Acne & Rosacea

Rosacea is an extremely common condition in the US. It affects primarily Caucasians of Northern European ancestry. Although often referred to as ‘adult acne,’ it often starts as an exaggerated flushing response to things like hot drinks, spicy foods, alcohol, caffeine, and sunlight. This flushing can result in permanent appearance of vessels on the face (telangectasias). Some people also develop ‘pimples’ on a background of flushing and a small number (primarily men) develop overgrowth of the tissues of the nose (rhinophyma). There are many effective treatments for rosacea depending on the stage and severity of your condition. For those with primarily flushing, avoiding the things that trigger the episodes is the first line of defense. There are also topical treatments commonly used in this stage of the disease. For those with severe ‘pimple’ outbreaks, a course of an oral antibiotic, typically a tetracycline, is used. The antibiotic is often continued for several months. In the treatment of rhinophyma, prevention is key. By taking the above measures, we can often prevent this complication from occurring. If rhinophyma has already developed, there are procedures for paring down the skin on the nose, typically performed by a plastic surgeon.

One of the most rewarding treatments we perform is the laser removal of dilated vessels on the nose and face (telangectasias) that have occurred as a consequence of rosacea. The procedure is fast, results are seen immediately in many cases, and patients are typically very pleased with the results. If laser treatment is not for you, covering these vessels can be accomplished using a makeup with a green base.

Acne is a skin condition that results in clogged pores called blackheads and whiteheads, inflamed pustules called pimples, and deeper lumps called nodules. Acne occurs on all parts of the body including the face, neck, chest, back, shoulders, and upper arms and occurs in all ages, 90% of teenagers develop acne and nearly 50% of adult women and 25% of the total adult popultaion get acne most commonly in their 20's to 40's. Acne tends to resolve overtime without treatment, but if left untreated can leave permanent scars. Therefore, acne should be treated and managed.

Acne is not caused by being dirty or unclean. Acne is caused by clogged pores and follicles as a result of one or more of the following: hormones, over production of sebum, overactive sebaceous gland, presents of Propionibacterium acne, and the inflammatory process. Acne begins to develop approximately 2–3 weeks before it appears on the skin's surface. It starts in the sebaceous follicles and pores. Deep within the skin the sebaceous glands are producing sebum, the oil that keeps the skin moist. As the skin renews itself, the old cells die and mix with the skin's natural oils and slough off. In acne patients those dead skin cells and oil clump together and clog the pores and follicles trapping bacteria within the follicle resulting in acne.

Acne treatment is a lifestyle change. First, one must wash their face once or twice a day with a medical grade mild cleanser or a medicated cleanser. Women should consult a dermatologist or skin care specialist as to what skin care and make-up is right for their skin. The dermatologist may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. Microdermabrasion or chemical peels may be used to remove the upper layers of the skin to unblock the pores and follicles and stimulate new skin growth. Oral antibiotics often are prescribed in conjunction with topical treatments to decrease bacteria and improve outcomes. If the acne is hormonal related, specific birth control pills may be prescribed. Also, dermatologist can treat acne scaring with laser skin resurfacing with laser.