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Acne

Acne is the single most common skin disorder and one of the most common conditions we see in our clinic.  Almost everyone develops acne at some point and about half of the population eventually requires medical treatment. It typically begins with puberty, but may also occur after the teenage years. While most of us outgrow acne at some point, it can persist into adulthood in some individuals.

What causes Acne?

There are many contributing factors, but all acne starts with a clogged pore. Our skin is in a constant state of renewal with dead skin cells continually being replaced by new ones. In acne prone skin, these dead cells mix with oil forming a sticky plug that blocks the pore. This forms whiteheads and blackheads and is known as comedonal acne.  

When the pore is blocked, bacteria feed on the oil from our skin and start to multiply. The bacteria stimulate the immune system which causes inflammation. This inflammatory response creates the red bumps and pustules seen in inflammatory acne.  

In more severe cases, large cysts can begin to form. This large inflammatory response can damage the skin and eventually lead to scarring.  It is crucial to stop acne before it reaches this stage as the appearance of acne scars is very difficult to reverse.

Acne Treatment

Acne can influence the way that people feel about themselves and can keep people from doing the things that they want to.  Successful treatment of acne can greatly improve self-esteem and confidence.  Some of the treatment options we commonly use are:

Oral Medications

  • Oral Antibiotics: When appropriate, they help decrease the number or bacteria infecting the pores. They also reduce inflammation to decrease the red bumps and pustules.
  • Spironolactone: This medication works by blocking the hormones that promote acne (androgens). It is particularly helpful in adult females with acne
  • Birth Control Pills: They work by helping to regulate hormone levels to improve acne
  • Accutane (Isotretinoin): Used for individuals with severe acne, scarring, or those who haven’t improved with standard treatments.  A course of treatment usually takes 5-6 months. Accutane is very effective in treating severe and resistant acne and is one of the only treatments that offers long term clearance of acne.

Topical Medications

  • Retinoids: These work by increasing exfoliation of dead skin cells,  preventing the plugging of pores
  • Benzoyl Peroxide: Mainly helps by decreasing the number of bacteria on the skin and has a mild effect to unplug pores and decrease inflammation.  
  • Topical Antibiotics: Help by decreasing the number of bacteria on the skin and also by decreasing inflammation


Other Treatments

  • Injections: A small amount of cortisone like medication can be injected into larger inflammatory acne lesions. This helps reduce the inflammation in the area and rapidly shrinks the lesions.
  • Comedone Extraction: Using a sterile technique, the contents of small blackheads and whiteheads can be removed to reduce the number of acne spots and clear your skin quicker

Acne treatment options can vary significantly from patient to patient depending on the type and severity of the acne. Most often, more than one treatment option is needed.

If you have questions regarding your acne, please schedule an appointment with one of our providers. They will be happy to create an individualized treatment plan for your acne.

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