Acne

Acne is a skin condition that is most common in teenagers, young adults, and women. This condition affects millions of Americans and is more common than any other skin disorder. Acne can be caused by hormones, stress, diet, and other factors, and it can lead to distress, anxiety, and permanent scarring. Acne blemishes can also contribute to low self-confidence and poor self-image.

Most often, acne develops during adolescence and may continue into adulthood, especially due to hormones that increase sebum (oil) production. The overproduction of sebum can trap bacteria in the glands and cause acne. Due to this fact, acne tends to affect areas with a high number of oil glands, such as the face, back, and upper chest.

The treatment of acne is guided primarily by the type of acne. There are several main types of acne: comedonal acne, hormonal acne, inflammatory acne, and severe, cystic scarring acne.

Comedonal Acne

Comedonal acne includes small bumps of whiteheads and blackheads. This type of acne is usually found on the forehead and chin and is caused by increased oil production in clogged hair follicles. It can also be triggered by sun damage, environmental factors, smoking, poor skin care, and diet.

Treatments for Comedonal Acne:

  • Topical retinoids including Retin-A® (tretinoin), TAZORAC® (tazarotene), and Differin® (adapalene): Topical retinoids clear out the hair follicles to avoid excess oil production and reduce comedone formation. These treatments are often used in combination with topical antibiotics for acne treatment.
  • Topical antibiotics including ACZONE® (dapsone), erythromycin, and clindamycin: Topical antibiotics reduce redness and inflammation. They also destroy acne-causing bacteria.
  • Sodium sulfacetamide: This treatment unclogs pores, kills acne-causing bacteria, and removes dead skin.
  • Benzoyl peroxide: Benzoyl peroxide kills acne-causing bacteria and dries out oily skin.

Hormonal Acne

Hormonal acne refers to deep acne cysts that occur around the mouth and jawline. This acne may be caused or worsened by hormone fluctuations. It is most common in teens and women, especially women going through pregnancy or menopause.

Treatments for Hormonal Acne:

  • Spironolactone: This treatment reduces sebum secretion and may also lower androgen levels to improve hormone balance.
  • Oral contraceptives: Oral contraceptives reduce androgen levels to rebalance the hormones and prevent hormonal acne.
  • Topical retinoids and/or antibiotics: Topical retinoids and/or antibiotics such as those listed above can unclog pores, kill acne-causing bacteria, and reduce inflammation.

Inflammatory Acne

Inflammatory acne includes small, red bumps and pustules. It occurs as an immune system response to destroy bacteria and repair damaged skin. As white blood cells flood the areas of damaged skin, it leads to visible inflammation as well as inflammatory acne. Stress hormones, which elicit a similar immune response, can also lead to inflammatory acne.

Treatments for Inflammatory Acne:

  • Antibiotics (topical and/or oral): Antibiotics reduce redness and inflammation and destroy acne-causing bacteria.
  • Topical retinoids: Topical retinoids reduce inflammation by unclogging pores and hair follicles.
  • Benzoyl peroxide: This treatment dries out oily skin and destroys acne-causing bacteria.
  • Sodium sulfacetamide: This treatment unclogs pores, destroys acne-causing bacteria, and removes dead skin.

Severe, Cystic Scarring Acne

Severe, cystic scarring acne includes nodules and cysts deep beneath the surface skin. They are formed by a buildup of oils, fluids, and white blood cells. This type of acne is common but rarer than other types. Acne nodules are often painful and deep in the skin layer. Without early treatment, the skin may never fully recover from this type of acne. As a result, it can often leave scars.

Treatments for Severe, Cystic Scarring Acne:

  • Accutane® (isotretinoin): Accutane® reduces sebum production and assists in skin renewal. This treatment can be highly effective but is not recommended for women who are pregnant or trying to become pregnant in the near future.
  • Photodynamic therapy (PDT): This treatment can minimize acne scars and kill acne-causing bacteria. Microdermabrasion or acetone is used to cleanse the skin, and the topical chemical aminolevulinic acid (LEVULAN®) is applied to increase the skin’s sensitivity to certain wavelengths of light. After one to three hours, the chemical is washed off, and either Intense Pulsed Light or a Pulsed Dye Laser is used to treat the skin.

Acne type and skin type will both determine which acne treatment is best for each patient. Dr. Neyman works closely with you to identify the best treatment for your needs. Through professional acne treatment, we can restore healthy skin and a clear, smooth complexion. We can also help you adopt a personalized at-home skin care regimen to control your acne and maintain healthy skin.

FAQs

What causes acne?

There are many causes of acne. They include certain types of bacteria, hormone changes (such as during puberty or pregnancy), hormonal imbalances, stress, diet, genetic factors, makeup, and even certain types of medicine.

What should I do if I have acne?

If you have uncontrolled acne, there are several steps to take. First, contact our dermatologist for a personal diagnosis of your condition and to determine the right treatment plan for you. Once our treatment plan has begun, you should adopt an at-home regimen to help care for your skin. As a part of this regimen, be careful to observe the following:

  • Cleanse your skin gently (avoid harsh scrubbing)
  • Shave carefully and only when necessary
  • Avoid touching acne-prone areas as much as possible
  • Avoid squeezing or picking at acne pimples
  • Avoid excess sun exposure, especially while on acne medicine
  • Make sure your makeup is oil-free and noncomedogenic
  • Wash your makeup brushes and applicators
  • Wash your hair regularly

Why do adults sometimes get acne?

Despite the common notion that acne primarily affects teens, it also affects millions of adults. Women are especially vulnerable. Because acne is often caused by hormonal fluctuations, women may experience acne breakouts during pregnancy, menopause, and even their monthly menstrual cycle. Acne can also be genetic and is a side effect of some medications (such as steroids and anticonvulsants).

Will my acne eventually go away?

While acne may or may not go away on its own, almost all cases of acne can be treated. The key is finding the right treatment for your skin type and acne condition. Our skin care experts at Colorado Skin & Vein can help you identify the best treatment to eliminate your acne.

When will I see results from my acne treatment?

While the time for improvement varies according to the treatment used, most treatments do not show results for several weeks or possibly months. It is generally recommended that patients continue their recommended treatment or combination of treatments daily for up to eight weeks before considering alternative treatments. Patience is necessary, but the end result of clearing up your acne is well worth the effort!

If my face is finally clear, can I stop my acne treatment?

You should follow your dermatologist’s recommendations about when to stop your acne treatment. Patients whose faces are clear and stop their medications without consulting their dermatologist may experience an acne breakout or flare-up shortly afterward. The best thing to do is consult your dermatologist with any questions about changing or stopping your acne treatment.

Acne is often a frustrating and discouraging skin condition. Our skin care experts can help you identify the ideal acne treatment for you so that you can finally have clear, unblemished, and healthy skin. To request your personal skin care consultation with us, please call 303.683.3235 or fill out our online contact form today.

Dr. Verebelyi is a member of ASLMS, ABVLM, AAFP and Mensa

Dr. Verebelyi is a nationally recognized authority on laser surgery. He is board certified by both the American Board of Family Practice and The American Board of Venous & Lymphatic Medicine. Dr. Verebelyi helped create the Fundamentals of Laser Surgery course given by American Society of Laser Medicine & Surgery (ASLMS) where he has worked as both a director and instructor. He is a Fellow at the ASLMS, member of the American College of Phlebology and a member of Mensa.

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