WHAT IS ACNE? Part 2

So the clogged pore is the primary event in acne.  Sometimes that is all there is - so retinoids, like Retin-A, Tazorac (the most potent), or differin and extractions are all that is needed.

However, most cases of acne show inflammatory (red) lesions, including some large painful cysts.  These are controlled by application preventively of topical antibiotics, benzoyl peroxide, and particularly effective in females - Aczone.  Additionally, oral medications can be used for one of 3 purposes:

1. Anti-inflammatory effects - doxycycline derivatives (they probably don't yield their benefits by killing bacteria);
2. Blocking testosterone in females - birth control pills or spironolactone; and
3. Preventing inflammatory lesions - Accutane type drugs.

Three pearls of wisdom for acne therapy:

1. Washing does not help acne (sorry Mom) - dirt has nothing to do with it and chemicals in soap are off the face in a minute so they have no time to penetrate;
2. Topical medications can be more effective than pills because they are delivered only to the target (skin and then into blood stream); and
3. You need to apply preventively: all over the place where you expect pimples.

Time, not usually medications, get rid of existing pimples. 80-90 % of patients are doing very well within a month on these regimens.

Acne Scar Treatments

For those with a limited number of wide superficial scars, fillers, such as Artefill (permanent), can be used with improvement seen immediately.  Dr. Hamilton is the American pioneer in Artefill treatments, having treated the first patients in the U.S. in 1997.

More extensive and deeper scars are treated very successfully with the Fraxel laser in a 5 treatment series that does not require any downtime.  Improvement is visible in most patients within approximately 4 weeks.

We treat many patients with acne scars, many of whom are quite severe and whose lives are markedly improved by these treatments.