne can be a very noticeable skin problem and can be controlled in almost every case.  Each person is different, however, and some patients clear much more easily than others.

Teenagers are more likely to have acne because of hormonal changes, increasing the productivity of oil glands in the skin and subsequent blockage.   The blocked pores contain growing bacteria which then irritate the skin (causing the redness around each blocked pore).  The blockage can also cause increased build-up of normal skin pigmentation in the ducts and even trap more light, causing spots that appear darker: “blackheads”.

While some experts have reason to suggest that reducing milk and dairy product intake might help reduce acne, experimental results have not yet shown strong indications. While eating chocolate probably has nothing to do with acne, the role that diet plays in acne is not completely clear; we are waiting for more experimental results.

Topical or systemic corticosteroids can be a cause of acne. Treatment for this is the same as for other causes.

Cleansers can help: use of “non-comedogenic” products (literally, those which don’t promote the growth of pimples) which are formulated to unclog the pores is beneficial.  In addition, antibiotics to help get rid of the offending bacteria often knocks out the cause of the inflammation.  Some “cosmetic” procedures (not covered by insurance) that may help include microdermabrasion and chemical peels (if you’re interested in this, please ask). Serious cases may be treated with Isotretinoin.  Isotretinoin must be used carefully, and users and dermatologists must adhere to a specific protocol, but it can completely clear extensive acne that seems otherwise untreatable.

Your case is, of course, individual.   While the length of your treatment cannot be guaranteed, you should know that almost all cases can be cleared.  All of our patients who complete acne therapy have found they smile more easily when they look in the mirror.  We look forward to that just as much as you do!

Small “blackheads” on a nose                        Acne scarring

To determine how you feel about your acne, you might want to consider these questions:

Over the past week, has your acne caused you to:

1. feel unattractive or dissatisfied with your appearance
2. feel upset
3. be concerned about meeting new people
4. be concerned about scarring

If you answer “yes” to any of the above, we would like to help.

Treatments:

To treat acne, we use many different therapies depending on your condition and your preferences.  These include:

• topical therapies, including cleansers, antibiotics, benzoyl peroxide and retinoids
• systemic antibiotics
• hormonal therapy
• isotretinoin
• acne surgery
• chemical peels, microdermabrasion and laser therapies (generally not covered by insurance)

“Acne surgery” is best done by your dermatologist in the office. Picking worsens acne and leaves scars — often the mark or scar from the picking is worse than the acne itself. In addition, habits such as picking, absent mindedly touching, rubbing or squeezing acne on your skin can trigger flares of pre-existing acne. Also, cysts and nodules can develop from the contents of the pimple leaking out into the surrounding tissue.

Especially with some of the oral antibiotics, sunburn may occur with less sun exposure than usual, so be careful when you go in the sun during the summer or on vacation, including skiing in higher altitudes. If you are using tetracycline and/or retinoids, the treated areas may be more easily sunburned than before. It is very important to use a sunscreen when using these products because the sun protective skin layer is thinned. If oral antibioitics doxycycline or tetracycline are taken with the evening meal, the increased risk of sunburn is reduced almost to zero.

Know that treatment for acne does not show results quickly because the causes of acne do not disappear quickly.  With daily treatment it takes 3 to 4 months to slow oil gland production, several months more to clear, and all this only while therapy is maintained. With good advice, good treatment regimens, and daily care, most are able to clear their acne.

If you already have scarring from acne, these treatments are available to you at our office, though probably not covered by insurance:

• chemical peels
• microdermabrasion
• laser therapy

“I have been going to Dr. Basuk for my acne for 2 years. I have recently started Accutane and have been on it for 2 months. The results have been amazing and the acne is now under control and almost gone! I feel like a new person. Dr. Basuk and her staff are wonderful and have been very helpful through the process.” – M.D., Hauppauge

“… my son was placed on Accutane … cleared his skin so quickly and completely with very minimal side effects.. – Judy N., Islip Terrace  [click for full quote]