Helton Skin and Laser Institute - Newport Beach, CA

Physician's Advice: Acne Treatments

Since acne is caused by plugged pores the best way to combat it is to keep the pores open. First off do not use products that are non comedogenic. This means they either have ingredients shown not to plug pores or they have been tested to not cause blockage. Avoid products with Dimethecone and isopropyl myristate. Stage make-ups like Mac are common offenders. Moreover, keep your face out of the shower stream. The pounding water acts as a massager bringing the blood to the surface squeezing the pore closed. Avoid extreme water temperature's for the same reasons. Don’t squeeze. If you feel you must, remember you have only one shot at it, so time it appropriately. The deeper cysts will eventually come to the surface so you may have to wait a week for those, but you can put an ice cube on them. Ice is natures anti-inflammatory. To a point, the less the inflammation the smaller the lesion will be. Mild exfoliation is good because the overactive oil glands will mix with dead skin cells make a microscopic sludge that further plugs the pore. Exfoliation reduces this. Be sure to exfoliate but not irritate. You can tell if your skin is irritated because the skin will turn mildly red. So be gentle. I recommend using a wash cloth or a gauze pad if you don’t like doing frequent laundry. Scrubbing cleansers are nice as well, but avoid the pulverized apricot versions since they have sharp edges.

Physical exfoliation is best accompanied by chemical exfoliation. This can be done in may ways. A salicylic acid cleanser like Neutragena Oil Free Acne Wash is a good choice . This will chemically disengage any dead skin cells that are about to fall off and the physical exfoliation will sweep them away. During the day, this can be followed by a benzoyl peroxide lotion at a strength of 2.5-10%. This will reduce the bacterial population and minimize the chances of bacterial invasion. If you are young, you may apply this to your entire face, if older then use the lower strengths and only apply to the lesions as peroxide can result in oxidization of the skin (READ WRINKLES.) At night time, cleanse again and it is time to use another chemical exfoliator in an attempt to keep the pores open. Glycolic acids are suitable for this purpose. They are also known as alpha hydroxyl acids or AHA’s. Glycolic acids have a special affinity for pores. A stronger acid is vitamin A acids, Retin A being the most popular prescription version. A dermatologist will prescribe a similar regime, but typically with both prescription strength topical antibiotic creams and acids. There is a stepwise approach to acne and each step needs to be tried for a period of 3 months before moving up. This seems forever to a teenager ,but if done this way, the acne will not become worse before it becomes better.

If topical treatment is not working, then oral therapy may be warranted. This may include oral antibiotics to reduce inflammation and bacteria. In a female, water pills or birth control pills may help stabilize hormonal swings. Last line efforts include Accutane which is effective in 95% of the cases. Accutane is a modified vitamin A. As such it is incorporated into developing fetal tissue, so extreme care is made to assure that the consumer avoids pregnancy for the course of therapy and 3 months after. The oil in the skin will flow into the blood stream and triglycerides and cholesterol need to be monitored monthly. There are other non traditional approaches to acne like blue light therapy, lasers and photodynamic therapy that are typically useful for people that cannot tolerate the classic approaches.

Reading cannot take the place of a physical exam and evaluation by a Dermatologist. This information is not personal medical advice nor does it infer a doctor patient relationship. If any adverse reactions occur from using any topical or medication, cease using the product and see your Physician. Or better yet, come see me for an appointment and acne program tailored to your needs.

Written by: Peter Helton, D.O. | Visit Dr Helton's blog

Helton Skin & Laser Institute | Peter Helton, D.O.
1901 Westcliff Dr, Suite 2 | Newport Beach, CA 92660 | 949.646.DERM (3376)