I have been working for Dr Frederick Quarles, one of Hampton Roads' leading dermatologists for over 8 years. He has been the President of the National Medical Association and was named the 2008 Practitioner of the Year by the National Medical Association. He has been in private practice for over 27 years.
I have learned an amazing amount of information from him. Prior to working for him as a medical assistant and Skin Care Specialist, I spent 20 years in the Navy as a corpsman, so I have over 25 years of expertise in the medical field as well.
Today I want to talk about acne, which affects 40 to 50 million Americans at any given time according to the American Academy of Dermatology (AAD). Acne can affect people of all ages, and some women don't develop their first case of acne until they are in their 40's. Acne causes many people emotional distress! They are embarrassed and upset by their skin. Let's be real, your face is the first thing most people look at, and we want to put our best face forward.
I can't tell you how many times I have heard patients say, "I have NEVER had an acne bump....why am I getting them now in my 30's..(or 40's)...(or 50's)???" This is more common than you might think. Often when an adult develops acne it is called "Rosacea" also referred to as "adult acne".
However, let's back up a bit and debunk a few myths about acne that most people think are true. First of all, despite what your mother told you, (or what you are telling your kids), fried foods, soda, and how much water a person drinks has NOTHING to do with acne. Fried foods and soda do not make acne worse, so eat french fries and drink Mountain Dew to your heart's content. It will not make your acne worse. It will however cause your waistline to increase, but that is not the topic for today.
Okay so now that you know what does NOT make your acne worse, let me tell you what DOES. Hormone and stress levels are a huge factor in acne. As a matter of fact many times I have heard from high school patients that their acne was doing really well after seeing the doctor and getting on a regimen of medication and products and procedures, but when they went off to college their acne got much worse. Many patients come home on their first school break with their acne flaring out of control. Let's face it, going to school is stressful, especially if it is their first year away from home.
Many of my female patients will often tell me that their acne is worse just before their menstrual cycle. Even if they no longer cycle due to menopause or birth control, they will notice that their acne goes through monthly cycles of better and worse. That is because our bodies' hormone levels still go up and down.
Acne is caused by the skin not shedding properly. So the skin clogs the pores, thus backing up the oil in the pore causing whiteheads and blackheads (comedones) or larger "juicier" bumps also called pustules. This is where acne medicine comes in. For comedonal acne, (blackheads and small whiteheads) the retinoids are a great medicine to use. These are medications such as Retin-A, Tretinoin, Tazorac, Epiduo, Differin, among others.
These medicines "teach" your skin to shed or slough properly so the oil can flow and not clog your pores. They can sometimes be irritating or drying, (especially to sensitive skin), so there are a couple of "tricks of the trade" you can use to help combat the irritation. 1) Use the medicine every other night to start so your skin can get used to the medicine. 2) Mix a dab of moisturizer in with the amount of medication you are putting on your skin so the moisturizer acts as a "buffer" it to make the medicine less irritating. Even with all of that you may notice some peeling with these medications. Of course if you have any concerns discuss them with your medical provider.
For the larger, "juicier" bumps, there are other things a medical provider can use. Benzoyl Peroxide is a great medicine for larger bumps, as well as topical or oral antibiotics. Benzoyl Peroxide can also be drying, so start that every other night also if you notice your skin being more dry than usual.
For people who have that really large acne all over their face that is painful and deep in the skin, (called cystic acne) they DEFINITELY need to seek out medical care. I have seen many patients put on Isotretinoin (aka Accutaine, Isotret, and a few more). This medication has many side effects and has to be monitored VERY closely by your dermatologist with monthly visits, blood tests, pregnancy tests (for females) among others. However, I have seen this medication literally work miracles for patients. I always think about the teenagers who went from kids with poor posture, hiding their faces behind their hair, poor self esteem before the medicine to kids who sit up straight, have improved self esteem, and smiling MUCH more. It can make a HUGE difference, but as I said, it needs to be closely monitored by a medical professional.
There are also some great products that can be used to help with acne. Glycolic acid cleansers are a wonderful product for people (even with sensitive skin in the right amounts) with oily, acne prone skin. A couple of glycolic cleansers that we sell in the office that I like (they can be purchased at many dermatologist's office or online) are:
Glyderm Gentle cleanser (made by Equalan Pharma) is a daily cleanser with 2% glycolic acid (also known as AHA or Alpha-hydroxy acid). It is very gentle and can be used by most people. The glycolic acid helps exfoliate the skin. However, it is a creamy cleanser and will NOT foam up.
Vivite Daily cleanser (made by Allergan) has a 12% glycolic acid compound in it, and is therefore a bit more exfoliating than the Glyderm. It is also stronger and can irritate sensitive skin. It is a creamy cleanser.
For those of you who LOVE to use a scrub, Vivite makes a nice one. PLEASE stay away from scrubs with nut shells as the exfoliating ingredient....nut shells can be sharp and scratch the skin. I really like the Vivite Exfoliating cleanser. It has a 15% Glycolic acid compound and very nice soft exfoliating beads that scrub without scratching or causing irritation. It should be used no more than two to three times per week.
Other products to try:
We have some products made by Topix Pharmacuetical that I love. You can also get these at many dermatologist's office or online. One of the reasons I really like Topix products is because they use many botanical ingredients in their products. I like botanics and more natural ingredients.
Topix 15% Glycolic pads.
I love these because they don't make your face sticky at all. You can use them in the morning after cleansing, or during the day if you get hot and sweaty and yucky......(love that medical term?) I tell my clients you can out some in a baggie and carry them with you during the day or to the gym, or the beach, etc.
These are Gly/Sal 5-2 pads. They have 5% glycolic and 2% salicylic. They are great for acne spot treatment.
ly/Sal 10-2 are pads with 10% Glycolic and 2% Salicylic acid.
Stronger than the 5-2 pads, they are also great for acne spot treatments.
There are lots of other products out there, too many to name them all. I shared with you just a few of my favorite acne treatment products. Generally speaking a product with salicylic acid can help with bumps. Glycolic acid is also a good product for skin too sensitive for Salicylic acid.
I am happy to answer any questions you all may have, and if you are local to the Hampton Roads area I do offer free skin care consultations at the doctor's office where I work, so you can call me or email me, or comment to schedule an appointment. :-) Please note I do NOT get paid by any of these companies, nor do I get paid for FREE consultations......
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