June is Acne Awareness Month! Dr. Amanda Doyle is here to reduce the stigma on Acne, and shine some light on one the most common skin conditions that affects millions of people everyday. Acne is both a physical and emotional burden, but it is curable, so let us help you achieve clear skin. Keep reading to learn everything you need to know about Acne from Dr. Amanda Doyle.
· According to the American Academy of Dermatology, Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually.
· Approximately 85 percent of people between the ages of 12 and 24 experience at least minor acne, but acne can occur at any stage of life and may continue into one’s 30s and 40s.
· Acne occurring in adults is increasing, affecting up to 15 percent of women.
What Causes Acne?
In the past, we used to think of acne as a straightforward condition. The typical acne pathway was: you had an open or closed comedone (known as a whitehead or blackhead) that got secondarily infected with a bacteria called P. acnes. Then, around this area, inflammation would develop, which resulted in the small or large red bumps we know as acne. We now know that it’s a little bit more sophisticated and complex than that. That process is still certainly part of the acne pathway. But, for many patients, acne is multifactorial and we know that acne can be due to a variety of different causes:
HORMONES: One of the most common causes is hormonal fluctuations. Stress can trigger a spike in one’s cortisol level. This stress hormone can wreck havoc on our bodies and skin and can result in acne flares.
LIFESTYLE: Acne can be related to lifestyle choices like diet: patients that have a higher glycemic index diet or those who eat too much processed foods and dairy often report an increase in acne.
PRODUCTS: Acne can also be caused by the products we apply on our face and the supplements that we ingest. Certain types of topical vitamin C and certain supplements can exacerbate acne. I’ve seen patients have acne from different types of cosmetics that are oil based so it’s very important to use oil-free, non-comedogenic products.
MEDICATIONS: Acne can also be due to medications. For example, different types of birth controls, IUDs, or oral and topical steroids can exacerbate acne if used for prolonged periods.
How Dr. Doyle Treats Acne
We have to get to the core cause of acne to effectively treat it. Step one is determining what type of acne a patient has. Is it medication or supplement related, or is it something exogenous in their environment that we can eliminate to improve their skin? If we eliminate that factor, will the skin improve? Figuring this out is a significant part of a long-term, successful regimen. In addition, working with the patient to get them on a solid regimen to optimize skin health and reduce acne is just as critical.
I typically treat acne from a multifactorial approach. We go over lifestyle additions that can be helpful for overall wellness and combine that with a tailored topical and/or oral regimen. For example, for very mild acne we may just need a good face wash, an oil-free moisturizer, sunscreen and a light retinol at night. If there’s a hormonal component, we can add something to address this like spironolactone or birth control. For someone with more inflammatory cystic lesions, we can add on oral antibiotics for a short period of time. If the acne is severe enough, we can consider multiple modalities. Every regimen is tailored to the patient’s needs.
While an at home regimen is a large part of the success, we can also do chemical peels as well as laser and light-based procedures to speed up and/or enhance results. Chemical peels containing alpha hydroxy acids like glycolic acid and beta hydroxy acids like salicylic acid can be helpful for lifting acne and acne-related pigmentation. Certain laser treatments, especially in combination with different topicals, can be quite effective. Red light treatments reduce swelling, redness and inflammation, improving the tone to create a more even complexion.
Post Acne: Acne Scarring and How to Treat it
Once we know that the skin is clear, and the patient is happy on their regimen and not developing new lesions, we also address any remaining scarring. Scarring leaves textural changes like depressions and concavity, which creates a lack of smooth, even skin. There are many kinds such as boxcar or icepick scarring and this type of textural change is permanent despite successful treatment of the acne itself. Luckily, we have tools to treat scars to make the skin more clear, smooth and even. My favorite treatment is our signature laser needling, which combines Clear+Brilliant with microneedling with PRP (platelet rich plasma).
We also have options for less severe scarring such as chemical peels or Clear+Brilliant on its own. If necessary, for more severe scarring, we can also consider modalities such as fractional laser, TCA cross and/or filler for scarring. Just like acne treatment, acne scarring treatment is tailored and customized to each patient’s needs.
Are you struggling with acne? Russak Dermatology Clinic is here to help! Give us a call at 646-873-7546 or email email@example.com to schedule your appointment today.