Acne & Acne Scarring

Acne is a skin condition with plugged pores (blackheads and whiteheads), inflamed pimples (pustules) and deeper lumps (nodules). Acne occurs on the face, as well as the neck, chest, back, shoulders and upper arms. Although most teenagers are affected by some form of acne, adults in their 20’s, 30’s, 40’s or even older, can also develop acne. Often it clears up after several years, even without treatment. Acne can be disfiguring and upsetting to the patient. Untreated acne can leave permanent scars; these may be treated by Dr. Cleaver in the future. Acne treatment is important to prevent acne scarring.

What causes acne?
Testosterone, a hormone which is present in both males and females, increases during puberty. This stimulates the sebaceous glands of the skin to enlarge, produce oil and plugs the pores. Whiteheads, blackheads and pimples are present in teenage years.

Acne also may develop later in life which is called adult acne. It may be related to hormones, childbirth, menopause or stopping the pill. Adult women may be treated at the period and at ovulation when acne is severe, or throughout their entire cycle. Adult acne is not rosacea (a disease in which blackheads and whiteheads do not occur). 

What can I do about acne?
Acne is not caused by not washing your face. In fact, washing it too often or vigorously may actually make it worse.  Washing your face with a mild cleanser and warm water, daily, is best for your acne.

Food even chocolate does not cause acne, but some foods may make your acne worse. Try to avoid those foods whenever possible.

You should wear as little cosmetics as possible, but the best to wear would be mineral based, oil free or water based products. Choose products that are non-comedogenic or non-acnegenic. Remember to remove your cosmetics every night with mild soap or cleanser and warm water. 

How do I treat it?
Before starting any medications including topical medications, it is important that you inform our staff if you are currently pregnant, trying to get pregnant or nursing. 

  • Topicals - Our physicians may prescribe topical creams, gels or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help open up the pores and reduce the bacteria. These products may cause some drying and peeling. You will be advised about correct usage and side effects that may occur. 
  • Acne Surgery - Acne surgery may be used to remove blackheads and whiteheads.  You should not pick, scratch, pop or squeeze the pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation and scarring may occur. 
  • Spa treatments - We offer microdermabrasions at the Dermatology Skin Spa to help with acne. This procedure removes the upper layers of the skin to improve irregularities in the surface, contour and helps to generate new skin.
    • The Dermatology Skin Spa also offers Beta Peels with salicylic acid or glycolic acid to help unblock the pores, opening up blackheads and whiteheads and stimulating new skin growth.
    • Dermalinfusion is another peel offered through the Dermatology Skin Spa to help remove the skin and stimulate new skin growth.
  • Injections - Some acne can be injected with corticosteroids to assist in their speedy disappearance. 
  • Oral medications - Oral antibiotics can be taken by mouth. Some of these used would be tetracycline, doxycycline, minocycline or erythromycin.
    • Birth control pills may improve acne and may be prescribed specifically for acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills. As a precautionary measure, use a second form of birth control.
    • Accutane is used in some cases of severe acne. Patients using this drug are monitored through the I Pledge system. There are monthly visits to the doctor as well as blood work being monitored.  Pregnancy must be prevented while using this medication. 
  • Light therapy - Photodynamic therapy may be used by using the blue wavelength of light to treat acne. 

The physicians will evaluate your acne and suggest the appropriate treatment regimes considering your age, sex and the type of acne you have. Remember that not everyone reacts to medication the same way. Sometimes after a couple of months of treatment, the treatment regimen may need to be altered for the individual. 

What can we do for acne scarring?
Cleaver Dermatology has a variety of methods that can be used to treat acne scars. Laser can resurface the skin. Microdermabrasion, chemical peels or electrosurgery can flatten scars. Soft tissue elevation with collagen or fat-filling products can elevate scars. Scar revision with a microexcision and the punch grafting technique can correct pitted scars. A combination of these methods can make noticeable differences in appearance. Acne is not curable but is controllable with the proper treatments. 

NOTE:  Remember that most insurance companies will not pay for the treatment of acne scarring as it is considered cosmetic.  Most still pay for the treatment of acne so it is best to treat it before it becomes a scar.