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Medical Dermatology


Acne is the most common skin condition that affects about 50 million Americans, of all ethnicities. Acne affects 85% of people between the ages of 12 and 24 and over 20% of adult women in their 30s and 40s.

Acne Vulgaris is the most common form of acne. Acne vulgaris has significant social and psychological effects. Studies report that severe acne can affect a person’s quality of life, self-esteem and mood. While acne is not a permanent condition, it can be disfiguring. Scarring is a permanent complication of acne vulgaris.

What is acne?

Acne is a complex skin condition that causes the formation of papules, pustules, nodules and cysts. It begins with the oil glands in the skin and the hair follicles on the face, neck, back and chest.

The oil glands produce a substance called sebum. Sebum carries dead skin cells to the skin’s surface through the hair follicles and normally they are sloughed off. However, when the body makes a lot of sebum the dead skin cells clump together inside the pore and become trapped.

Sebaceous plugs are called comedones. These are noninflammatory and appear as whiteheads or blackheads. Inflammatory acne occurs when the bacteria called P. acnes invades the clogged pores creating inflammation, redness, swelling, pimples and hyperpigmentation. If the infection goes deeper in the skin, it causes acne nodules and cysts.

What causes acne?

Acne is a complex disease that involves a combination of factors including hormones, inflammation, abnormal skin cell growth, excess production of sebum, overgrowth of bacteria inside clogged pores, stress, diet, certain medications and a genetic predisposition.

Hormone changes during puberty, a monthly menstrual period, and around menopause stimulate increased oil production. Stress hormones also stimulate oil glands to increase oil production and clogs pores. Other triggers include high humidity and sweating.

There are many effective products to treat acne.

How is acne diagnosed?

During a dermatology consultation, your board-certified dermatologist will discuss the potential causes of your acne including your hormones, family history, and skin regimen. He will examine your skin to rule out other skin conditions such as rosacea that look like acne.

After your doctor determines you have acne, he will grade the acne on a scale of one to four with four being the most severe. When there are just a few whiteheads, blackheads, and pimples it is considered mild acne. Noninflammatory and mild inflammatory acne often heal without leaving a scar. Moderate and severe acne frequently leave scars. Cystic acne is severe and the most common type of acne that affects teenagers and results in scarring.

How is acne treated?

Treatment options are determined by the severity of acne. The goal of medical treatment is to prevent and treat acne to avoid scarring and limit the extent and duration of acne. During your appointment you will be instructed on the best way to take care of your skin to prevent clogged and infected pores. A skin care regimen including cleansers, moisturizers, make-up, and medications will be made for you.

Your doctor may prescribe topical retinoids, such as tretinoin or Retin-A®. These medications normalize skin cell turnover and prevent clogged pores. Retinoids can be drying, but if used in small amounts, in combination with a moisturizing cream, they can be very effective in preventing acne and improving skin quality.

Your treatment plan may also include oral or topical antibiotics to kill the bacteria, decrease inflammation, and reduce oil production. Topical benzoyl peroxide and oral doxycycline are common medications used for this purpose.

For women suffering from hormonal acne, birth control pills or other hormonally acting medications may be considered. Accutane® or isotretinoin may be prescribed for patients with severe nodular acne.

In office dermatologic treatments for severe acne include:

  • Chemical peels open pores to treat blackheads and acne papules and can improve mild scarring.
  • Painful, inflamed acne cysts can be injected with low strength steroid solution to reduce inflammation and help to prevent scarring.

Treatment will help to clear the skin, prevent new breakouts, and reduce the risk of scarring.

Combination therapy has been found to be more effective in treating acne than monotherapy.

Contact Phoenix Surgical Dermatology to schedule a consultation and discover all your treatment options available.

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