Dealing with Acne
Acne is a condition that is misunderstood by many patients and doctors. First let me say that I am not a dermatologist and anyone with severe acne should see a dermatologist for their unique expertise. Having said that, I see (as do most cosmetic facial surgeons) many patients with active acne. In some cases patients may outgrow the acne, but a large percentage of patients may end up with permanent scarring. This is very unfortunate, especially for young patients who don’t know better. If any adult is reading this and they have a child with active acne, I implore them to seek treatment for their child.
Acne has little to do with what we eat and the other associated wife’s tales.
Diet and acne are related
The bottom line is we need more research. We do know that people in some indigenous societies do not experience acne whatsoever across the entire population. This is in stark contrast to the widespread presence of acne throughout all modern society. It leaves us to ponder the question of whether the indigenous people’s diet contributes to their acne-free skin. Discovering a dietary way of preventing acne may be a future reality, however, we may live so differently from our hunter/gatherer ancestors that it has become close to impossible to replicate our ancestral diet. But, let’s see if we can work together to come to some consensus from our own experiences. If you feel that you have cleared your acne using a particular diet, or if you are planning on attempting a diet of some kind, please post your method on the Nutrition & Holistic health message board.
(above taken from www.acne.org which is a very valuable resource for patients)
Acne is a condition that is a result of a bacterial skin infection. The bacterium P. acnes lives in the pores and with an increase in sebum (oil gland) production it causes the pustules and sometimes cysts that we call zits. Some acne is associated with comedones (blackheads) while cystic acne is more of an inflammatory process. Severe acne requires treatment with such medications as Accutane and is essential to have a qualified dermatologist when using this type of drug.
For the more garden variety acne cases that I see in cosmetic patients or their children, the treatment includes numerous factors. Skin care is one of the most important. Very few patients take a serious approach to medically based skin care. Simple skin care with cleansers, toners, a retinoid (such as Retin-A) can assist acne prevention and treatment. Oral antibiotics such as Minocycline are frequently used once a day and topical antibacterial wipes (1% cleocin) used twice a day have worked well in my practice.
Ancillary treatments such as microdermabrasion can assist exfoliation. A recently approved LED single wavelength light treatment has also been useful with a nonsurgical, nonprescription treatment regimen. I have one of the few Omnilux LED devices in the area. This FDA approved acne treatment involves the patient sitting in front of an LED device for 20 minutes, twice a week for about a month. This simple treatment has benefited many patients in my practice. This treatment is more beneficial for inflammatory acne than “blackhead” type of acne. Although some patients do not respond to the Omnilux, most do and it is an affordable option to more aggressive treatments.
Finally, for patients that have acne scarring, multiple options exist to improve the scars. The CO2 laser is the gold standard for acne scarring and can produce dramatic improvement. Other treatments for acne scars include injecting fillers under the scar, subcision (undermining the scar with a special needle) and surgically removing the scar. I perform all of these treatments for acne scarring and frequently combine these treatments, depending upon the severity of the acne scars. Acne patients need to be careful not to be taken advantage of. There are many devices, new lasers and practitioners that promote or promise miracle cures. If a miracle cure existed for acne, no one would have it. Although the newer lasers such as the fractional lasers may show promise, the results have been disappointing in my experience. I have yet to see any treatment that can compete with the CO2 laser. Although the recovery a hassle, the results are predictable and reliable.
If you have a loved one, friend, or coworker with acne, encourage them to seek treatment before they develop scars. For those patients that already have acne scars, an experienced cosmetic facial surgeon can improve their appearance and self confidence.
Joe Niamtu, III DMD
Cosmetic Facial Surgery