Acne and Rosacea

Acne

​​While acne is most commonly associated with adolescence, it can be present at any age.  Essentially all boys and most girls will suffer some form of acne during puberty.  Although most outgrow their problems with acne by their early 20's, approximately 3/4 or middle age adults will have at occasional acne flare-ups.  Such flares of acne are known to be associated with stress, menstrual periods, use of birth control pills, menopause, pregnancy, and use of oil-containing skin products.

Acne presents in many forms and variations. While the most common type of acne is acne vulgaris, it has many variations.  Classification of the former includes:  comodonal, papular, pustular, or cystic.  It can be graded from mild, moderate or severe.  Other types include: infantile and neonatal acne, acne rosacea,
perioral dermatitis, drug induced acne, hidradenitis suppurativa, keloid acne, and Favre-Racouchot syndrome.

What causes acne?
Acne results from plugged sebaceous gland such that the oil produced by the glands is trapped within the pores.  A plug forms and makes the pore bulge, forming a white head.   This plug may become darkened, causing a blackhead.   Regardless, a bacteria called Proprionibacterium acnes, prospers in the clogged follicles. When the bacteria forms pus, and this along with inflammation moves into the surrounding tissue forming pimples.

Sometimes teen avoid seeking treatment as they are told that it will just go aways with time.  Unfortunately, along the way the acne can become so severe that scars eventually can form.  While the stigmata of having active acne can be over-whelming to the teenager, acne scarring can be a life-long problem.   Accordingly, it is important to seek an expert opinion as early as possible to both get control of the problem and prevent long-term scarring.  

Acne Treatments Choices
Acne treatment requires a daily regimen which includes a good skin-care regimen, topical and sometimes oral treatments, all which is best managed by a physician with vast experience in acne management, such as Dr. Atkins. After an evaluation with her, she will suggest products or prescribe medications based the amount of sebum production, sloughing of dead skin cells, whether bacteria is present in pustules or papules, and the presence of inflammation. Several of these factors may be present. Genetic or hormonal factors may also impact your condition. ​

Acne Treatment Options​
Topical Treatments
Benzoyl Peroxide – antibacterial for P. acnes. Decreases FFA (free fatty acid formation). It represents an common and ideal first-line treatment.

 

Salicylic Acid – unplugs follicles.

Azaleic Acid – antibacterial for P. acnes. Normalizes keratinization.

Retinoids (tretinoin, adapalene, tazarotene) – frees up the cells of acne and increases cell turnover.

Topical Antibiotics (erythromycin, clindamycin) – anti-bacterial for P. acnes.

Benzoyl peroxide plus antibiotics – dual antibactieral and FFA effect.

Oral Treatments
Antibiotics (minocycline, doxycycline, erythromycin, tetracycline) – bactericidal of P. acnes, reduction of FFA.

Isotretinoin – normalizes keratinization, decreases sebum production, depletes P. acnes, inhibits neutrophils.

Oral Contraceptives – decrease sebum production.​

 

Light therapy
Dr. Atkins may recommend "Blu-U Blue Light" treatments, as this modality is known to be effective on P. acnes. 

 

All of these treatments have risks, some more than others (e.g. Isotretinoin or Accutane) so it is very important to be under the management of a qualified physician such as Dr. Atkins.
 

 

​Rosacea

Rosacea usually presents as redness of the skin of the face, most commonly in the cheeks, forehead and nose.  It usually starts after age 30 and is characterized by flare-up followed by periods without any redness.  Rosacea tends to worsene with further aging, often becoming more persistent.  Small blood vessels can become visible more advanced stages, as well as skin thickening and infections.  It is more common in women, and seems to be present in people who blush easily.

 

While there in no specific cure for rosacea, symptom specific treatment can be quite helpful when properly administered by an experienced physician such as Dr. Atkins.  After your evaluation with her, she will make recommendations that may include topical agents and laser light therapies.

 

​

Call our office to schedule your consult today! 678-213-2220