What is Acne and Acne Scarring?
Acne is chronic inflammation of the hair follicles and oil glands that occurs after adolescence and manifests as comedones (whiteheads & blackheads), papules, nodules, cysts or papulopustules. Often, but not always, it is followed by scars.
Acne scarring occurs when spots become inflamed or do not heal properly. It also occurs when people pick or cause trauma to the area. Some people are more prone to scarring because of hereditary factors. Advanced Dermatology, P.C. and our Center for Laser and Cosmetic Surgery, offers various treatments for significant reduction of acne scars. These include chemical peels, microdermabrasion, and laser therapy. Fraxel, Erbim, and C02 are some of the lasers we use for resurfacing treatments.
What causes Acne?
The exact cause of acne is unknown, but it is believed that it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.
Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many teenagers with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are known to cause acne. Cosmetics may alter the cells of the follicles and make them stick together, producing a plug promoting acne.
Factors that can cause an acne flare include:
- Changing hormone levels in adolescent teenagers and adult women 2 to 7 days before their menstrual period starts
- Oil from skin products (moisturizers or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
- Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
- Squeezing or picking at blemishes
- Hard scrubbing of the skin
- Stress. (e.g. Less Sleep)
Can infants get Acne?
Yes. In the first few weeks after delivery, many babies, particularly boys, will develop red pimples and whiteheads on the cheeks and nose due to the high levels of male hormones (called androgens) circulating in their bodies. These hormones prompt oil production to the baby’s immature oil glands, leading to the growth of bacteria and the development of acne. As the weeks pass, androgen levels decline and infant acne usually goes away. If acne persists or is severe, a doctor can prescribe standard anti-acne drugs for babies, including benzoyl peroxide and possibly even topical or oral antibiotics.
How is Acne treated?
Dermatologists may recommend an OTC or prescription topical medicine for people with mild signs of acne. Topical medicine is applied directly to the acne lesions or to the entire area of affected skin. There are several OTC topical medicines used for mild acne. Each works a little differently. The following are the most common ones:
- Benzoyl peroxide – destroys P. acnes, and may also reduce oil production
- Resorcinol – can help break down blackheads and whiteheads
- Salicylic acid – helps break down blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicles
- Sulfur – helps break down blackheads and whiteheads.
Topical OTC medicines are available in many forms, such as gels, lotions, creams, soaps, or pads. In some people, OTC acne medicines may cause side effects such as skin irritation, burning, or redness, which often get better or go away with continued use of the medicine. If you experience severe or prolonged side effects, you should report them to your doctor.
Several types of prescription topical medicines are used to treat acne. They include:
- Antibiotics – help stop or slow the growth of bacteria and reduce inflammation
- Vitamin A derivatives (retinoids) – unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac)
- Others – may destroy P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation. Some examples are prescription strength Benzoyl peroxide, sodium sulfacetamide/sulfur-containing products, or Azelaic acid (Azelex).
What other treatments are available for Acne?
Dermatologists may use other types of procedures in addition to drug therapy to treat patients with acne. For example, the doctor may remove the patient’s comedones during office visits. Sometimes your doctor will inject corticosteroids directly into lesions to help reduce the size and pain of inflamed cysts and nodules.
Early treatment is the best way to prevent acne scars. Once scarring has occurred, the doctor may suggest a medical or surgical procedure to help reduce the scars. A superficial laser may be used to treat irregular scars. Dermabrasion (or microdermabrasion), which is a form of “sanding down” scars, is sometimes used. Another treatment option for deep scars caused by cystic acne is the transfer of fat from another part of the body to the scar. A doctor may also inject a synthetic filling material under the scar to improve its appearance.
Does laser treatment work for Acne & Acne Scarring?
Laser treatment for acne works by penetrating the deep layers of the skin without harming its surface. While light therapy reduces the presence of bacteria that cause acne, laser treatments have an effect on the sebaceous glands that produce excess oil. Laser treatment may also reduce the appearance of scarring caused by acne, so it can be used on people who currently have acne or acne scarring.
Does it work on all types of Acne?
How many treatments are required?
Is the treatment difficult?
No. At your first visit your physician will assess your condition and review previous treatments. Then you will have your first full treatment with re-treatments scheduled three to six weeks apart for the next three to four months. Each treatment will typically last 15 to 20 minutes.
Is the treatment painful?
There is some minor discomfort associated with the treatment. Most patients describe the treatment as a series of rubber band snaps to the skin. Your physician can reduce or eliminate this discomfort by providing you with a topical anesthetic or by cooling the treated area with ice or an air-cooling device.
Will laser treatment make my Acne worse?
Laser treatment is designed to gently target and reduce the redness associated with inflammatory acne. It will not aggravate an existing condition. However, if the underlying causes of your acne condition change, your acne could worsen independent of the laser treatment.
Before & After Results with Smooth Beam Laser
Before & After Results with Smooth Beam Laser
Acne Scarring: Before & After Results with Fraxel Laser
Acne: Before & After Results with Aura Laser
Before & After Results with Apogee Laser
Advanced Dermatology P.C. and The Center for Laser and Cosmetic Surgery would like to thank Juvéderm® for the above supplied web content.
Advanced Dermatology’s, Robert Ecker, M.D. speaks on Acne
Advanced Dermatology’s Robert Ecker, M.D. speaks with NASRF’s fellow on Acne
Acne Treatment video with SMOOTH BEAM Laser
Whitney Bowe, M.D., discusses acne and diet
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