Acne - FAQ's
Frequently Asked Questions about Acne
Q: What is acne?
A. Acne is a controllable disorder of the follicle evolving from the buildup of dead skin cells, bacteria, and the increasing amounts of oil that stick together and sludge up the pores of genetically inclined individuals. Acne comes in two basic types and varies in severity from individual to individual:
- An inflamed condition normally associated with soreness, redness, swelling, pus formation-nodules, cysts, pustules, papules, etc.
- A non-inflamed condition usually accompanied with closed comedones (whiteheads) or open comedones (blackheads). Acne lesions usually occurs on the face, neck, chest and shoulders.
Q: What causes acne?
A. The exact cause of acne is unknown, but doctors believe it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). Hormone increase in both boys and girls during puberty, and cause the sebaceous glands to enlarge and make more sebum.
Q: Does everyone get acne?
A. Acne affects all skin colors and skin types. It can be a frustrating issue as you never know if, where, or when it will present itself. People with skin of color are faced with additional challenges such as post inflammatory dark spots and scarring, thus preventative care is essential.
More Frequently Asked Questions about Acne
Q: How can I control my acne?
A. Any acne therapy has 3 goals: First, to kill the Propionibacterium acnes; second, to reduce inflammation, and third, to prevent sebaceous glands from producing excess oil, clogging pores and creating an environment that allows the P.acne bacteria to flourish.
You can control your acne through the continued use of a properly prescribed skin regime for home care and in-clinic treatments on a regular basis. Under these circumstances, you can expect your acne to be improved in approximately 3 months. Most acne conditions, if left untreated, will worsen and increase the chance of scarring. Each treatment will bring you one step closer to having clear skin.
Q: What can I expect during my acne consultation?
A. During your complimentary consultation you will be evaluated and the optimum treatment regimen will be outlined for you. An acne specialist will provide you with a comprehensive overview of causes that may contribute to your acne condition and how genetics, stress, diet and use of over-the-counter products can aggravate your acne prone skin.
Q: How can I prepare myself for a consultation?
A. It is a good idea to prepare for your first visit by making notes about your acne. You will be asked about your background, things like how long you've had acne, how you've treated it and what was your experience with previous treatments. If you provide us with detailed information about what you have used in the past, we can tell if the medication was too strong, if it was used improperly, or if you just didn't respond to it. There are many factors that can aggravate acne prone skin, and the more information we have from you about allergies, things that have triggered flare ups in the past, your diet, lifestyle, and supplements you are taking the more likely we will be able to help you. Make sure you prepare any questions you might have. Being informed will make your treatment much easier to deal with.
Q: What will I experience during an in-clinic Acne Treatment, and how does it benefit me?
A. The treatment will help in normalizing the skin, preventing breakouts and controlling even the most difficult-to treat-acne. Therapeutic Acne Facials are corrective procedures designed to exfoliate dead skin cells and cleanse the follicle (pores). We treat the face and those parts of the neck, back and chest affected by skin disorders such as acne, razor bumps and post inflammatory pigmentation. During the treatment, a steam-activated enzyme mask will soften the skin impactions, making the extraction of skin impurities more successful. To enhance the effectiveness, a chemical peel, high frequency or oxygen treatment may be added or substituted during your regular visit.
Q: In between treatments, how do I maintain or improve my skin at home?
A. We carefully select and customize your home-care products. Your Acne Specialist will advise you on the proper skin care regime necessary to balance your skin and eventually control acne. Detailed home care instructions will be given to you during an initial consultation and treatment.
Q: How fast can I expect to have clear skin?
A. There is no overnight cure for acne, and in most instances and even with the strongest of medications, it often takes months to get acne under control and years of maintenance to keep your skin clear. Prepare to act on long-term treatment options. Most of the people see improvement after the first Acne treatment.
Q: What factors have a tendency to aggravate those prone to acne?
A. Acne is very diverse and can have many aggravating factors. A thorough client questionnaire by our Acne Specialist is vital. There will be those of you who have tried everything; if you are not clearing up chances are that one or more of the factors listed below could be delaying your progress.
- Stress - physical, emotional or job related stress.
- Seasons - hormone levels fluctuate as seasons change, which alter the amount of oil produced (reaching their highest in October).
- Climate - humidity induces excretion.
- Pressure or Friction - caused by caps, headbands or anything in direct contact with the skin for any length of time.
- Picking - picking not only aggravates, but can worsen an acne condition and induce scarring.
- Diet - foods high in iodine (processed foods, salty snacks, etc.) should be eliminated. A well balanced diet is recommended.
- Pregnancy - hormonal fluctuations affect skin conditions.
- Birth Control Pills - consult your physician to have your proper dosage prescribed.
- Cosmetics - the use of the wrong skin care products may have a devastating effect on your acne-prone skin condition.
- Lifestyle - inadequate sleep (less than 8 hours per night) or drug and alcohol use.
(Consult with your Dermavita Acne Specialist for guidance).
Q: How can stress cause acne?
A. When you are under stress, your body secretes stress hormones including cortisol. Combined with the surge of these hormones and the negative effects of stress, your immune system can produce skin breakouts as an immune system reaction. Also, if you are under stress your body produces more sebum (skin oil), which may additionally contribute to acne breakouts.
Q: Why doesn't simply cleansing my face with an appropriate cleanser twice a day clear up my acne condition?
A. Since the comedone (blackhead) is formed below the surface of the skin, it can't be affected by topical, non-penetrating, cleansing products. Acne is not caused by having a “dirty” face and can't be washed away. Only products that are specifically designed to penetrate into to the follicle, loosen the impactions and kill bacteria will be successful in clearing up an acne condition.
Q: What products do I need to control my acne?
A. The professional staff at Dermavita will customize a treatment plan to help get your acne and breakouts under control. Our products contain ingredients purified to their most natural, potent form, resulting in highly absorbable effectiveness. Our clients have seen dramatic results from the use of these products, both alone and in conjunction with their in-clinic regimen. The treatment products may include ingredients such as: Benzoyl Peroxide, Salicylic, Glycolic, Kojic or Lactic Acid, Zinc, Retinols, Sulfur, Azulene, non-comodogenic oil-free maintenance products, natural supplements to detox your skin, and more.
Q: How can topical acid exfoliation help my skin?
A. Glycolic and Salicylic acid constitute an effective topical treatment for acne for several reasons. Acids reduce the buildup of dead skin cells in the pore, excessive flaking and help fade dark spots. Home care products are available in gels and lotions in strengths ranging from 5% to 10%. Oil free gels are more appropriate for acne and should be introduced in a thin application every other night and built up gradually. Skin brighteners (hydroquinone, kojic acid, bearberry extract and azelaic acid) work better when formulated with Salicylic acid (also known as BHA), an anti-bacterial acne ingredient, which carries them deeper down the follicle to target the problem.
Q: What is Benzoyl Peroxide?
A. Benzoyl Peroxide is a very effective topical acne treatment available without a prescription. It penetrates the pore, releases oxygen and kills Propioni-bacterium acnes that live without oxygen below the skin's surface. It also causes peeling deep in the follicle similar to Retin-A, which loosens acne impactions. However, all BPO products are not created equal. Some BPO medications are so glutted with acne-aggravating ingredients that they can actually cause clogged pores and breakouts. Also, the shelf life of some over-the-counter products may not be monitored closely; older BPO products lose their potency. Common side effects are irritation and dryness. An appropriate BPO product should be recommended by a skin therapist.
Q: Are there any facts or precautions I need to know about Benzoyl Peroxide?
A. Yes, there are some facts that you should be aware of:
- Begin your use of Benzoyl Peroxide at the level your Acne Specialist has recommended. Exceeding the recommended time limits may cause discomfort.
- Do not use any other products in conjunction with what your Acne Specialist has recommended while on your series of treatments.
- During the initial weeks of therapy you will experience some dryness, redness, itching, flaking, tightness and mild peeling. This will subside as your skin adapts to the products.
- Avoid the eye area completely.
- Benzoyl Peroxide may bleach hair and fabrics; all products should be kept out of the reach of children.
Q: How can Retin-A help with acne?
A. Retin-A, Tazorac, Defferin (called Vitamin A acid, Tretinoin, or Retinoic acid) are topical treatments available in a variety of brand names as .01% and .02 1/2 % alcohol-based gels, and .05% liquid and a .025%, .05% and .1% cream. The gel and liquid varieties are helpful in the treatment of non-inflammatory acne including blackheads, closed comedones, clogged pores and rough texture. The comedogenic cream versions (which include Renova, Retin-A Micro and others) are loaded with isopropyl myristate and stearic acid and other emollients and can be acne aggravators. These creams are put to better use as anti-aging treatments for the non-acne-prone person with photo-damaged skin. The problem with non-comedogenic retinoids is that while they cause a desirable peeling effect deep in the follicle and help loosen and dislodge comedones, they don't kill bacteria like BPO. Usually a combination of different products produce desired results.
Q: What is Comedogencity?
A. Comedogenic means a substance's ability to penetrate into pores and cause the formation of comadones, blackheads and slightly elevated small whiteheads appearing usually over the cheeks, chin and sometimes the forehead. Periodically, some of these blackheads and whiteheads will turn into inflamed pustules.
Here are the most common comedogenic ingredients found in moisturizers, sun blocks, tanning lotions, foundations, pressed powders, and other cosmetics: Isopropyl Myristate, Linseed Oil, Olive Oil, Cocoa Butter, Coal Tar, Isopropyl Isostereate, Lanolic Acid, Acetylated Lanolin, Oleyl Alcohol, Octyl Palmitate, Isostearic Acid, Myreth 3 Myristate, Butyl Sterate
We offer a wide range of proven non-clogging skin care products are available, including custom formulated moisturizers and foundations to match your color.
Q: When are antibiotics needed?
A. Although antibiotics are our last choice for acne treatment, our medical provider can prescribe them in severe cases to reduce inflammation and to help fight bacteria with acne, stage IV. Antibiotics, either topically applied to the skin (Clindamyacin, Erythromycin) or taken systematically (Tetracyclin and its derivatives) control surface bacteria that aggravate and often foster acne. Antibiotics are more effective when combined with other topical products such as Benzoyl Peroxide, Salicylic Acid or retinoids.
Q: What is Accutane?
A. Accutane is an extremely potent systematic retinoid, a vitamin A derivative, used in the treatment of severe cystic acne, which is treatment-resistant. It works by shutting down the sebaceous activity in the entire body. Side effects can include severe birth defects, diabetes, kidney malfunction, severe dry and peeling skin, conjunctivitis, chapped lips, gum inflammation and bleeding, severe skin sensitivity, sometimes permanent hair loss, aching joints, nausea and vomiting, bone changes, headaches, blurred vision, rectal bleeding and digestive disturbances. Regular pregnancy testing, foolproof birth control and blood tests for liver, kidney function and glucose levels are mandatory.
Unfortunately, many patients with lesser grades of acne are being prescribed Accutane quite casually. Not only is Accutane potentially dangerous, it simply doesn't work for most types of acne. There are thousands of disillusioned post-Accutane failure cases that were promised permanent results and put at risk when Accutane was clearly not indicated for them. Some cystic acne will clear up after one or more cycles of Accutane only to have the condition to return within months of stopping the drug. Recently, taking Accutane has been linked to depression, and suicide and the FDA has determined that this must be mentioned on all literature. In addition, because Accutane interferes with the skin enzyme collagenase, there is an increased risk of severe scarring if procedures like dermabrasion, deep chemical peels, laser resurfacing and other facial surgery are performed after taking it.
Q: Do I have red marks on my face after my acne has gone away?
A. Often, people with lighter complexions complain about red or purplish marks or spots that remain after their acne has cleared. These spots are called “macules” and will likely fade with time. However, they can be difficult to treat and may or may not fade away completely.
Q: Are these dark or red spots scars?
A. No, these spots are not scars and some, if not most, will fade away with time. Also if necessary they can be lightened with an appropriate treatment unless the pigment is very deep. With post inflammatory pigmentation it is essential to be extremely patient and allow sufficient time for the spots to fade as this type of pigmentation takes the longest to lighten. To accelerate the lightening process, seek out professional treatments and help.
Q: Is acne in skin of color different then acne in light skin?
A. Yes, acne in darker complexions is more likely to leave post inflammatory pigment and scars, thus preventative care is essential.
Q: What's the difference between a dark spot and an acne scar?
A. Darks spots are post-inflammatory pigmentation, meaning temporary pigment left behind after your acne has healed. They are not scars and most will fade over time. In dark complexions, these spots can become brown, black, or any shade in between. Often times people with dark complexions are more concerned about these dark acne related pigmentations than the acne itself as these spots occur more often on their skin.
Scars are caused by acne that took a long time to heal. Scars appear as either raised bumps on the skin or as indentations. The best way to prevent both scars and dark spots is not allowing breakouts to surface by controlling your breakouts with appropriate treatment. If acne scars are not in a mature stage (up to 1 year) there are treatment options that can help to eliminate them.
Q: After my acne clears what can I do about scarring?
A. There are several treatment options depending on your individual situation and severity of skin damage. The most popular treatments are:
Microdermabrasion: A series of Microdermabrasion treatments removes the upper most layer of skin to minimize the appearance of more superficial scars with no downtime.
Laser Treatments: A variety of light-based treatments can be used to treat acne scarring. For more severe scarring ablative lasers like CO2 and irbium tips could be an option, although these one-time procedures are used less often now because of prolonged post-treatment healing and possible side effects.
Non-ablative Fractional lasers are more popular due to quick recovery time, easier downtime, and evident clinical improvement within a few sessions. Fractional lasers help resurface the skin by creating microscopic wounds that reveal smoother skin in as little as two or three treatments. Sometimes a combination of fractional and IPL are used for the best outcome boosting collagen production within the skin, resulting in a more even complexion. The IPL will also help with post-inflammatory redness.
Dermal fillers: Can be used alone or in conjunction with other scar treatments. Fillers such as Juvederm or Belotero can be injected to elevate depressed acne scars. The result of the treatment is temporary, and depending on the filler used it will need to be repeated every few months.
Dermabrasion: This is usually a one-time procedure that requires two to three weeks of recovery and diligent sun protection for life. This procedure has lost popularity since laser technology has developed and taken over.
Q: Why am I breaking out before my period?
A. We can definitely blame hormones for those premenstrual breakouts. Androgen, a male hormone, is the most responsible for breakouts. Androgen levels peak right before your period starts. Some birth control pills such as Ortho Tri-cyclen may keep your skin clear by keeping androgen levels in check. Also, proper exfoliation with glycolic, salicylic, or retinoid will increase the rate at which your skin cells shed and in turn decrease the likelihood that your pores will become clogged and form pimples. Spot treatment with Drying lotion contains sulfur, zinc and salicylic acid overnight will speed up the healing process for already existing breakouts.
Q: How does diet affect my acne?
A. Diet does not cause acne, however, ingredients and substances in the diet may aggravate acne.
Iodide: Excessive long-term ingestion of iodide whether in vitamins, drugs or food can induce acne. Once ingested and mixed into the bloodstream, excess iodide is excreted through the oil glands. Iodide irritates the pore and causes acne flare-ups. It is especially irritating to the susceptible pores of acne-prone persons. Iodized sea salt should be avoided, and Seafood such as Kelp, Squid and Crab are high in iodide. Iodides have been added to cowlick and may find their way into milk, as well as beef, especially concentrated in the liver. Junk food is high in iodides because of the sea salt added to them. Vitamin and mineral supplements are loaded with iodides.
Food containing hormones:Foods high in testosterone-like steroids (such as peanut oil) can stimulate your sebaceous glands similarly to the way hormones in your body do and may cause problems.
Swimming pool disinfectants, industrial disinfectants, etc., also may contain iodides.
Q: How can parents help their teens deal with acne?
A. Parents of teenage children probably had acne when they themselves were younger, as this is a genetic disorder, but the passage of time may cause them to forget how embarrassing acne can be. In order to help their teenage children cope with their acne, parents need to be morally supportive and be able to offer practical advice about acne treatments and acne medicine.
Acne is best treated in the early stages and can be treated topically with a simple and reasonable home care program and deep-pore cleansing Corrective Treatments. We often wish that parents would bring their children in sooner before their acne becomes out of control.
Start your children early on a good skin care system and prevent them from a bigger acne problem later and the worst - acne scarring.
Q: Does skin of color need sun protection?
A. All skin colors and types need protection from the sun. Daily use of sun protection is especially vital for darker skin to prevent dark spots from getting darker.
Q: Is Rosacea an acne condition?
A. Rosacea is not an acne condition and it should never be treated like one. It is a common but poorly understood disorder of the facial skin that is estimated to affect well over 16 million Americans. Rosacea with its red-faced, sometimes acne-like skin condition is an inflammatory skin condition with signs and symptoms that may include:
- Redness on the cheeks, nose, or forehead
- Small visible blood vessels
- Tendency to blush or flush easily
- Tightness and dryness
- Thickening of the skin on the cheeks, nose, or forehead
- Watery or irritated eyes
- Small bumps or pimples on the face
When rosacea is diagnosed the treatment is tailored for each individual case as the symptoms of rosacea vary substantially from one patient to another. The treatments may include topical or oral antibiotics, laser treatments to remove visible blood vessels and reduce extensive redness, gentle and appropriate skin care regime to reduce inflammation and to reduce the effect of rosacea on appearance.