Dr Finger: Q&A Acne and Skincare treatment in Savannah, Georgia

 In Acne

Acne can be classified as teenage or adult. Typically, teenage acne begins at about puberty and 90% have some acne during their teenage years, even if mild. Adult acne usually occurs about the age of menopause, although it is seen even in adults beyond that age. In addition, body builders who take anabolic steroid hormones usually have outbreaks of acne. This implicates hormones as a main factor. Regardless of the cause, acne wreaks havoc on one’s appearance and self-confidence. Teenagers are already going through emotionally sensitive times with dating, peer pressures and simply becoming adults. Acne can be a disabling, disfiguring disease physically and depressing emotionally. Many afflicted with acne become withdrawn and secluded over their appearance. At times acne results in mild to severe disfiguring scars that are permanent. Many of those affected feel that it means they do not clean their faces or that they are not clean, and the embarrassment can be immense. I have had patients requesting dermabrasions, laser treatments or other modes of scar reduction when the scars are hardly noticeable to me, but to them it was a handicap. Those with severe scar disfigurement obviously require long-term laser and surgical treatment.

Acne is not curable, but it is controllable. The common denominators in acne are oily skin, bacteria, inflammation and hormonal imbalance, either puberty or changing hormones of adults. Treatments can be categorized as:
1. Habits
2. Topical treatment
3. Antibiotics
4. Prescription medications
5. Over-the-counter treatments

1. Habits—there is no proof that diet affects acne, but in my experience treating acne for decades, there is a close connection between acne and simple carbohydrate intake, such as sugar, white bread, white potato and basically anything sweet. The added benefit is weight reduction. Another factor is people constantly touching their affected areas with their fingers. Both cysts and pustules contain bacteria. When you touch or squeeze them and then touch another place on your face, you have inoculated another area of your face with the bacteria.

2. Topical treatment—we have developed the New Youth Acne Clear System, which is specifically designed for effective acne treatment from mild to severe resistant cases. The treatment begins with proper cleansing of the skin with an acne cleanser at least twice a day. Other Acne Cleansers are available over the counter. Look for ingredients that include benzyl peroxide (the most effective over-the-counter antibacterial agent) and anti-inflammatories. Tea tree and Clove essential oils help clear bacteria that cause acne and blemishes.

Next, use a Toner containing salicylic acid, anti-inflammatories and mild enzymes such as papaya. This will help remove bacteria and oil residue after cleansing. The New Youth Acne Toner contains a bioactive complex that reduces sebum production seen in acne/oily skin.

The next product in the system to be used is a treatment cream with benzyl peroxide, 3.5% in the morning and 10% in the evening (used for severe cases). Other ingredients are various nutrients, anti-inflammatories and anti-oxidants.

Finally, the last step is a daily moisturizer, which is fragrance and oil free. Our moisturizer contains vitamins, anti-oxidants and other ingredients helpful for healthy skin.

Your physician or skin care specialist will help you with other suggestions.

3. Antibiotics—these have been important in the care of acne patients. Tetracycline and analogs such as Minocin have been a main-stay. Also erythromycin has been used extensively. All are usually helpful in the treatment, but it takes diligence and persistence, particularly with some resistant cases. One cannot expect one mode of treatment to be effective. Sometimes hormone levels should be checked to see if there is a correctable imbalance, particularly in adults.

4. Prescription medications—the last to be tried is Accutane, an analog of Vitamin A. This is very effective in cystic acne. Because of possible severe complications that may arise from its use, a patient must have special registration, which can be furnished by your pharmacist. A treatment course may take to 6 months and side effects are often severe, such as dry, chapped lips, dry nose with nose bleeds, dry skin, joint and bone pain, and more. But for severe cystic acne, it is often worth it if the patient can tolerate the side effects and risks. Through the years, I treated many patients with Accutane and most patients were happy with the results.

Scars from acne are deforming and often depressing. In an attempt to smooth acne scarred skin, dermabrasion (sanding with a motorized wire brush) was the treatment of choice many years ago. Today the Fraxel laser is the best mode of therapy. Individual severe, deep pits can also be excised (cut out) with a small scalpel and sutured under local anesthesia. Even a facelift may be a good choice in older patients whose loose skin accentuates the scars. Acne scarred skin can be improved dramatically, but not as smooth as one who never had the problem.

5. Over-the-counter treatments–vitamin A is another option, up to 100,000 units a day. Even higher doses can be used, but should be supervised by your physician.

Zyporex Cream—this is a once a day treatment containing various nutrients including trea tree Oil, herbs and anti-inflammatories. It is cost effective and the web page contains testimonials.

Acneticin—this is a pill-by-mouth treatment containing nutrients, vitamins, herbs, and anti-inflammatories. Testimonials tout it’s effectiveness.

Oxycerin—this is a serum containing 5% tea tree serum plus other herbs and nutrients that appears to be effective.

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