ACNE AND 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 get some form of acne, adults in their 20’s, 30’s, 40’s or even
older, can develop acne.  Often acne 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. 
To avoid acne scarring, treating acne is important. 

How do you get acne?

Acne is not caused by dirt or chocolate!  Testosterone, a hormone which is
present in both males and females, increases during puberty.  It stimulates
the sebaceous glands of the skin to enlarge, produce oil and plugs the pores. 
Whiteheads, blackheads and pimples are present in teenage years.

Early acne occurs before the first period and is called prepubertal acne. 
When acne is severe and forms deep “pus-filled” lumps it is called cystic acne. 
This is usually more common in males. 

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 even throughout
the 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.  But 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.  The best to wear would be
mineral based, oil free or water based products.  Choose products that are
non-comedogenic or non-acnegenic. Remove your cosmetics every night with
mild soap or cleanser and water. 

How do I treat it?

Topicals - Dr. Cleaver, Shawnee or the residents may prescribe topical creams,
gels or lotions with vitamin A acid-like drugs, benzol 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. 

Before starting any medications including the topical medication, it is important
that you inform our staff if you are currently pregnant, trying to get pregnant or
nursing. 

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
removed 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.

In some cases of severe acne, Accutane is used.  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. 

Dr. Cleaver, Shawnee or the residents 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 so 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?

Dr. Cleaver can treat the scars by a variety of methods.  Laser can resurface the skin.
  Microdermabrasion, chemical peels or electrosurgery can flatten depressed 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
and combination of these methods can make noticeable differences in appearance.
 Remember acne is not curable but is controllable with the proper treatments. 

NOTE:  You have to 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.