Acne & Rosacea

Acne & Rosacea

Although groundbreaking advances have been made in the treatments of Acne and Rosacea, they are still all-too common skin problems.

At Greater Miami Skin and Laser Center we can help guide you through a wide variety of options: from the latest and most effective treatments medicine can offer, to simple lifestyle changes and better skin care routines that can help you manage and improve the look and health of your skin.

Certain treatments for Acne and Rosacea may be covered by some insurance plans.

ACNE

Acne begins to afflict most of us in our tween years and some people may find themselves still battling Acne at the onset of their fight against aging. It is one hormonally-fueled teenage problem we don’t always outgrow!

Acne is a disorder resulting from the behavior of hormones and other substances in the skin’s oil glands and hair follicles that can lead to plugged pores and outbreaks of unsightly pimples or zits that show up on the face, neck, back, chest, and shoulders. People with Severe Inflammatory Acne may develop painful nodules or cysts. Although typically not a s3erious health threat, Acne can be a source of significant emotional distress, and in some cases can lead to permanent scarring, which is why it is crucial to consult your dermatologist.

What Causes Acne: Truth vs Myth
Although eating that large candy bar will not cause you to break out, certain factors can trigger or worsen Acne.

Hormones: The exact cause of Acne is still unknown, but doctors one important factor is an increase in male sex hormones (androgens). These hormones increase in both boys and girls during puberty, and cause the oil glands to enlarge and create more sebum (oil). Other factors that may cause a hormonal imbalance that can trigger Acne can be pregnancy, hormonal fluctuations during your menstrual cycle, and changing or switching birth control pills.

Family history: Acne can be hereditary. Open your parents’ high school yearbook and you may discover the ancestry of your Acne.

External or environmental factors such as using lithium-based drugs or oil-based cosmetics or moisturizers, grease present in the workplace (for example, a hot kitchen with fry vats); pressure from sports helmets, equipment or uniforms; pollution, squeezing, picking or scrubbing blemishes, and, of course, stress can also exacerbate Acne-prone skin.

Treatment for blackheads, whiteheads, and Mild Inflammatory Acne

For mild signs of Acne, doctors typically recommend OTC or prescription topical medicines which are available in gels, lotions, creams, soaps, or pads, and are applied directly on the skin. The most common OTC topical medicines are: Benzoyl Peroxide, Resorcinol, Sulfur and Salicylic Acid.

Moderate to severe Inflammatory Acne may be treated with prescription topical or oral medicines, alone or a combination of the two. Some topical options include Antibiotics, Vitamin A derivatives (retinoids), prescription-strenth Benzoyl, Sodium Sulfacetamide/Sulfur-containing products, or Azelaic acid.

Like OTC topical medicines, prescription topical medicines are prescribed based on your skin type. For example, creams and lotions tend to be good choices for patients who have sensitive skin because they provide moisture as an added benefit.

Your doctor may combine both prescription topical and an oral medication or antibiotics since oral antibiotics can curb the growth of bacteria and reduce inflammation. Some common antibiotics used to treat Acne are tetracycline, minocycline, and doxycycline. Other oral medicines less commonly used are: clindamycin, erythromycin, or sulfonamides.

Both topical and oral prescriptions may cause side effects and you may not see benefits immediately. In fact, some medications may cause your Acne to get worse before it gets better. Make sure that you discuss all your options thoroughly with your doctor.

Treatment for Severe Nodular or Cystic Acne

Nodules or cysts are a sign of Severe Inflamatory Acne, which should be treated by a dermatologist. Patients who don’t see improvement with medicines already mentioned, may be prescribed Isotretinoin for 15 to 20 weeks. It noticeably reduces the size of the oil glands so that much less oil is produced and bacteria growth decreases.

After 15 to 20 weeks of treatment with Isotretinoin, most patients notice that their Acne fades away completely or almost completely. If flares continue after a course of Isotretinoin, doctors may repeat treatment or prescribe other medications.

Because Isotretinoin can cause birth defects in the developing fetus, it is important that women are not pregnant and do not get pregnant while in treatment. Women must use two separate effective forms of birth control simultaneously for one month before treatment begins, during the entire course of treatment, and for one full month after stopping the drug.

Some patients with Acne can become depressed by the changes in the appearance of their skin during treatment or soon after completing a course of medicines, so it’s important to consult your doctor if you or someone you know feels unusually sad or is experiencing symptoms of depression.

Treatments for Hormonally Influenced Acne in women

In some women, Acne is caused by an excess of male hormones (androgens). Clues that this may be the case include hirsutism (excessive growth of hair on the face or body), premenstrual acne flares, irregular menstrual cycles, and higher blood levels of certain androgens.

To treat women with this type of Acne, doctors may prescribe birth control pills, low-dose corticosteroid drugs, (such as prednisone or dexamethasone), or anti-androgen drugs.

Other treatments for Acne

In addition to drug therapy, your doctor may use other types of procedures to treat Acne. He or she may remove the patient’s comedones by administering corticosteroids injections directly into lesions during office visits. This helps to reduce the size and pain of inflamed cysts and nodules.

Microdermabrasion
Dermabrasion (or microdermabrasion), which is a form of “sanding down” scars, can be a wonderful treatment option for Acne patients.

Microdermabrasion is a gentle and safe skin re-surfacing therapy that can offer significant results with no down time. During the process, a MegaPeel EX® machine sprays jets of fine mineral crystals across the skin’s surface. These are quickly vacuumed, along with dead skin cells, leaving skin gently polished and revitalized. This treatment stimulates the production of new skin cells resulting in smoother texture and supple appearance.
Other microdermabrasion systems, such as those that use wand-like instruments can achieve similar results to those obtained with particlemicrodermabrasion and chemical peels, but without the adverse effects of loose particles, irritation and skin reaction. Unlike other mircrodermabraders, the NewApeel® Aesthetic Exoliation System uses no loose crystals or other abrasives.

Besides treating Acne and Acne scars, Microdermabrasion is a great option for sun-damaged in the face, skin, neck and shoulders; age spots in the hands and face, minor to moderate fine lines, blackheads and whiteheads, minor scars, hyperpigmentation, oily skin and rejuvenation.

Microdermabrasion Acne Face Smoothing Treatments are available at the Greater Miami Skin and Laser Center.

Acne Scars

Once scarring has occurred, your doctor may suggest a medical or surgical procedure with a superficial laser to treat irregular scars. Another option for deep scars caused by cystic acne is the transfer of fat from another part of the body to the scar.

A doctor may also inject a synthetic filling material under the scar to improve its appearance.

Although these options can greatly improve your chances of reducing the appearance of scar tissues, doctors agree that early treatment is the best way to prevent Acne scars.

Take Control of Acne

Clean skin gently
If you have Acne, you should gently wash your face with a mild cleanser in the morning and in the evening, as well as after heavy exercise. Cleanse your face gently from under the jaw to the hairline and be sure to thoroughly rinse your skin. The variety of facial cleansers out there can be overwhelming, so if you’re not sure what to buy and you wish to avoid a long and possibly acne-ridden session of trial and error, ask your doctor for advice on the best type of cleanser to use, especially if you have sensitive or Acne-prone skin.

Using strong soaps or rough scrubbing pads is not the way to go since they can actually make the problem worse. Astringents are not recommended unless the skin is very oily, and if used, they should only target the oily spots. If you have oily hair, you should shampoo it every day.

Avoid frequent handling of the skin
Whenever possible, avoid rubbing and touching skin lesions. Squeezing, pinching or picking at blemishes can lead to the development of dark blotches or scars.

Shave carefully
Men should test both electric and safety razors. When using a safety razor, make sure the blade is sharp and soften your beard thoroughly with soap and water before applying shaving cream. Shave gently and only when necessary to reduce the risk of nicking blemishes.

Avoid sunburns and tanning
Suntans may make blemishes less visible and make the skin feel drier, but these benefits are short-lived and there are known risks of excessive sun exposure. Many of the medications used to treat Acne can make you more prone to sunburn.

Choose your cosmetics carefully
While undergoing Acne treatment, you may need to change some of the cosmetics you use. All your cosmetics, such as foundation, blush, eye shadow, moisturizers, and hair-care products should be oil free and labeled noncomedogenic. For some people, however, even these products may worsen Acne.

What research is being done on Acne?


Medical researchers are working on new drugs to treat Acne, particularly topical antibiotics that may replace some of those currently in the market. Scientists are also trying to better understand the mechanisms involved in Acne so that they can develop new treatment options. For example, one group of NIAMS-supported researchers is studying the mechanisms that regulate sebum production in order to identify ways to effectively reduce its recurrence without the side effects of current medicines. Another group is trying to identify possible immunologic interventions. Other areas of research involve examining the effects of Isotretinoin on an area of the brain that might lead to depression, as well as developing a laser system to treat Acne and Acne-related scars without damaging the outer layers of the skin.
Researchers in Germany have taken P. acnes and identified its genetic information (genome). This information may help researchers develop new treatments to target the bacteria.

Acknowledgments

NIAMS gratefully acknowledges the assistance of Laurence H. Miller, M.D., Chevy Chase, MD; Kenneth A. Katz, M.D., M.Sc., University of Pennsylvania School of Medicine, Philadelphia; Edward W. Cowen, M.D., National Cancer Institute, NIH; and Alan Moshell, M.D., NIAMS, NIH, in the preparation and review of this information.
Publication Date: January 2006 by National Institutes of Health www.nih.gov and NIAMS www.niams.nih.gov

ROSACEA

Rosacea is an inflammatory skin condition which causes certain blood vessels to enlarge in the area of the forehead, nose, cheeks and chin, giving the appearance of being and red or flushed. In certain cases, Rosacea can cause burning and swelling of the skin and bumps that can contain pus or become painful. Some men may develop a swollen nose and the affected skin may become thicker in time. Rosacea may cause eyes and eyelids to become inflamed as well. About 14 million people in the United States alone suffer from Rosacea. It is most common in women (especially during menopause) and fair skinned people between the ages of 30 and 60. Up to 50% of people who suffer from Rosacea can develop eye problems such as redness, dryness, itching, burning, excess tears, and the uncomfortable feeling of having sand
in their eyes. Eyelids may become inflamed or swollen, and the eyes may become sensitive to light, experience blurred vision and other problems.

What causes Rosacea?
While the exact cause is still unknown, some doctors think Rosacea occurs when blood vessels expand too easily, which can trigger flushing of the skin. People who blush a lot may be more likely to develop Rosacea. It is also believed that people inherit the likelihood of getting the disease.
Though not thoroughly-proven, some patients claim that heavy exercise, sunlight, wind, extreme temperatures, hot or spicy food, menopause, alcohol consumption, emotional stress and the use of steroids on the face can worsen their Rosacea.

Although there is no known cure this condition can be treated and controlled with the help of dermatologists and, in time, the skin may improve. Treatment options for Rosacea include topical and oral antibiotics, electrosurgery to treat small red lines, and removal of extra skin tissue from the nose. Many Rosacea sufferers have found that green-tinted make-up can be a temporary solution to help neutralize redness.

If Rosacea is affecting your eyes, your doctor may prescribe oral antibiotics or steroid eye drops. Your best defense against infection is to clean your eyes often with watered-down baby shampoo or an over-the-counter eyelid cleanser. After cleaning, you can apply a warm (but not hot) compress a few times a day.

Take Control of Rosacea

You can play an active role in treating Rosacea by keeping a written log of when flares happen, using a sunscreen that protects against UVA and UVB rays every day and has a
sun-protecting factor (SPF) of 15 or higher, avoiding irritating products on your face and following your doctor’s treatment plan.

What’s the latest in Rosacea Research?
Current research about Rosacea focuses on finding newer and more effective medications, treating eye conditions that are caused by Rosacea, studying the body’s immune system’s role in Rosacea and finding ways to reduce scarring if extra skin on the nose is removed.

For more information about Rosacea and other related conditions refer to:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health

The information in this publication was summarized from the US Government. Web site: www.niams.nih.gov

Microdermabrasion Acne Face Smoothing Treatments are available at the Greater Miami Skin and Laser Center.