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Rosacea

Questions and Answers about Rosacea

This booklet contains general information about rosacea (ro-ZAY-she-ah). It defines rosacea and describes its symptoms, possible causes, and treatments. If you have further questions after reading this booklet, you may wish to discuss them with your doctor.

  • What Is Rosacea?
  • Who Gets Rosacea?
  • What Does Rosacea Look Like?
  • How Is the Eye Affected?
  • What Causes Rosacea?
  • Can Rosacea Be Cured?
  • What Research Is Being Conducted to Help People With Rosacea?
  • Where Can People Find More Information About Rosacea?

Information Box

Working With Your Doctor to Manage Rosacea

What Is Rosacea?

Rosacea is a chronic (long-term) disease that affects the skin and sometimes the eyes. The disorder is characterized by redness, pimples, and, in advanced stages, thickened skin. Rosacea usually affects the face. Skin on other parts of the upper body is only rarely involved.

Who Gets Rosacea?

Approximately 14 million people in the United States have rosacea. It most often affects adults between the ages of 30 and 60. Rosacea is more common in women (particularly during menopause) than men. Although rosacea can develop in people of any skin color, it tends to occur most frequently and is most apparent in people with fair skin.

What Does Rosacea Look Like?

There are several symptoms and conditions associated with rosacea. These include frequent flushing, vascular rosacea, inflammatory rosacea, and several other conditions involving the skin, eyes, and nose.

Frequent flushing of the center of the face, which may include the forehead, nose, cheeks, and chin, occurs in the earliest stage of rosacea. The flushing often is accompanied by a burning sensation, particularly when creams or cosmetics are applied to the face. Sometimes the face is swollen slightly.

A condition called vascular rosacea causes persistent flushing and redness. Blood vessels under the skin of the face may dilate (enlarge), showing through the skin as small red lines. This is called telangiectasia (tel-AN-je-ek-tay-ze-ah). The affected skin may be swollen slightly and feel warm.

A condition called inflammatory rosacea causes persistent redness and papules (pink bumps) and pustules (bumps containing pus) on the skin. Eye inflammation and sensitivity as well as telangiectasia also may occur.

In the most advanced stage of rosacea, the skin becomes a deep shade of red and inflammation of the eye is more apparent. Numerous telangiectases are often present, and nodules in the skin may become painful. A condition called rhinophyma also may develop in some men; it is rare in women. Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. People who have rosacea also may develop a thickening of the skin on the forehead, chin, cheeks, or other areas.

How Is the Eye Affected?

In addition to skin problems, up to 50 percent of people who have rosacea have eye problems caused by the condition. Typical symptoms include redness, dryness, itching, burning, tearing, and the sensation of having sand in the eye. The eyelids may become inflamed and swollen. Some people say their eyes are sensitive to light and their vision is blurred or otherwise impaired.

What Causes Rosacea?

Doctors do not know the exact cause of rosacea but believe that some people may inherit a tendency to develop the disorder. People who blush frequently may be more likely to develop rosacea. Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness.

Factors that cause rosacea to flare up in one person may have no effect on another person. Although the following factors have not been well-researched, some people claim that one or more of them have aggravated their rosacea: heat (including hot baths), strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, and long-term use of topical steroids on the face. Patients affected by pustules may assume they are caused by bacteria, but researchers have not established a link between rosacea and bacteria or other organisms on the skin, in the hair follicles, or elsewhere in the body.

Can Rosacea Be Cured?

Although there is no cure for rosacea, it can be treated and controlled. A dermatologist (a medical doctor who specializes in diseases of the skin) usually treats rosacea. The goals of treatment are to control the condition and improve the appearance of the patient’s skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.

Some doctors will prescribe a topical antibiotic, such as metronidazole, which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve.

ome people who have rosacea become depressed by the changes in the appearance of their skin. People who have rosacea may experience low self-esteem, feel embarrassed by their appearance, and claim their social and professional interactions with others are adversely affected. A doctor should be consulted if a person feels unusually sad or has other symptoms of depression, such as loss of appetite or trouble concentrating.

Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.

Electrosurgery and laser surgery are treatment options if red lines caused by dilated blood vessels appear in the skin or if rhinophyma develops. For some patients, laser surgery may improve the skin’s appearance with little scarring or damage. For patients with rhinophyma, surgical removal of the excess tissue to reduce the size of the nose usually will improve the patient’s appearance.

Working With Your Doctor to Manage Rosacea

The role you play in managing your rosacea is important. You can take several steps to keep rosacea under control:

  • Keeping a written record of when flares occur may provide clues about what is irritating the skin.
  • Most people should use a sunscreen every day that protects against UVA and UVB rays (ultraviolet rays) and has a sun-protecting factor (SPF) of 15 or higher, but sunscreen is particularly important for people whose skin is irritated by exposure to the sun.
  • Using a mild lubricant may be helpful, but avoid applying any irritating products to the face. Some people find that a green-tinted makeup effectively conceals skin redness.
  • If your eyes are affected, faithfully follow your doctor’s treatment plan and clean your eyelids as instructed.

What Research Is Being Conducted to Help People With Rosacea?

Researchers are studying the eyes of people who have rosacea to find ways to prevent dry eyes and other eye problems related to rosacea. Scientists also are evaluating the most effective ways to use medications to treat rosacea and the best methods to minimize scarring of the sebaceous glands when removing excess nasal tissue in rhinophyma.

Additionally, researchers are looking at the immunological aspects of rosacea. In one study, researchers found that people with rosacea had high levels of cathelicidins, peptides with antimicrobial and proinflammatory properties that protect the skin against infection. (Cathelicidins are secreted in an inactive form and undergo a cleaving process to take on their active form.) Investigators also discovered that levels of stratum corneum tryptic enzyme or SCTE—the enzyme responsible for cleaving the inactive cathelicidins into their active form—were also elevated in people with rosacea.

Where Can People Find More Information About Rosacea?

  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
    Phone: 301-495-4484
    Toll free: 877-22-NIAMS (226-4267)
    TTY: 301–565–2966
    Fax: 301-718-6366
    Email: [email protected]
    Website: http://www.niams.nih.gov
  • American Academy of Dermatology (AAD)
    Website: http://www.aad.org
    Phone: 847-330-0230
    Toll free: 866-503-SKIN (7546)
  • National Rosacea Society
    Website: http://www.rosacea.org
    Toll free: 888-NO-BLUSH (662-5874)

For additional contact information, visit the NIAMS Web site, or call the NIAMS Information Clearinghouse.

Acknowledgments

NIAMS gratefully acknowledges the assistance of Mark Dahl, M.D., Mayo Clinic, Scottsdale, AZ; Sam Huff, National Rosacea Society, Barrington, IL; Robert Katz, M.D., Rockville, MD; M. Carol McNeely, M.D., University Dermatology Associates, Washington, DC; Larry Miller, M.D., Chevy Chase, MD; Alan Moshell, M.D., NIAMS, NIH; and Gary Peck, M.D., Washington Hospital Center, Washington, DC, in the review of this booklet.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS Web site at www.niams.nih.gov.

For Your Information

This booklet contains information about medications used to treat the health condition discussed here. When this booklet was printed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.

Clinical Trials for Rosacea

1 Recruiting Atralin Gel for the Treatment of Rosacea

Condition: Rosacea
Interventions: Drug: vehicle gel;   Drug: Atralin gel
2 Not yet recruiting Open Label Pilot Study of Apremilast in Treatment of Rosacea

Conditions: Erythematotelangiectatic Rosacea;   Papulopustular Rosacea
Intervention: Drug: Apremilast
3 Active, not recruiting Zinc Sulfate in the Treatment of Rosacea: A Randomized, Controlled Trial

Condition: Rosacea
Interventions: Drug: zinc sulfate;   Drug: placebo
4 Not yet recruiting Study to Evaluate the Safety and Efficacy of Topical Minocycline FXFM244 in Rosacea Patients

Condition: Rosacea
Intervention: Drug: Topical Minocycline Foam FXFM244
5 Completed A Study to Determine the Safety and Efficacy of Atralin (Tretinoin 0.05%) Gel for the Treatment of Rosacea

Condition: Rosacea
Interventions: Drug: tretinoin gel 0.05%;   Drug: vehicle
6 Recruiting Combination Therapy for the Treatment of Rosacea

Condition: Erythematotelangiectatic Rosacea
Interventions: Drug: calcium dobesilate;   Procedure: pulsed dye laser
7 Completed A Phase II, Randomized Study of ACZONE™ (Dapsone) Gel, 5% for Papulopustular Rosacea.

Condition: Rosacea
Interventions: Drug: Vehicle control, 2x/day;   Drug: ACZONE (dapsone) Gel, 5%, 2x/day;   Drug: ACZONE (dapsone) Gel, 5%, 1x/day;   Drug: MetroGel® (metronidazole gel), 1.0% 1x/day;   Drug: ACZONE (dapsone) Gel, 5%, 1x/day (AM) + MetroGel (metronidazole gel), 1.0%, 1x/day (PM)
8 Completed Effects of PRK 124 Lotion in Acne Rosacea

Condition: Acne Rosacea
Intervention: Other: PRK 124
9 Completed Determine the Effect of Administering Periostat(R) Twice Daily on Patients With Acne Rosacea

Condition: Acne Rosacea
Intervention: Drug: doxycycline hyclate 20 mg twice daily
10 Completed Exploratory Study of Azelaic Acid 15% Foam Compared to Vehicle in Patients With Papulopustular Rosacea

Condition: Papulopustular Rosacea
Interventions: Drug: Azelaic acid;   Drug: Vehicle
11 Recruiting Safety and Efficacy Study of Clindamycin Phosphate 1.2% and Tretinoin 0.025% Gel to Treat Rosacea

Condition: Rosacea
Interventions: Drug: Clindamycin Phosphate 1.2% And Tretinoin 0.025% Gel;   Drug: placebo
12 Completed Dose-Finding Study of CD07805/47 Topical Gel in Subjects With Erythematotelangiectatic Rosacea

Condition: Erythematotelangiectatic Rosacea
Intervention: Drug: CD07805/47
13 Active, not recruiting Efficacy of Topical Azelaic Acid 15% Gel Plus Anti-inflammatory Dose Doxycycline or Metronidazole Gel 1% Plus Anti-inflammatory Dose Doxycycline in Moderate Papulopustular Rosacea

Condition: Papulopustular Rosacea
Interventions: Drug: azelaic acid gel plus 40 mg doxycycline;   Drug: metronidazole plus doxycycline
14 Completed Isotretinoin in Papular-Pustular Rosacea

Condition: Papular-pustular Rosacea
Interventions: Drug: isotretinoin;   Drug: placebo
15 Completed Systemic Bioavailability Study Of Col-118 Administered Topically as a 0.18 % Facial Gel And Brimonidine Ophthalmic Solution 0.2%

Condition: Erythematous Rosacea
Interventions: Drug: 0.18% COL-118 facial gel (1.8 mg brimonidine);   Drug: 0.2% brimonidine ophthalmic solution (0.1 mg brimonidine tartrate/drop)
16 Recruiting Efficacy of Topical Cyclosporin for Ocular Rosacea

Condition: Rosacea
Intervention: Drug: Cyclosporin 0.05% Ophthalmic Solution
17 Completed Safety and Efficacy Study to Compare Two Rosacea Treatment Regimens

Condition: Rosacea
Intervention: Drug: doxycycline
18 Completed Laser-Mediated Photodynamic Therapy of Acne Vulgaris and Rosacea

Condition: Acne Vulgaris and Rosacea
Interventions: Device: Long-pulsed dye laser (Candela) and PDT (methylaminolevulinate);   Device: Long-pulsed dye laser;   Device: Long-pulsed dye laser assisted fotodynamic therapy (methylaminolevulinate)
19 Not yet recruiting A Study of DER 45-EV Gel to Treat Rosacea

Condition: Rosacea
Interventions: Drug: DER 45 EV;   Drug: Vehicle
20 Active, not recruiting Safety and Efficacy of Azelaic Acid Foam 15% in Papulopustular Rosacea

Condition: Papulopustular Rosacea
Interventions: Drug: Azelaic acid foam 15%;   Drug: Foam vehicle

Acne Treatments: Current Treatment Options

Topical

  • Retinoids
  • Benzoyl Peroxide
  • Antibiotics
  • Azelaic Acid
  • Salicylic Acid

Comination treatments

  • Benzoyl Peroxide + Antibiotics

 

Oral

  • Antibiotics
  • Isotretinoin
  • Corticosteroids

Retinoids

  • Adapalene (Differin)

  • Tretinoin (Retin A, Renova, Avita)

  • Tazaratone (Tazorac, Avage)

-Do not use in pregnant, breastfeeding, or trying to become pregnant.

-May be irritating, use small amount, avoid around the eyes, apply every other night

                                                                                                           

Severe Acne

Techniques to minimize irritation

–  gradual introduction of medication; initiate use with low concentration formulations

–  no scrubbing

–  adequate moisturization

–  brief application followed by gentle washing

ANTIBIOTICS: topical

  • Clindamycin ( Clindets wipes, or clindagel)

  • Erythromycin

  • Metronidazole ( Metrogel)

  • Sulfa ( Klaron)

ANTIBIOTICS: Oral

  • Amoxicillin

  • Tetracycline
  • Doxycycline
  • Minocycline

  • Azithromycin


 Practical ACNE Review: Top 10 List

1. Benzoyl Peroxide

2. Topical Retinoids

3. Topical Antibiotics

4. Salicyclic acid

5. Glycolic acid

6. Combination topical products (Antibiotics & BP)

7.  Oral antibiotics

8. Oral Retinoids

9. Oral Contraceptives

10. Oral Antiandrogens ( Spironolactone)

Blue Light Treatment : Photodynamic Therapy

Acne Treatment

There’s no reason to suffer with acne. If you have acne, it can be embarrassing and lead to low self esteem. Without treatment severe cases of acne can be disfiguring, leaving permanent scars. New techniques are available to treat acne and minimize outbreaks.

Acne is an equal opportunity condition, afflicting teenagers, young adults, and occasionally even more mature adults. Blue Light Acne Treatment uses light – without drugs or antibiotics – to treat hard to control acne, including acne vulgaris. The special blue light kills the p. acnes bacterium that grows inside clogged pores that swell up and form pimples on the skin.

Light treatments involve sitting with your face close to the light for a short time (typically 8 to 16 mins 40 secs) about once or twice per week for a period of about five weeks or so. The procedure is safe, not painful, and not hot. Over the course of the treatments, many people experience noticeable control or clearing up of their acne. Just as with any treatment, blue light does not necessarily work on everyone.

Beginner’s Guide to Microdermabrasion

What is microdermabrasion?

Microdermabrasion is a machine-assisted gentle skin exfoliating treatment that has grown in popularity in recent years. It is also referred to as microderm, lunchtime peel, Parisian peel, and Diamond peel.

It is a simple skin rejuvenation procedure that makes use of a fine crystal abrasive tip and vacuum suction. Contrary to popular belief, needles are not used during microdermabrasion, making it non-invasive and painless.

The vacuum pressure and speed are adjusted depending on the sensitivity and tolerance of the skin. Microdermabrasion is often  compared to the feeling of a cat licking your face: a deep, yet gentle abrasive force.

Microdermabrasion sessions vary from five minutes to one hour. No recovery time is required after microdermabrasion and patients can immediately return to daily activity after their session. Makeup and non-irritating creams can be applied right after microdermabrasion to speed up the already short recovery process, but are not necessary.

Often called “Microderm” for short, it is a procedure to help exfoliate or temporarily remove a few of the top layers of the skin called the stratum corneum. Much like brushing your teeth, microderm helps to gently remove “plaque” and skin debris. Since human skin typically regenerates at approximately 30 day intervals, skin improvement with microdermabrasion is temporary and needs to be repeated at average intervals of 2-4 weeks for continued improvement.  Multiple treatments in combination with sunscreen, sun avoidance, and other skin care creams yield best results.

First developed in Italy in the late 20th century, microdermabrasion is a skin resurfacing procedure which has advantages of low risk and rapid recovery compared to the other resurfacing methods such as dermabrasion, chemical peeling, and laser resurfacing. Since microdermabrasion produces only a very superficial depth of removal, it works best on improving superficial skin conditions such as early photoaging (sun damage), fine lines, age spots, enlarged pores, acne, and superficial scarring. Usually multiple treatments (6 – 12 sessions) are recommended to see a significant improvement. Initially, people choose weekly treatments, and then gradually extend to monthly or bimonthly maintenance or touch up treatments.

Who should get microdermabrasion?

Microdermabrasion is very useful for people with dull skin, mild acne, acne discoloration and pick marks, and very superficial acne scars. Individuals with deeper acne scars may expect a much longer series of treatments or likely benefit from physician performed surgical dermabrasion or laser resurfacing.

Microdermabrasion is a noninvasive (no needles, no surgery) procedure with essentially no downtime. Treatment risks are very minimal and may include temporary skin discoloration- darker or less commonly lighter skin areas ( called post inflammatory hyperpigmentation or hypopigmentaion)/ or scarring are very low compared to other more traditional resurfacing approaches. Therefore, microdermabrasion may be a good treatment option for patients with superficial skin problems and busy lifestyles.

Microderm should not be confused with Dermabrasion with is an invasive surgical procedure performed typically by dermatologists or plastic surgeons under local or general anesthesia. This was a very popular procedure for acne scars. Dermabrasion requires anesthesia and would be too painful otherwise. Dermabarasion was performed with sand paper like products and machine rotary devices to sand down the skin. Layers of epidermis are usually removed and the resulting open wounds may take  from 5-20 days to fully heal. The risk of infection is much higher with this type of procedure. Dermabrasion is also performed for certain types of deep scars. It should not be performed by non- specialized physicians fully trained in this highly technical procedure.

How does microdermabrasion work?

Traditionally, the crystal microdermabrasion system contains a pump, a connecting tube, a handpiece, and a vacuum. While the pump creates a high-pressure stream of inert crystals, such as aluminum oxide, magnesium oxide, sodium chloride, and sodium bicarbonate, to abrade the skin, the vacuum removes the crystals and exfoliated skin cells. Alternatively, the inert crystals can be replaced by a roughened surface of the tip in the diamond microdermabrasion system.

Unlike the crystal microdermabrasion system, the diamond microdermabrasion machine does not produce particles from crystals that may be inhaled into patients’ nose or blew into eyes. Hence, the diamond microdermabrasion is safer to be used on the area around eyes and lips. Generally, the slower the movement of the handpiece against the skin and the more numbers of passes over the skin, the deeper the treatment is achieved.

 

Which areas can I have microdermabrasion?

Face is the most common area for microderm. It can also be performed on essentially any skin area including neck, chest, back, and hands.

 

How often can I have microdermabrasion?

Microdermabrasion can be done  as frequently as weekly or up to every 8 weeks depending on your skin’s tolerance and desired cosmetic effects.  Many people choose to start with weekly treatments for 3 sessions, then change to a monthly maintenance regimen.

Typical Microderm Schedule:

  • Week 1: 1st session
  • Week 2: 2nd session
  • Week 3: 3rd session
  • Monthly: 4th– 12th sessions

Much like brushing your teeth, microderm helps to gently remove “plaque” and skin debris.

Since human skin typically regenerates at approximately 30 day intervals, skin improvement with microdermabrasion is temporary and needs to be repeated at average intervals of 2-4 weeks for continued improvement.

Usually multiple treatments (6 – 12 sessions) are recommended to see a significant improvement.

 

What are different types of microdermabrasion?

  • Crystal Microdermabrasion
  • Diamond Microdermabrasion
  • Home Microdermabrasion
  • Vacuubrasion
  • Cream Microdermabrasion

 

What are microderm crystals made of?

Microderm crystals are typically made of a very fine, abrasive material like aluminum oxide. Other inert microderm crystals include magnesium oxide, sodium chloride, and sodium bicarbonate.

  • Aluminum oxide
  • Magnesium oxide
  • Sodium chloride (salt)
  • Sodium bicarbonate (baking soda)

These ultrafine white crystals are disposable and should be discarded after each use. The microderm vacuum removes the crystals and exfoliated skin cells. Inhalation of crystals should be avoided and masks are often worn by the operator doing the treatment. There are some possible concerns of inhalation exposure and basic safety precautions should be taken.

Alternatively, microderm crystals can be replaced by the roughened surface of a diamond tip microdermabrasion system.

 

What does the vacuum do in microdermabrasion?

The vacuum part of microderm has four basic roles:

  • It gently pulls and lifts a small section of skin for microabrasion.
  • It can spray a stream of crystals across the targeted skin area.
  • It focally stimulates blood circulation and creates mild swelling in the skin.
  • It collects the used crystals and dead skin in a receptacle for easy disposal.

 

What should people expect before and after microdermabrasion?

Generally, softer and smoother skin that feels fresher and more rejuvenated is the expected outcome after a session of microdermabrasion. Before starting the microdermabrasion treatment, eye protection such as eye pads or goggles may be placed. Often the skin may be prepared and cleaned of makeup and oils. Yet, no topical or local anesthetic is required. The skin will be stretched to provide some tension in order to achieve the most effective abrasion and vacuum. The hand piece is moved over the skin with repeated single, smooth passes. Usually, 2-4 passes per area are sufficient.

The treated area is then cleaned with wet cloth. Mild pinkness of the skin is the desired outcome and usually resolves within hours after microdermabrasion. In addition, exfoliation of skin may occur as well. Continuously apply moisturizer or ointment if exfoliation occurs. Patients may also experience a mild sunburn like sensation for a few days. Moreover, liberal application of sunscreen is recommended as photosensitivity may be increased.

Microdermabrasion, especially with the coarse diamond-studded instrument, may stimulate the production of collage, thereby helping skin rejuvenation. As age spots from early photoaging and fine lines are removed, the skin becomes softer and smoother.

Because microdermabrasion only causes superficial injury on skin, it works the most effectively for fine lines, shallow scars, and dull skin. Lesions like deep wrinkles, scars or ice-pick acne scars, and stretch marks tend to extend into the deeper layers of the dermis and usually require more aggressive skin resurfacing modalities to treat. Similarly, microdermabrasion is not effective for pigmentary problems including melasma or postinflammatory hyperpigmentation that arise from deeper skin.

 

What are the benefits of microdermabrasion?

Microdermabrasion can create superficial ablation on skin, primarily in the epidermis, which helps remove the outermost dead skin cells and accelerate the rate of skin rejuvenation. As a result, microdermabrasion can be an effective procedure for fine lines and more superficial scars. For patients who have concerns of photoaging, microdermabrasion can be a preventative measure. Studies have also shown that microdermabrasion facilitates the absorption of some topical medications through increasing the permeability of hydrophilic active ingredients of the medicine. In the long-round, sun damage and photoaging may be decreased and skin moisture may be improved. Since microdermabrasion only causes superficial injury, scarring and pigmentary changes almost never happen from this procedure. Moreover, microdermabrasion possesses the advantages of rapid recovery and low risk and has little or no impact on patients’ lifestyle.

 

Does microdermabrasion help with acne scars?

Microdermabrasion is very useful for people with active acne, mild acne discoloration and pick marks, and very superficial or raised acne scars. Dermatologists use microderm to help unclog pores and clear acne. Often used in combination with gentle glycolic peels and medical acne extractions, microderm can help speed up acne clearing.

Individuals with deeper acne scars may expect a much longer series of treatments or likely benefit from physician performed surgical dermabrasion or laser resurfacing. As a general rule, the greater the potential benefits with a cosmetic treatment, the greater the potential risks and side effects. The possible risks with more aggressive treatments like dermabrasion and laser are much greater than microdermabrasion.

Deeply pitted acne scars would, at best, be expected to respond minimally to microdermabrasion. Pitted or depressed scars are very difficult to treat and may require combination treatments including subcision, punch excision, punch elevation, dermabrasion, laser resurfacing, and medium to deep chemical peels including 35% Trichloracetic acid (TCA) or phenol peels.

 

Does insurance pay for microdermabrasion?

These procedures are almost always considered cosmetic and not be paid by traditional medical insurance companies. Since microderm is often used to treat medical conditions like acne, acne scarring, melasma, and keratosis pilaris, it may be possible to deduct some costs as medical expenses. In appropriate cases, payment options may include using benefits of plans like Health Savings Accounts (HSA) or Health  Remittance Accounts (HRA) to pay for microderm. You will want to check the specific benefits and provisions of your plan and also review your tax deductions with a tax professional.

What is Vacubrasion?

Vacubrasion is a novel new at home microdermabrasion machine. This new device easily helps everyone to access microdermabrasion at home without buying expensive machines and equipment. This new at-home microdermabrasion kits often can provide the same or better depth of skin abrasion and  remove the dead skin cells by vacuuming as professional microdermabrasion. Basically, fine diamond abrasive particles and suction  help gingerly abrade the skin and remove surface cells to achieve the result of skin smoothening.

How is Vacubrasion less expensive than microdermabrasion creams?

Many microdermabrasion at-home creams cost $10-$95, which usually provides about 20-30 treatments, while some can be over $100. Once the jar is used up, so is your initial investment. These creams often use the aluminum oxide crystals or other sand-like fine debris to help manually exfoliate the skin. Multiple vendors, including L’Oréal, offer a microdermabrasion cream kit for average of $10-$30.

How is Vacuubrasion less expensive than other home microdermabrasion machines?

Vaccubrasion  It is made of durable, simple stainless steel parts that need no to little upkeep and can even be periodically rinsed off in the sink. Vacubrasion does not require expensive machines that break easily and require purchasing extra parts. Mini home microdermabrasion units are sold commercially and retail from $150-$350.

Rosacea FAQ

  • What is rosacea?
  • Is rosacea like acne?
  • What causes rosacea?
  • What are risk factors for rosacea?
  • Is rosacea contagious?
  • What are the signs and symptoms of rosacea?
  • How is rosacea diagnosed?
  • What else could it be?
  • What happens to the nose?
  • What happens to the eyes?
  • How is rosacea cured?
  • What about using acne medicine?
  • What is used for treating rosacea?
  • What should be avoided?
  • What foods are good for rosacea?
  • What natural or home remedies can help rosacea?
  • Does rosacea get worse with age?
  • How should I care for the skin of my face?
  • How are the telangiectasias (the red lines) treated?
  • How is a rhinophyma (the W.C. Fields nose) treated?
  • What effect may rosacea have on my life?
  • For more information
  • Rosacea t A Glance

What is rosacea?

Rosacea (roz-ay-sha) is a very common red, acne-like benign skin condition that affects many people worldwide. As of 2010, rosacea is estimated to affect at least 16 million people in the United States alone and approximately 45 million worldwide. Most people with rosacea are Caucasian and have fair skin. The main symptoms of rosacea include red or pink patches, visible tinybroken blood vessels, small red bumps, red cysts, and pink or irritated eyes. Most people with the disease may not even know they have rosacea or that it is a diagnosable and treatable condition. Many people who have rosacea may just assume they blush or flush easily or are just very sun sensitive. .

Rosacea is considered a chronic (long-term), non-curable skin condition with periodic ups and downs. As opposed to traditional or teenage acne, most adult patients do not “outgrow” rosacea. Rosacea characteristically involves the central region of the face, causing persistent redness or transient flushing over the areas of the face and nose that normally blush — mainly the forehead, the chin and the lower half of the nose. It is most commonly seen in people with light skin, and particularly in those of English, Irish and Scottish backgrounds. Some famous people with rosacea have included former President Bill Clinton and W.C. Fields.

The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps that often resemble teenage acne. In fact, rosacea can frequently be mistaken for common acne. Rosacea is also referred to as acne rosacea.

Is rosacea like acne?

Rosacea is basically different than acne, although the two can coexist. It is also sometimes called “adult acne.” Unlike common acne, rosacea is not primarily a plague of teenagers but occurs most often in adults (ages 30 to 50), especially those with fair skin. Different than acne, there are usually no blackheads or whiteheads in rosacea. Furthermore, most teens eventually outgrow acne whereas patients with rosacea don’t generally outgrow it. Rosacea consists mostly of small red bumps that are not “squeezable” or extractable like blackheads. Squeezing a rosacea pimple usually causes a scant amount of clear liquid to expel. Unlike traditional acne where professional extractions can help remove whiteheads and blackheads, squeezing or extracting rosacea bumps does not help improve the rosacea.  People with rosacea individuals  tend to have a rosy or pink color to their skin as opposed to acne patients whose skin is usually less red.

Rosacea strikes both sexes and potentially all ages. Overall, it tends to be more frequent in women but more severe in men. It is very uncommon in children, and it is very infrequently seen in darker skin tones or black skin. Overall, it is seen in light-featured adults between 30-50 years of age.

Rosacea is sometimes called “adult acne.”

What causes rosacea?

The exact cause of rosacea is still unknown and remains a mystery. The basic process seems to involve dilation of the small blood vessels of the face. Suspected causes of rosacea include but are not limited to genetic factors, genetics plus sun exposure, a mite sometimes found in hair follicles (Demodex folliculorum), the bacteria Helicobacter pylori (that is associated with stomach ulcers), gastrointestinal disease, and medications that cause blood vessels to widen. There seems to be a hereditary component to rosacea in a large number of  people. Often people have close family members with rosacea.

Rosacea tends to affect the “blush” areas of the face and is more common in people who flush easily. Additionally, a variety of triggers are known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. A flare-up can be caused by changes in the weather like strong winds or a change in the humidity. Sun exposure and sun-damaged skin is generally associated with rosacea. Exercise, alcohol consumption, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year’s holidays.

What are risk factors for rosacea?

Rosacea risk factors include fair skin, English, Irish or Scottish heredity, easy blushing, and having other family members with rosacea called “positive family history”. Additional risk factors include female gender, menopause, and adults in the age range 30-50years old.

Is rosacea contagious?

No. Rosacea is not considered contagious or infectious. There is no evidence that rosacea can be spread by contact with the skin, sharing towels, or through inhalation.

 

 

 

What are the signs and symptoms of rosacea?

Typical signs and symptoms of rosacea include facial flushing, blushing, redness, burning, red bumps, and small cysts. The symptoms tend to come and go. The skin may be clear for weeks, months, or years and then erupt again. Rosacea tends to evolve in stages and typically causes inflammation of the skin of the face, particularly the forehead, cheeks, nose, and chin.

When rosacea first develops, it may appear, then disappear, and then reappear. However, the skin may fail to return to its normal color and the enlarged blood vessels and pimples arrive in time. Rosacea may rarely reverse itself.

Rosacea generally lasts for years, and, if untreated, it tends to gradually worsen.

 

 

How is rosacea diagnosed?

Rosacea is usually diagnosed based on the typical red or blushed facial skin appearance and symptoms of easy facial blushing and flushing. Rosacea is largely under diagnosed and most people with rosacea often do not know they have the skin condition. Many people may not associate their intermittent flushing symptoms with a medical condition. The facial redness in rosacea may be transient and come and go very quickly.

Dermatologists are physicians who are specially trained in the diagnosis of rosacea. Generally no specific tests are required for the diagnosis of rosacea.

In unusual cases, a skin biopsy may be required to help confirm the diagnosis of rosacea.  Occasionally, a non-invasive test called a skin scraping may be performed by the dermatologist in the office to help exclude a skin mite infestation by Demodex which can look just like rosacea. A skin culture can help exclude other causes of facial skin bumps like staph infections or herpes infections. Blood tests are not generally required but may be used to help exclude less common causes of facial blushing and flushing including lupus, other autoimmune conditions, and dermatomyositis.

 What else could it be?

While most cases of rosacea are fairly straightforward, there are some atypical cases that are not as easy to diagnose. Other conditions and rosacea look-alikes include:

  • Acne vulgaris
  • Demodex folliculitis
  • Staph  infection
  • Lupus
  • Medication reaction (example: niacin)
  • Seborrheic dermatitis
  • Allergic or contact dermatitis
  • Eczema
  • Seasonal allergies
  • Allergic conjunctivitis
  • Perioral dermatitis
  • Carcinoid Syndrome
  • Impetigo
  • Herpes Simplex

 

 

What happens to the nose?

The nose is typically one of the first facial areas to be affected in rosacea. It can become red and bumpy and develop noticeable dilated small blood vessels. Left untreated, advanced stages of rosacea can cause a disfiguring nose condition called rhinophyma (ryno-fy-ma), literally growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks (like the old comedian W.C. Fields). There may also be thick bumps on the lower half of the nose and the nearby cheek areas. Rhinophyma occurs mainly in men. Severe rhinophyma can require surgical correction and repair.

 

Some people falsely attribute the prominent red nose to excessive alcohol intake, and this stigma can cause embarrassment to those with rosacea. Although a red nose may be seen in patients with heavy alcohol use, not every patient with rosacea abuses alcohol.

What happens to the eyes?

Rosacea may or may not affect the eyes. Not everyone with rosacea has eye issues. A complication of advanced rosacea, known as ocular rosacea, affects the eyes. About half of all people with rosacea report feeling burning, dryness, and grittiness of the eyes (conjunctivitis). These individuals may also experience redness of the eyelids and light sensitivity. Often the eye symptoms may go completely unnoticed and not be a major concern for the individual. Many times, the physician or ophthalmologist may be the first one to notice the eye symptoms. Untreated, ocular rosacea may cause a serious complication that can damage the cornea, called rosacea keratitis. An ophthalmologist can assist in a proper eye evaluation and prescribe rosacea eye drops. Oral antibiotics may be useful to treat skin and eye rosacea. Untreated eye rosacea may cause permanent damage, including impaired vision.

How is rosacea cured?

Rosacea is currently not considered a curable condition. While it cannot be cured, it can usually be controlled with proper, regular treatments.

There are some forms of rosacea that may be significantly cleared for long periods of time using laser, intense pulse light, photodynamic therapy, or isotretinoin (Accutane). Although still not considered a “cure,” some patients experience long-lasting results and may have remissions (disease-free period of time) for months to years.

What about using acne medicine?

Since there is some overlap between acne and rosacea, some of the medications may be similar. Acne and rosacea have in common several possible treatments including (but not limited to) oral antibiotics, topical antibiotics, sulfa-based face washes, isotretinoin, and many others. It is important to seek a physician’s advice before using random over-the-counter acne medications since they can actually irritate skin that is prone to rosacea. Overall, rosacea skin tends to be more sensitive and easily irritated than that of common acne.

What is used for treating rosacea?

There are many treatment choices for rosacea depending on the severity and extent of symptoms. Available medical treatments include antibacterial washes, topical creams, antibiotic pills, lasers, pulsed-light therapies, photodynamic therapy, and isotretinoin.

Mild rosacea may not necessarily require treatment if the individual is not bothered by the condition. More resistant cases may require a combination approach, using several of the treatments at the same time. A combination approach may include home care of washing with a prescription sulfa wash twice a day, applying an antibacterial cream morning and night, and taking an oral antibiotic for flares. A series of in-office laser, intense pulsed light or photodynamic therapies may also be used in combination with the home regimen. It is advisable to seek a physician’s care for the proper evaluation and treatment of rosacea.

Topical creams

With the proper treatment, rosacea symptoms can be fairly well controlled. Popular methods of treatment include topical (skin) medications applied by the patient once or twice a day. Topical antibiotic medication such as metronidazole applied one to two times a day after cleansing may significantly improve rosacea. Azelaic acid (Finacea gel 15%) is another effective treatment for patients with rosacea. Both metronidazole and azelaic acid work to control the redness and bumps in rosacea.

Some patients elect combination therapies and notice an improvement by alternating metronidazole and azelaic acid: using one in the morning and one at night. Sodium sulfacetamide (Klaron lotion) is also known to help reduce inflammation. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin).

Common topical medications used either 1-2 times a day:

  • (Finacea gel 15%)
  • (Klaron lotion)
  • gel (Erygel)
  • Clindamycin gel, solution, or lotion (Cleocin).

 

 

 

Oral antibiotics

Oral antibiotics are also commonly prescribed to patients with moderate rosacea. Tetracycline, doxycycline, minocycline, and amoxicillin are among the many oral antibiotics commonly prescribed and they actually help reduce inflammation and pimples in rosacea. A newer low dose doxycycline preparation called Oracea 40mg once a day has been used in rosacea. The dose may be initially high and then be tapered to maintenance levels. Common side effects and potential risks should be considered before taking oral antibiotics.

Oral antibiotics include:

  • 100mg
  • 500mg

Miscellaneous Medications

Short-term topical cortisone (steroid) preparations of minimal strength may in occasional cases also be used to reduce local inflammation. Some mild steroids include desonide lotion or hydrocortisone 0.5% or 1% cream applied sparingly once or twice a day just to the irritated areas. There is a risk of causing a rosacea flare by using topical steroids. Prolonged use of topical steroids on the face can also cause Perioral dermatitis.

Some doctors may also prescribe tretinoin (Retin-A), tazarotene (Tazorac), or adapalene (Differin) which are prescription medications also used for acne. Rarely, permethrin (Elimite) cream is prescribed for rosacea cases that are associated with skin mites. Permethrin is also used for the body mites that cause scabies.

Isotretinoin (Accutane)

Isotretinoin is infrequently prescribed in cases of  severe and resistant rosacea. Often it is used after multiple other therapies have been tried for some time and have failed. It is used as a daily capsule for 4-6 months. Isotretinoin is not typically used in rosacea and it is most commonly used in the treatment of severe, common acne called acne vulgaris. Close physician monitoring and blood testing are necessary while on isotretinoin. Typically at least 2 forms of birth control are required for females on this medication and pregnancy is absolutely contraindicated while on isotretinoin.

Cleansers

In addition, prescription or over-the-counter sensitive skin cleansers may also provide symptom relief and control. Harsh soaps and lotions should be avoided, whereas simple and pure products such as Cetaphil or Purpose gentle skin cleanser may be less irritating. Patients should avoid excessive rubbing or scrubbing the face.

  • Cetaphil Cleanser
  • Purpose Soap
  • Sulfa based washes ( example: Rosanil)
  • Benzoyl Peroxide washes  (example: Clearasil)

 

Laser and intense pulsed light

Many patients are now turning to laser and intense-light treatments to treat the continual redness and noticeable blood vessels on the face, neck, and chest. Often considered a safe alternative, laser and intense pulse-light therapy may help to visibly improve the skin and complexion.

Laser treatment may cause some discomfort. While most patients are able to endure the procedure, ice packs and topical anesthetic cream can help alleviate the discomfort. Multiple treatments are typically necessary and the procedure is not covered by most insurances. Treatments are recommended in three- to six-week intervals; during this time, sun avoidance is necessary. Risk, benefits, and alternatives should be reviewed with your physician prior to treatment. Laser treatments may be combined with photodynamic therapy (light-activated chemical using Levulan) for more noticeable results.

Photodynamic therapy

Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that is applied to the skin and a light to activate the sensitizer. Levulan (aminolevulonic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can also be used to treat some rosacea patients. The use of PDT in rosacea is considered off-label use to some extent, since it is primarily designed for regular acne. PDT is thought to work at reducing the inflammation, pimples, and also improving the skin texture. PDT is an in-office procedure performed in your physician’s office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.

Glycolic peels

Glycolic-acid peels may additionally help improve and control rosacea in some people. The chemical peels can professionally be applied for approximately two to five minutes every two to four weeks. Mild stinging, itching, or burning may occur and some patients experience peeling for several days after the peel. Any peel can irritate very sensitive skin and cause flares for some people. Peels should be used with caution in rosacea as not everyone is bale to tolerate these treatments.

Sun protection

Sun exposure is a well known flare for many rosacea sufferers. Sun protection using a wide-brimmed hat (at least 6 inches) and physical sunscreens  (like zinc or titanium) are generally encouraged. Because rosacea tends to occur in mostly fair-skinned adults, the use of an appropriate daily sunscreen lotion and overall sun avoidance is recommended. Zinc-based sunscreens (SPF 30 or higher) provide superior sun protection.

What should be avoided?

While not all rosacea people are exactly the same, there are some common rosacea triggers. Avoiding these potential triggers may also help relieve symptoms and disease flares. It may be helpful to keep a personal diary of foods and other triggers that flare rosacea symptoms.

Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible. Red wine and chocolate are two well known rosacea triggers. Some listed foods may have no effect on your rosacea but severely affect someone else. Individual reaction patterns vary greatly in rosacea and therefore a food diary may help to elucidate your special triggers.

Possible rosacea dietary triggers include:

  • Dairy including yogurt ,sour cream, cheese (except cottage cheese)
  • Alcohol including red wine, beer, vodka, gin, bourbon, and champagne
  • Chocolate  
  • Soy sauce
  • Yeast extract
  • Eggplants, Avocados, Spinach
  • Some beans and pods, including lima, navy or peas
  • Citrus fruits, including tomatoes, bananas, red plums, raisins or figs
  • Spicy and temperature hot foods

Potent cortisone or steroid medications on the face should be avoided because they can promote widening of the tiny blood vessels of the face. Some patients experience severe rosacea flares after prolonged use of topical steroids.

Vasodilator pills can also flare rosacea. Vasodilators include several blood pressure medications like nitrates, calcium channel blockers, and thiazide diuretics.

These potential triggers are found in many skin cleansers and should be avoided in rosacea.

  • Alcohol
  • Witch hazel
  • Peppermint
  • Eucalyptus oil
  • Clove oil
  • Fragrance
  • Menthol
  • Salicylic acid

 

 

 

What foods are good for rosacea?

Foods that help avoid rosacea flares include less spicy meals, non-alcoholic cool beverages, caffeine-free drinks, non-dairy cheese, and thermally cooler meals.

What natural remedies can help rosacea?

Rosacea skin tends to be fairly sensitive and may easily flare with self treatment or common acne therapies. Any home treatment or attempts for natural remedies should be approached with mild caution. As with any rosacea therapy, some people may experience sensitivity or irritation with treatment. Several possible natural remedies including dilute vinegar cleansing and green tea applications may be useful in rosacea.

Dilute white vinegar facial soaks or cleansing daily or weekly using approximately 1 part regular table vinegar to 6 parts water may be helpful. Vinegar is thought to help as a natural disinfectant and can help decrease the number of yeasts and bacteria on the skin. Since vinegar may flare rosacea in some people, a small test area should be tries before applying to the entire face.

Green tea soaks to the face may also help decrease the redness and inflammation seen in rosacea. Green tea is thought to have anti-inflammatory properties. A few commercially available products also use green tea as the active ingredient.

Does rosacea get worse with age?

Yes. Although rosacea has a variable course and is not predictable in everyone, overall it tends to gradually worsen with age, especially if untreated.  In small studies, many rosacea sufferers have reported that without treatment their condition had advanced from early to middle stage within a year.  With good therapy, it is possible to prevent progression of rosacea.

How should I care for the skin of my face?

Proper skin care involves using a gentle cleanser to wash the face twice a day. Over-washing may cause irritation. A sunscreen lotion is advisable each morning. Your physician may prescribe a topical antibiotic to use once or twice a day under your sunscreen.

Rubbing the face tends to irritate the reddened skin. Some cosmetics and hair sprays may also aggravate redness and swelling.

  • Gentle skin cleanser twice a day
  • Sunscreen in AM
  • Sun avoidance

Facial products such as soap, moisturizers, and sunscreens should be free of alcohol or other irritating ingredients. Moisturizers should be applied very gently after any topical medication has dried. When going outdoors, sunscreens with an SPF of 15 or higher are needed.

How are the telangiectasias (the red lines) treated?

Telangiectasias are the small blood vessels that arise on the surface of the skin, commonly on around the nose, cheeks, and chin.

Simple cover-up makeup can be used for the telangiectasias. There are some green-based moisturizers or tinted foundations that may help conceal the redness.

Telangiectasias can also be medically treated in your physician’s office with a small electric needle, a laser, intense pulse light, or minor surgery to close off the dilated blood vessels. Usually, multiple treatments are required for best results and only a portion of the blood vessels may be improved with each treatment. Not everyone responds the same to these types of treatments, and your physician can help you decide which treatment is best for your skin type, condition, and size of blood vessels.

  • Electrocautery
  • Laser
  • Intense Pulse Light Therapy

How is a rhinophyma (the W.C. Fields nose) treated?

Rhinophyma of the nose is frequently treated by surgery. The excess tissue may be removed with a scalpel, laser, or electro surgery. Dermabrasion can help improve the look of the scar tissue. Follow-up treatments with laser or intense pulsed light may help lessen the redness. Medical maintenance therapy with oral and or topical antibiotics may be useful to decrease the chance of recurrence.

What effect may rosacea have on my life?

Rosacea may affect your life minimally, moderately, or severely depending on how active the condition is and your overall tolerance of the skin symptoms.

Some people have absolutely no symptoms and are not bothered at all by their rosacea. They may enjoy perfectly healthy normal lives without any effect from this benign skin condition. Some patients really like the pink glow to their cheeks and find it gives them a pleasant color without having to use blush. They may not even know they have rosacea. They usually do not want to use any treatment.

People with moderate rosacea may have periodic flares that require treatment with oral antibiotics, lasers, and other therapies. They may continuously take an antibiotic daily for years and years to keep their symptoms under control. Many of these people may complain of embarrassment from the flushing and blushing of rosacea. They may have ups and downs and times that their disease is quiet and other times when it feels like it is on fire. With the help of their physician, these patients can learn the pattern of their rosacea and develop a treatment plan to keep it from interfering in their daily lives.

Other patients have very bothersome rosacea that causes them issues on a daily basis. There are subsets of severe rosacea sufferers who have extreme psychological, social, and emotional symptoms. Some have developed social phobias causing them to cancel or leave situations when their rosacea is flaring or active. Some patients complain of looking like they have been drinking alcohol when in fact they don’t drink at all. Although rosacea is not a grave medical situation, severe cases may wreak havoc in some patient’s lives. It is important for these patients to discuss their physical and emotional concerns with their physicians and to get professional help in treating their rosacea.

Overall, promptly diagnosed and properly treated, rosacea should not prevent people with the condition from enjoying long and productive lives.

Additional information is available from the American Academy of Dermatology at www.aad.org. Names of U.S. board certified dermatologists are available on this website.

 

 

Rosacea at a Glance

  • Rosacea is a common, chronic, incurable, adult, acne-like skin condition.
  • It has periodic ups and downs (flares and remissions).
  • Rosacea symptoms tend to come and go.
  • It is easily controllable and medically manageable.
  • Rosacea may begin with easy facial blushing or flushing.
  • Rosacea  commonly affects the central third of the face, especially the nose.
  • Rosacea causes tiny red pimples and fine red lines on the facial skin.
  • Rosacea may be mistaken for rosy cheeks, sunburn, or quite often, acne.
  • Rosacea triggers include alcohol, hot or spicy foods, emotional stress, and heat.
  • Rosacea can be a very bothersome and embarrassing condition.
  • Untreated rosacea tends to worsen over the time and be a progressive disease.
  • Rosacea untreated can cause a bulbous red nose (like W.C. Fields).
  • Prompt recognition and proper treatment permit people with rosacea to enjoy life.

 

 


Information in this publication and site is not intended to serve as medical advice. Individuals may use the information as a guide to discuss their treatments with their own physicians. This site does not promote nor endorse the unauthorized practice of medicine by non-physicians or state licensed health care providers.
Medicine is a constantly changing science and not all therapies are clearly established. New research changes drug and treatment therapies daily. The authors, editors, and publisher of these artciles have used their best efforts to provide information that is up-to-date and accurate and is generally accepted within medical standards at the time of publication. However, as medical science is constantly changing and human error is always possible, the authors, editors, and publisher or any other party involved with the publication of this article do not warrant the information in this article is accurate or complete, nor are they responsible for omissions or errors in the article or for the results of using this information. The reader should confirm the information in this article from other sources prior to use. In particular, all drug doses, indications, and contraindications should be confirmed in the package insert.

Acne for Teens

What is Acne?

Acne is the term used to describe clogged pores or comedones (blackheads, whiteheads), pimples and deeper lumpes such as cysts or nodules that usually occur on the face, neck, back, shoulders and upper arms. 

There are so many types of acne.  The most common is called acne vulgaris.  Almost everyone goes through a period of acne at one time or another.  Just beneath the surface of the skin lie hundreds of tiny glands called sebaceous glands.  Their function is to collect and excrete the oily substance called sebum, to keep the skin healthy. 

However, the tiny pathway for the sebum to escape often becomes clogged, and a bacterium called p. acne grows inside.  In a short time, the area swells up, and forms a pimple on the skin.  At certain times of life, this process becomes very active, troublesome and hard to control.   

 

Acne Myths

– Not to worry, “You will grow out of it”
-Acne is caused by poor hygiene
-Acne is caused by something in your diet
-Vigorous washing helps
-Treatments don’t work

 


Treatment Options 

Acne Treatments

Blue Light Treatment
Photodynamic Therapy
Acne Treatment

If you have acne, it can be embarrassing and lead to low self esteem. Without treatment severe cases of acne can be disfiguring, leaving permanent scars. New techniques are available to treat acne and minimize outbreaks.

Acne is an equal opportunity condition, afflicting teenagers, young adults, and occasionally even more mature adults. Blue Light Acne Treatment uses light – without drugs or antibiotics – to treat hard to control acne, including acne vulgaris. The special blue light kills the p. acnes bacterium that grows inside clogged pores that swell up and form pimples on the skin.

Light treatments involve sitting with your face close to the light for a short time (typically 8 to 16 mins 40 secs) about once or twice per week for a period of about five weeks or so. The procedure is safe, not painful, and not hot. Over the course of the treatments, most patient experience noticeable control or clearing up of their acne for a very long period.

 

– Acne Facial Treatment

Popular acne treatments include a deep pore cleansing that may include a glycloic peel, manual extractions, acne healing mask, microdermabrasion  and a cool refreshing slush.  It is designed to help with acne, pigmentation, rough skin, blemishes and rosacea.   

Facial Steps

  • Glycolic and or salicylic peels  
  • extractions using 30g needle or lancet and comedone extractor 
  • slush ( light cryotherpay on swab)
  • Microdermabrasion
  • steam, high frequency

– Acne Products

Glycolic Gly/Sal Acne Wash

Medicated cleanser with glycolic and salicylic acids to treat acne.  A gentle wash with immediate results. 

Benzoyl Peroxide Wash 5% or 10%

Therapeutic wash with benzoyl peroxide for the treatment of acne prone skin.  Excellent for thoes fighting acne on the face and body. 

Glycolic Acne Pads

Toning pads with 5% glycolic acid and 2% salicylic acids for exceptional toning and exfoliation.  Great for teens in sports.


Personalize your Acne Treatment ( Your Dermatologist or Doctor will typically recommend one of these choices for your skin type)

1. Wash AM and PM: Wash your face twice daily with:

  • Alternate Benzoyl peroxide wash and Glysal wash or Salac Or DHL Sal Shampoo-Use one wash in AM (shower) and in the PM (by sink).  
  • Acne soap (DHS sal shampoo, Salac, Neutrogena oil-free acne wash, Panoxyl Bar 5%, Benzac wash, Brevoxyl wash, TRIAZ, Brevoxl).
  • Ovace face wash, Plexion Cleanser, Rosanil, Clenia.
  • Mild Soap/ Cleanser (Dove, Purpose, Basis, Cetaphil, Oil of Olay)
  •  Obagi Cleanser ( Step 1) and then apply Obagi Toner ( Step2)  

2. AM: Apply the following each morning:

  • Cleocin (clindamycin) lotion, clindet pledget (wipe), clindagel
  • Benzoyl peroxide- (Benzac,Brevoxyl, Triaz), Triaz Pad
  • Klaron Lotion, Metrogel, Metrolotiom
  • Benzaclin, Duac gel spot treatment

3. PM: Please apply the following each evening:
(if too irritating, use every other night)  Use these all over face- don’t spot treat, but DO avoid crevices like corners of mouth, nose, and eyes (All OF THESE MAY BE IRRITATING)

  • Differin gel/cream pledgets to all over face 
  • Retin A  (tretinoin)
  • Tazorac every night  / only every other night to  face, back, chest, arms
  • ­­­­­­­­­­Benzaclin, Duac gel spot treatment, Finacea gel   

4.  Take the following pill: (follow the proper directions for all medications)

  • Tetracycline
  • Minocin/ Minocycline/ Dynacin/ Doxycyline/ Adoxa
  • Amoxicillin
  • Zithromax

5.   AM or PM: If your skin gets dry, you can use non-comedogenic moisturizers                                                                            

  •   Oil free moisturizer sunscreen or glycolix elite facial moisturizer 
  •   Cetaphil or Eucerin lotion for face with sunscreen 
  •   Desowen lotion- once or twice a day ONLY for red itchy rash, dry areas- (don’t  use regularly)                

6.  AM: Use Sunscreens Daily  

  • Moisturizing sunscreens like Physician’s Complex SPF 30 sunscreen with zinc
  • Gel(non oil) suncreens- Ombrelle, Presun clear gel, solbar liquid, Ti-Screen

7.  If you wear cosmetics make sure they are oil-free and try to avoid powders.  

8. If you have any allergic reaction, stop the medication and call our office. STOP ALL MEDICATIONS IMMEDIATELY IF DECIDE TO BECOME PREGNANT OR THINK YOU MAY BE PREGNANT.   

9.   Return for a follow up appointment when suggested by your physician 

  • Facials/ Acne Treatments   
  • Glycolic Gentle Peels series every 2-4 weeks to begin       
  • Medium TCA/Jessner Peel (Blue peel) (1 hour appt )7 days downtime: Face, Neck or Chest
  • Blue light or laser precision peel (15-30 min appt)  
  • Acne Extractions
  • Photofacial/ Photo rejuvenation for brown spots, freckles, age spots, red areas, broken vessels, wrinkles- This may include several treatments. 



An Overview:
Acne & Related Inflammatory disorders
ACNE & Inflammatory Disorders

  • Acne Vulgaris      

  • Acne Rosacea

  • Perioral Dermatitis

  • Hidradenitis Suppurativa

  • Keratosis Pilaris

  • Folliculitis

  • Acneiform Dermatitis

     

Who is Affected?

  • Everyone at some time in their life

  • From babies to seniors

  • high prevalence

  • Often under treated or self treated

  • Atypical presentations of common disease

  • May lead to permanent scarring

  • Controllable

 Why Treat Acne?

  • Psychosocial impact
  • self esteem, confidence, job, social status
  • Untreated may lead to permanent scarring
  • Emphasis in teenagers -classic occurrence

Dispelling Acne Myths

  • Acne is not caused by poor hygiene or diet
  • Vigorous washing will not remove comedones and may worsen inflammation
  • Topical therapies should be applied to all potential acne areas, not just to lesions, because they work by preventing the formation of new lesions (they do little to shrink existing lesions)

ACNE TRIAD: What makes acne?

  • Follicular plugging (pores closed)
  • Sebum production ( oil production)
  • Bacterial colonization

•   Acne is disease caused by 4 interrelated processes affecting the pilosebaceous unit

–  altered follicular hyperkeratinization

–  sebaceous gland hyperactivity

–  Propionibacterium acnes (P acnes) proliferation

–  Inflammation/immune hypersensitivity to
P acnes

TRIPLE THERAPY IS KEY!

 1. Retinoid (unplugs)

 2. Benzoyl peroxide (antibacterial, unplugs,etc)

 3. Antibiotics (decrease bacteria)- oral or topical

 Combine one product out of each category .


Current Treatment Options

Topical

Retinoids

Benzoyl Peroxide

Antibiotics

Azelaic Acid

Salicylic Acid

Comination treatments

Benzoyl Peroxide + Antibiotics

 

Oral

Antibiotics

Isotretinoin

Corticosteroids

RETINOIDS

  • Adapalene (Differin)
  • Tretinoin (Retin A, Renova, Avita)
  • Tazaratone (Tazorac, Avage)

-Do not use in pregnant, breastfeeding, or trying to become pregnant.

-May be irritating, use small amount, avoid around the eyes, apply every other night


Severe Acne: Techniques to minimize irritation

–  gradual introduction of medication; initiate use with low concentration formulations

–  no scrubbing

–  adequate moisturization

–  brief application followed by gentle washing

ANTIBIOTICS: topical

  • Clindamycin ( Clindets wipes, or clindagel)
  • Erythromycin
  • Metronidazole ( Metrogel)
  • Sulfa ( Klaron)

ANTIBIOTICS: Oral

  • Amoxicillin
  • Tetracycline
  • Doxycycline
  • Minocycline
  • Azithromycin

 

Antibiotic Resistance

•   Clindamycin and erythromycin have become less effective topical acne therapies in the past 20 years

•   Loss of efficacy is due to the acquisition of resistance by P acnes

•   The addition of BPO dramatically reduces resistance to erythromycin and clindamycin

Other Oral Prescriptions 

  • Oral Contraceptives
  • Spironolactone ( anti-androgen)
  • Accutane
Practical ACNE Review: Top 10 List

1. Benzoyl Peroxide

2. Topical Retinoids

3. Topical Antibiotics

4. Salicyclic acid

5. Glycolic acid

6. Combination topical products (Antibiotics & BP)

7.  Oral antibiotics

8. Oral Retinoids

9. Oral Contraceptives

10. Oral Antiandrogens ( Spironolactone)

Differential Diagnosis:

  • eczema
  • folliculitus
  • drug reaction
  • rosacea
  • delusions of parasitosis
  • neurotic excoriations
  • furuncluosis
  • hidradenitis suppurativa

 

Acne if Pregnant or Breastfeeding

SAFE:

  • Erythromycin gel
  • oral amoxicillin/ampicillin

NOT SAFE:

  • Retinoids (Retin-A, Differin, Tazorac)
  • Oral Tetracylines

 

Lasers

  • Different targets based on laser source
  • Some target bacteria, some redness, others collagen 
  • usually multiple treatments needed 
  • No guarantees 
  • Generally cosmetic/ non- insurance

 What is Rosacea?

  • Primarily Red
  • Located on Cheeks and Nose
  • more in Caucasians (Scottish, Irish)
  • Inflammatory

 How to Treat Rosacea

  • Sulfa Wash as directed
  • Metrogel
  • Oral Antibiotics
  • Lasers or Photofacial

 

Postacne Scarring -Treatment option:

  • Dermal fillers ( collagen)
  • Laser therapy
  • Surgery ( punch removals)
  • Facial peels 

 

Therapy for Postacne Scarring

Postacne Scarring

The “ACNE SAMPLER”

In office adjunctive treatment :      

  • Glycolic  and or salicylic peels
  • extractions using 30g needle or lancet and comedome extractor
  • slush ( light cryotherapy on swab) 

 

Summary

  • Acne affects many ages from infancy to geriatric
  • “Triple therapy” very effective:

          -topical retinoid

          -topical antibiotic &/or benzoyl peroxide

          -oral antibiotic

  • Accutane for severe, cystic, or refractory acne
  • Acne is a common condition
  • Acne may persist into adulthood in some patients (mostly women)
  • Patients with acne commonly experience both physical and psychologic impairment

Photodynamic Therapy

  • Uses  a photosensitizer compound
  • Apply to skin and leave on for a time
  • Expose skin to controlled amount light
  • Levulan ( part of porphyrin system)
  • Has downtime 2-7 days- red/sunburn
  • Works by oxygen free radical formation

 


Information in this publication and site is not intended to serve as medical advice. Individuals may use the information as a guide to discuss their treatments with their own physicians. This site does not promote nor endorse the unauthorized practice of medicine by non-physicians or state licensed health care providers.
Medicine is a constantly changing science and not all therapies are clearly established. New research changes drug and treatment therapies daily. The authors, editors, and publisher of these artciles have used their best efforts to provide information that is up-to-date and accurate and is generally accepted within medical standards at the time of publication. However, as medical science is constantly changing and human error is always possible, the authors, editors, and publisher or any other party involved with the publication of this article do not warrant the information in this article is accurate or complete, nor are they responsible for omissions or errors in the article or for the results of using this information. The reader should confirm the information in this article from other sources prior to use. In particular, all drug doses, indications, and contraindications should be confirmed in the package insert.

Current Research and Clinical Trials in Acne

www.ClinicalTrials.gov for a list of current acne research opportunities.


Rank Status Study
1 Completed Safety and Efficacy of MBI 226 1.25% and 2.5% Topical Acne Solutions in the Treatment of Acne

Conditions: Acne Vulgaris;   Acne;   Propionibacterium Acnes
Intervention: Drug: MBI 226 Acne Solutions
2 Completed Safety and Efficacy of MBI 226 2.5% and 5.0% Topical Acne Solutions in the Treatment of Acne

Conditions: Acne Vulgaris;   Acne;   Propionibacterium Acnes
Intervention: Drug: MBI 226 Acne Solutions
3 Active, not recruiting Comparative Antimicrobial Efficacy of Two Topical Acne Therapies for the Treatment of Facial Acne

Condition: Acne
Interventions: Drug: Antibiotic and benzoyl peroxide gel;   Drug: Antibiotic and topical retinoid gel
4 Completed A Study of Acne Treatment in Children Ages 9 to 11

Condition: Acne Vulgaris
Interventions: Drug: Retin-A Micro 0.04% facial acne treatment;   Drug: Vehicle control
5 Completed Comparison Study of Topical Acne Regimens

Condition: Acne
Intervention: Drug: Acne Free, Proactiv
6 Terminated Pilot Study of a Dietary Intervention to Prevent Acne Recurrence

Condition: Acne
Intervention: Behavioral: Minimization of milk and dairy products in the diet
7 Active, not recruiting Plant-based Dietary Intervention for Treatment of Acne

Condition: Acne
Interventions: Behavioral: Low-fat, vegan diet;   Behavioral: Control
8 Terminated Photodynamic Therapy in the Treatment of Acne

Condition: Acne Vulgaris
Intervention: Device: LumaCare LC-122M non-coherent light source with LUM-I, fiber optic probe, 610 nm-660 nm output range
9 Recruiting Safety and Efficacy of Skin Cleanser Contained Roselle Extract in Acne

Condition: Acne
Interventions: Other: skin cleanser contained Hibiscus sabdariffa extract;   Other: marketed skin cleanser
10 Recruiting Efficacy of Lappa Arctium (Homoeopathic Medicine) in Treatment of Acne Vulgaris

Condition: Acne Vulgaris
Intervention: Drug: Lappa Arctium
11 Active, not recruiting Adherence to Study Medication Compared to Generic Topical Clindamycin Plus Generic Topical Tretinoin in Subjects With Mild to Moderate Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: clindamycin phosphate 1.2% and tretinoin 0.025%;   Drug: clindamycin 1% gel plus tretinoin 0.025%
12 Completed A Study of Different Use Regimens Using Two Acne Treatments

Condition: Acne Vulgaris
Intervention: Drug: benzoyl peroxide wash and tretinoin gel
13 Completed Comparative Efficacy and Safety of Benzoyl Peroxide Used in Combination With Clindamycin vs. Benzoyl Peroxide Used in Combination With Clindamycin and Doxycycline in the Treatment of Moderate Acne

Condition: Acne
Interventions: Drug: Benzoyl peroxide with clindamycin;   Drug: Benzoyl peroxide with clindamycin and doxycycline
14 Active, not recruiting A Study to Compare the Tolerability and Efficacy of Tazorac Cream Used With Duac Gel or Acanya Gel for Treatment of Acne

Condition: Acne Vulgaris
Interventions: Drug: Tazorac Cream and Duac Topical Gel;   Drug: Tazorac Cream (tazarotene 0.1%) plus Acanya Gel (clindamycin phosphate 1.2%/benzoyl peroxide 2.5%).
15 Terminated
Has Results
Efficacy And Safety Of Azithromycin SR Compared With Minocycline In Acne

Condition: Acne Vulgaris
Interventions: Drug: Azithromycin microspheres;   Drug: minocycline-placebo capsules;   Drug: Azithromycin microspheres-placebo;   Drug: Minocycline capsules,
16 Active, not recruiting NdYag Laser for Acne Keloidalis Nuchae

Conditions: Acne Keloidalis Nuchae;   NdYag Laser;   AKN;   Acne Keloidalis;   AK;   Dermatitis Papillaris Capillitii;   Folliculitis Keloidalis Nuchae;   Sycosis Nuchae;   Acne Keloid;   Keloidal Folliculitis;   Lichen Keloidalis Nuchae;   Folliculitis Nuchae Scleroticans;   Sycosis Framboesiformis
Interventions: Device: NdYag Laser(hair removal laser) plus topical corticosteroid;   Drug: Topical corticosteroid alone
17 Recruiting A Study to Examine the Safety and Efficacy Of Drospirenone and Ethinyl Estradiol (YAZ) Compared With Placebo In The Treatment Of Moderate Truncal Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: drospirenone and ethinyl estradiol;   Drug: Placebo tablets
18 Completed Microdermabrasion for Acne

Condition: Acne Vulgaris
Intervention: Device: microdermabrasion
19 Enrolling by invitation Proof of Concept Study to Investigate the Recurrence of Acne Post Isotretinoin

Condition: Acne
Interventions: Drug: tretinoin microsphere 0.04% gel;   Drug: vehicle gel
20 Completed Infrared Non-Cutting Laser Therapy for Acne

Condition: Acne Vulgaris
Intervention: Device: CoolTouch II laser

21 Active, not recruiting Non-Cutting Laser Therapy in the Treatment of Acne

Condition: Acne Vulgaris
Intervention: Device: V-Beam laser, Candela Corp., 595 nm wavelength
22 Completed Study of Two Different 10.0% Benzoyl Peroxide Creams for Mild to Moderate Acne Vulgaris

Condition: Acne Vulgaris
Intervention: Drug: topical benzoyl peroxide 10.0% cream – Formulations #1 and #2
23 Active, not recruiting Trial of Clindamycin / Benzoyl Peroxide Gel in Subjects With Acne

Condition: Acne Vulgaris
Interventions: Drug: clindamycin / benzoyl peroxide gel;   Drug: clindamycin gel;   Drug: BPO gel;   Drug: vehicle gel
24 Completed Safety and Efficacy Study of Topical Methyaminlevulinate (MAL) in Subjects With Facial Acne

Condition: Acne
Intervention: Drug: MAL
25 Completed A Split-Face, Paired-Comparison, Pilot Study to Evaluate Safety and Efficacy of Two Topical Salicylic Acid 1.0% Creams for Mild to Moderate Acne Vulgaris

Condition: Acne Vulgaris
Intervention: Drug: topical salicylic acid 1.0% cream
26 Completed Comparison of Efficacy and Safety of Azelaic Acid 15% Gel With Its Vehicle in Subjects With Mild to Moderate Acne

Condition: Acne Vulgaris
Interventions: Drug: Azelaic Acid Gel 15% (Finacea, BAY39-6251);   Drug: Vehicle gel (SH H 655 PBA)
27 Completed Evaluation of the Effectiveness, Safety, and Tolerability of Duac Akne Gel and Epiduo Gel in the Treatment of Facial Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: Epiduo Gel;   Drug: Duac Gel
28 Completed A Study to Evaluate Tolerability of Two Topical Drug Products in the Treatment of Facial Acne

Condition: Acne Vulgaris
Interventions: Drug: clindamycin and benzoyl peroxide gel (Duac® Topical Gel);   Drug: benzoyl peroxide and adapalene gel (EPIDUO™ Gel)
29 Recruiting the Comparison Efficacy of Azithromycin With Doxycycline in the Treatment of Acne Vulgaris

Condition: Acne
Interventions: Drug: Doxycycline;   Drug: Azithromycin
30 Completed Comparison of Stacked-Pulses Vs. Double-Pass Treatments of Facial Acne With a 1450 Nm Laser

Conditions: Acne;   Acne Scars
Intervention: Device: 1450nm diode laser
31 Completed Phase IV Study to Gather More Information About the Safety of ACZONE Gel, 5% in Treating Subjects With Acne Who Have G6PD Deficiency

Condition: Acne Vulgaris
Interventions: Drug: ACZONE Gel, 5%;   Drug: Vehicle
32 Recruiting Safety and Efficacy of the Use of Botox on Acne

Condition: Acne Vulgaris
Interventions: Drug: Botulinum Neurotoxin Type A;   Drug: Bacteriostatic saline
33 Completed Study to Demonstrate the Efficacy and Safety of Adapalene/Benzoyl Peroxide Topical Gel in Subjects With Acne Vulgaris

Condition: Acne Vulgaris
Intervention: Drug: Adapalene/Benzoyl Peroxide
34 Recruiting A Study to Evaluate the Safety and Efficacy of Tazarotene Foam, 0.1%, in Subjects With Common Facial Acne

Condition: Acne Vulgaris
Interventions: Drug: Tazarotene Foam;   Drug: Vehicle Foam
35 Completed Fractional Resurfacing Device for Treatment of Acne Scarring

Condition: Acne Scarring
Intervention: Device: 10,600 nm fractional CO2 laser system
36 Active, not recruiting Efficacy & Safety of Clindamycin and Tretinoin in Acne

Condition: Acne
Intervention: Drug: Clindamycin Phosphate 1.2% and Tretinoin 0.025% Gel
37 Completed A Phase 2 Study of ASC-J9 Cream in Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: ASC-J9 cream;   Drug: placebo
38 Completed Study of Benzoyl Peroxide Cream for Mild to Moderate Acne Vulgaris

Condition: Acne Vulgaris
Intervention: Drug: Benzoyl Peroxide
39 Completed Measuring Adherence in Subjects With Acne Vulgaris in a Clinic Population Subtitle: Topical Benzoyl Peroxide for Acne

Condition: Acne Vulgaris
Intervention: Drug: Benzoyl Peroxide
40 Active, not recruiting Safety and Efficacy of 1550nm Fractional Laser Treatment for Acne Scars in Fitzpatrick Type IV-VI Skin

Condition: Acne Scarring
Intervention: Procedure: Fractionated Laser Resurfacing
41 Completed Safety and Efficacy Study of Clindamycin/Benzoyl Peroxide/Tazarotene Cream in Subjects With Acne

Condition: Acne Vulgaris
Interventions: Drug: Benzoyl peroxide/clindamycin gel + tazarotene cream;   Drug: Benzoyl peroxide/clindamycin gel + vehicle cream;   Drug: Benzoyl peroxide gel + tazarotene cream;   Drug: Clindamycin gel + tazarotene cream;   Drug: Vehicle gel+ tazarotene cream;   Drug: Vehicle gel + vehicle cream
42 Recruiting Apremilast in the Treatment of Moderate to Severe Acne

Condition: Acne
Intervention: Drug: apremilast
43 Completed
Has Results
Treatment of Acne Vulgaris With Doryx Tablets Compared to Doxycyline Hyclate

Condition: Acne Vulgaris
Interventions: Drug: Doxycycline hyclate (Doryx);   Drug: Doxycycline hyclate
44 Not yet recruiting Safety and Efficacy Study of Acnase Creme in the Treatment of Acne Vulgaris I and II

Condition: Acne Vulgaris
Interventions: Drug: Benzoyl Peroxide 5% and Sulphur 2%;   Drug: Vehicle of Acnase
45 Recruiting Study to Compare the Acne Relapse Rate of Oral Minocycline to Oral Minocycline in Combination With Topical Tretinoin, Followed by Topical Tretinoin Alone

Condition: Acne Vulgaris
Interventions: Drug: Minocycline;   Drug: Minocycline + Tretinoin 0.01%
46 Active, not recruiting Efficacy and Safety Study of Finacea to Treat Acne Vulgaris and Post-Inflammatory Hyperpigmentation

Conditions: Acne Vulgaris;   Post Inflammatory Hyperpigmentation
Intervention: Drug: Azelaic acid
47 Completed The Development and Evaluation of an “E-Visit” Program for the Management of Acne

Condition: Acne Vulgaris
Interventions: Other: Evisit;   Other: Office visit
48 Completed Pulsed Dye Laser Treatment of Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: Fixed combination of clindamycin 1% + benzoyl peroxide 5%;   Device: Pulsed dye laser
49 Withdrawn The Treatment of Acne Vulgaris With Radiofrequency Device

Condition: Acne Vulgaris
Intervention: Device: Radio Frequency
50 Completed Efficacy and Tolerance of a Derivative of Salicylic Acid and 5% Benzoyl Peroxide in Facial Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: Lipo Hydroxy Acid;   Drug: 5% benzoyl peroxide gel
51 Terminated Topical 5-ALA-PDT With Blu-U Therapy Versus Topical 5-ALA With Pulse Dye Laser In Treating Recalcitrant Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: 5-ALA with Blu-U Light;   Drug: 5-ALA with Candela V-beam Pulse Dye Laser
52 Completed A Comparative Study of the Tolerability of Two Combination Therapies for the Treatment of Acne

Condition: Acne Vulgaris
Interventions: Drug: BENZOYL PEROXIDE/ CLINDAMYCIN;   Drug: BENZOYL PEROXIDE/ ADAPALENE
53 Completed Evaluate Safety & Efficacy of an OC Preparation vs Placebo for 6 Treatment Cycles in Women With Moderate Acne

Condition: Acne Vulgaris
Interventions: Drug: YAZ (DRSP 3 mg/EE 0.02 mg, BAY86-5300);   Drug: Placebo
54 Completed Evaluate Safety & Efficacy of an Oral Contraceptive (OC) Preparation Versus Placebo for 6 Treatment Cycles in Women With Moderate Acne

Condition: Acne Vulgaris
Interventions: Drug: YAZ (DRSP 3 mg/EE 0.02 mg, BAY86-5300);   Drug: Placebo
55 Recruiting A Study to Evaluate the Efficacy of Silk – Like Bedding Fabric, as Used in a Standard Pillow Case, in the Treatment of Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Device: silk-like fabric standard pillowcase;   Device: pillowcase made of 100% cotton
56 Recruiting “A Randomized, Controlled, Evaluator-blinded Pilot Study to Evaluate the Effect of Automated Text Message Reminders on Patient Compliance With Topical Medications and Its Efficacy on Skin Disease Control in Adolescents and Adults With Mild to Moderate Acne”

Conditions: Acne;   Patient Compliance
Intervention: Other: Text message reminders
57 Completed Safety and Efficacy Study of Association Between Tretinoin and Clindamycin on the Treatment of Acne Mild and Moderate

Condition: Acne Vulgaris
Intervention: Drug: application of the topic gel
58 Recruiting Exploratory Study to Evaluate the Efficacy and Safety of CD07223 Gel in Subjects With Acne

Condition: Acne
Intervention: Drug: Epiduo vehicle gel
59 Completed
Has Results
A Study to Demonstrate the Efficacy and Safety of Adapalene/Benzoyl Peroxide Topical Gel in Subjects With Acne Vulgaris

Condition: Acne Vulgaris
Interventions: Drug: Adapalene/Benzoyl Peroxide;   Drug: Adapalene;   Drug: Benzoyl Peroxide;   Drug: Topical Gel Vehicle
60 Not yet recruiting Open and Comparative Study to Measure Tolerability and Efficacy of Taro Elixir

Conditions: Acne Vulgaris II or III Degree;   Boils
Interventions: Drug: oxytetracycline, taro elixir;   Drug: Taro Elixir

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Acne

Questions and Answers About Acne

This booklet contains general information about acne. It describes what acne is and how it develops, the causes of acne, and the treatment options for various forms of acne. Information is also provided on caring for the skin. If you have further questions after reading this booklet, you may wish to discuss them with your doctor.

What Is Acne?

Acne is a disorder resulting from the action of hormones and other substances on the skin’s oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Although acne is usually not a serious health threat, it can be a source of significant emotional distress. Severe acne can lead to permanent scarring.

How Does Acne Develop?

Doctors describe acne as a disease of the pilosebaceous units (PSUs). Found over most of the body, PSUs consist of a sebaceous gland connected to a canal, called a follicle, that contains a fine hair (see “Normal Pilosebaceous Unit” diagram). These units are most numerous on the face, upper back, and chest. The sebaceous glands make an oily substance called sebum that normally empties onto the skin surface through the opening of the follicle, commonly called a pore. Cells called keratinocytes line the follicle.

Normal Pilosebaceous Unit

 

 

 

 

 

 

 

 

 

 

 

The hair, sebum, and keratinocytes that fill the narrow follicle may produce a plug, which is an early sign of acne. The plug prevents sebum from reaching the surface of the skin through a pore. The mixture of oil and cells allows bacteria Propionibacterium acnes (P. acnes) that normally live on the skin to grow in the plugged follicles. These bacteria produce chemicals and enzymes and attract white blood cells that cause inflammation. (Inflammation is a characteristic reaction of tissues to disease or injury and is marked by four signs: swelling, redness, heat, and pain.) When the wall of the plugged follicle breaks down, it spills everything into the nearby skin – sebum, shed skin cells, and bacteria – leading to lesions or pimples.

People with acne frequently have a variety of lesions, some of which are shown in the diagrams below. The basic acne lesion, called the comedo (KOM-e-do), is simply an enlarged and plugged hair follicle. If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo and produces a white bump called a whitehead. A comedo that reaches the surface of the skin and opens up is called an open comedo or blackhead because it looks black on the skin’s surface. This black discoloration is due to changes in sebum as it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.

Type of Lesions


Other troublesome acne lesions can develop, incuding the following:

  • Papules – inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
  • Pustules (pimples) – papules topped by white or yellow pus-filled lesions that may be red at the base
  • Nodules – large, painful, solid lesions that are lodged deep within the skin
  • Cysts – deep, painful, pus-filled lesions that can cause scarring.

What Causes Acne?

The exact cause of acne is unknown, but doctors believe it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.

Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are known to cause acne. Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug.

Factors That Can Make Acne Worse

Factors that can cause an acne flare include:

  • Changing hormone levels in adolescent girls and adult women 2 to 7 days before their menstrual period starts
  • Oil from skin products (moisturizers or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
  • Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
  • Environmental irritants, such as pollution and high humidity
  • Squeezing or picking at blemishes
  • Hard scrubbing of the skin
  • Stress.
Myths About the Causes of Acne

There are many myths about what causes acne. Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on the development and course of acne in most people. Another common myth is that dirty skin causes acne; however, blackheads and other acne lesions are not caused by dirt. Stress doesn’t cause acne, but research suggests that for people who have acne, stress can make it worse.

Who Gets Acne?

People of all races and ages get acne. It is most common in adolescents and young adults. An estimated 80 percent of all people between the ages of 11 and 30 have acne outbreaks at some point. For most people, acne tends to go away by the time they reach their thirties; however, some people in their forties and fifties continue to have this skin problem.

How Is Acne Treated?

Acne is often treated by dermatologists (doctors who specialize in skin problems). These doctors treat all kinds of acne, particularly severe cases. Doctors who are general or family practitioners, pediatricians, or internists may treat patients with milder cases of acne.

The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by this disease. Drug treatment1 is aimed at reducing several problems that play a part in causing acne:

  • abnormal clumping of cells in the follicles
  • increased oil production
  • bacteria
  • inflammation.

1 All medicines can have side effects. Some medicines and side effects are mentioned in this booklet. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.

Depending on the extent of the problem, the doctor may recommend one of several over-the-counter (OTC) medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth). The doctor may suggest using more than one topical medicine or combining oral and topical medicines.

Treatment for Blackheads, Whiteheads, and Mild Inflammatory Acne

Doctors usually recommend an OTC or prescription topical medicine for people with mild signs of acne. Topical medicine is applied directly to the acne lesions or to the entire area of affected skin.

There are several OTC topical medicines used for mild acne. Each works a little differently. Following are the most common ones:

  • Benzoyl peroxide – destroys P. acnes, and may also reduce oil production
  • Resorcinol – can help break down blackheads and whiteheads
  • Salicylic acid – helps break down blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicles
  • Sulfur – helps break down blackheads and whiteheads.

Topical OTC medicines are available in many forms, such as gels, lotions, creams, soaps, or pads. In some people, OTC acne medicines may cause side effects such as skin irritation, burning, or redness, which often get better or go away with continued use of the medicine. If you experience severe or prolonged side effects, you should report them to your doctor.

OTC topical medicines are somewhat effective in treating acne when used regularly; however, it may take up to 8 weeks before you see noticeable improvement.

Treatment for Moderate to Severe Inflammatory Acne

People with moderate to severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination.

Prescription Topical Medicines

Several types of prescription topical medicines are used to treat acne. They include:

  • Antibiotics – help stop or slow the growth of bacteria and reduce inflammation
  • Vitamin A derivatives (retinoids) – unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are tretinoin (Retin-A2), adapalene (Differin), and tazarotene (Tazorac)
  • Others – may destroy P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation. Some examples are prescription strength Benzoyl peroxide, sodium sulfacetamide/sulfur-containing products, or Azelaic acid (Azelex).

Like OTC topical medicines, prescription topical medicines come as creams, lotions, solutions, gels, or pads. Your doctor will consider your skin type when prescribing a product. Creams and lotions provide moisture and tend to be good choices for people with sensitive skin. If you have very oily skin or live in a hot, humid climate, you may prefer an alcohol-based gel or solution, which tends to dry the skin. Your doctor will tell you how to apply the medicine and how often to use it.

For some people, prescription topical medicines cause minor side effects, including stinging, burning, redness, peeling, scaling, or discoloration of the skin. With some medicines, such as tretinoin, these side effects usually decrease or go away after the medicine is used for a period of time. If side effects are severe or don’t go away, notify your doctor.

2 Brand names included in this booklet are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

As with OTC medicines, the benefits of prescription topical medicines are not immediate. Your skin may seem worse before it gets better. It may take from 4 to 8 weeks to notice improvement.

Prescription Oral Medicines

For patients with moderate to severe acne, doctors often prescribe oral antibiotics. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Common antibiotics used to treat acne are tetracycline (Achromycin V), minocycline (Dynacin, Minocin), and doxycycline (Adoxa, Doryx, and Monodox).

Other oral medicines less commonly used are clindamycin (Cleocin), erythromycin, or sulfonamides (Bactrim). Some people taking these antibiotics have side effects, such as an upset stomach, dizziness or lightheadedness, changes in skin color, and increased tendency to sunburn. Because tetracyclines may affect tooth and bone formation in fetuses and young children, these drugs are not given to pregnant women or children under age 14. There is some concern, although it has not been proven, that tetracycline and minocycline may decrease the effectiveness of birth control pills. Therefore, a backup or another form of birth control may be needed. Prolonged treatment with oral antibiotics may be necessary to achieve the desired results.

Treatment for Severe Nodular or Cystic Acne

People with nodules or cysts should be treated by a dermatologist. For patients with severe inflammatory acne that does not improve with medicines such as those described above, a doctor may prescribe isotretinoin (Accutane), a retinoid (vitamin A derivative). Isotretinoin is an oral drug that is usually taken once or twice a day with food for 15 to 20 weeks. It markedly reduces the size of the oil glands so that much less oil is produced. As a result, the growth of bacteria is decreased.

Advantages of Isotretinoin (Accutane)

Isotretinoin is a very effective medicine that can help prevent scarring. After 15 to 20 weeks of treatment with isotretinoin, acne completely or almost completely goes away in most patients. In those patients where acne recurs after a course of isotretinoin, the doctor may institute another course of the same treatment or prescribe other medicines.

Disadvantages of Isotretinoin (Accutane)

Isotretinoin can cause birth defects in the developing fetus of a pregnant woman. It is important that women of childbearing age are not pregnant and do not get pregnant while taking this medicine. Women must use two separate effective forms of birth control at the same time for 1 month before treatment begins, during the entire course of treatment, and for 1 full month after stopping the drug. You should ask your doctor when it is safe to get pregnant after you have stopped taking isotretinoin.

Some people with acne become depressed by the changes in the appearance of their skin. Changes in mood may be intensified during treatment or soon after completing a course of medicines like isotretinoin. There have been a number of reported suicides and suicide attempts in people taking isotretinoin; however, the connection between isotretinoin and suicide or depression is not known. Nevertheless, if you or someone you know feels unusually sad or has other symptoms of depression, such as loss of appetite, loss of interest in once-loved activities, or trouble concentrating, it’s important to consult your doctor.

Other possible side effects of isotretinoin include:

  • dry eyes, mouth, lips, nose, or skin (very common)
  • itching
  • nosebleeds
  • muscle aches
  • sensitivity to the sun
  • poor night vision
  • changes in the blood, such as an increase in fats in the blood (triglycerides and cholesterol)
  • change in liver function.

To be able to determine if isotretinoin should be stopped if side effects occur, your doctor may test your blood before you start treatment and periodically during treatment. Side effects usually go away after the medicine is stopped.

Treatments for Hormonally Influenced Acne in Women

In some women, acne is caused by an excess of androgen (male) hormones. 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 elevated blood levels of certain androgens.

The doctor may prescribe one of several drugs to treat women with this type of acne:

  • Birth control pills – to help suppress the androgen produced by the ovaries
  • Low-dose corticosteroid drugs, such as prednisone (Deltasone) or dexamethasone (Decadron, Hexadrol) – to help suppress the androgen produced by the adrenal glands
  • Antiandrogen drugs such as spironolactone (Aldactone) – to reduce the excessive oil production.

Side effects of antiandrogen drugs may include irregular menstruation, tender breasts, headaches, and fatigue.

Other Treatments for Acne

Doctors may use other types of procedures in addition to drug therapy to treat patients with acne. For example, the doctor may remove the patient’s comedones during office visits. Sometimes the doctor will inject corticosteroids directly into lesions to help reduce the size and pain of inflamed cysts and nodules.

Early treatment is the best way to prevent acne scars. Once scarring has occurred, the doctor may suggest a medical or surgical procedure to help reduce the scars. A superficial laser may be used to treat irregular scars. Dermabrasion (or microdermabrasion), which is a form of “sanding down” scars, is sometimes used. Another treatment 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.

How Should People With Acne Care for Their Skin?

Clean Skin Gently

If you have acne, you should gently wash your face with a mild cleanser, once in the morning and once in the evening, as well as after heavy exercise. Wash your face from under the jaw to the hairline and be sure to thoroughly rinse your skin.

Ask your doctor or another health professional for advice on the best type of cleanser to use.

Using strong soaps or rough scrub pads is not helpful and can actually make the problem worse. Astringents are not recommended unless the skin is very oily, and then they should be used only on oily spots.

It is also important to shampoo your hair regularly. If you have oily hair, you may want to wash it every day.

Avoid Frequent Handling of the Skin

Avoid rubbing and touching skin lesions. Squeezing, pinching or picking blemishes can lead to the development of scars or dark blotches.

Shave Carefully

Men who shave and who have acne should test both electric and safety razors to see which is more comfortable. 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 a Sunburn or Suntan

Many of the medicines used to treat acne can make you more prone to sunburn. A sunburn that reddens the skin or suntan that darkens the skin may make blemishes less visible and make the skin feel drier. However, these benefits are only temporary, and there are known risks of excessive sun exposure, such as more rapid skin aging and a risk of developing skin cancer.

Choose Cosmetics Carefully

While undergoing acne treatment, you may need to change some of the cosmetics you use. All cosmetics, such as foundation, blush, eye shadow, moisturizers, and hair-care products should be oil free. Choose products labeled noncomedogenic (meaning they don’t promote the formation of closed pores). In some people, however, even these products may make acne worse.

For the first few weeks of treatment, applying foundation evenly may be difficult because the skin may be red or scaly, particularly with the use of topical tretinoin or benzoyl peroxide.

What Research Is Being Done on Acne?

Medical researchers are working on new drugs to treat acne, particularly topical antibiotics to replace some of those in current use. As with many other types of bacterial infections, doctors are finding that, over time, the bacteria that are associated with acne are becoming resistant to treatment with certain antibiotics, though it is not clear how significant a problem this resistance represents.

Scientists are also trying to better understand the mechanisms involved in acne so that they can develop new treatments that work on those mechanisms. 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 production without the side effects of current medicines. Another group is trying to understand how P. acnes activates the immune system in order 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 and developing a laser system to treat acne and acne-related scars without damaging the outer layers of the skin.

Researchers in Germany, funded by German institutions, have taken P. acnes and identified its genetic information (genome). This information may help researchers develop new treatments to target the bacteria.

Where Can People Find More Information on Acne?

  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
    Information Clearinghouse
    National Institutes of Health

    1 AMS Circle
    Bethesda,  MD 20892-3675
    Phone: 301-495-4484
    Toll Free: 877-22-NIAMS (226-4267)
    TTY: 301–565–2966
    Fax: 301-718-6366
    Email: [email protected]
    Website: http://www.niams.nih.gov

    NIAMS provides information about various forms of arthritis and rheumatic disease and bone, muscle, joint, and skin diseases. It distributes patient and professional education materials and refers people to other sources of information. Additional information and updates can also be found on the NIAMS Web site.

  • American Academy of Dermatology (AAD)

    P.O. Box 4014
    Schaumberg,  IL 60618-4014
    Phone: 847-330-0230
    Toll Free: 866-503-SKIN (7546)
    Fax: 847-240-1859
    Website: http://www.aad.org

    This national organization can provide referrals to dermatologists. It also publishes a brochure on acne for adults and a fact sheet for young people. These are available on the organization’s Web site or can be obtained by calling or writing to the academy.

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 booklet.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services’ National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS Web site at www.niams.nih.gov.

For Your Information

This publication contains information about medications used to treat the health condition discussed here. When this publication was printed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.

For updates and for any questions about any medications you are taking, please contact the U.S. Food and Drug Administration at:

U.S. Food and Drug Administration

Toll Free: 888-INFO-FDA (888-463-6332)
Website: http://www.fda.gov/

NIH Publication No. 06-4998

 

 




Versión PDF de este documento

Fecha de publicación: agosto de 2005
Fecha de revisión: agosto de 2006

¿Qué es el acné?
Esenciales: hojas informativas de fácil lectura

El acné es una enfermedad que afecta las glándulas sebáceas. Estas glándulas están debajo de la piel, y producen una sustancia grasosa llamada sebo. Los pequeños hoyos en la piel se llaman poros y están conectados a estas glándulas a través de un canal que se llama folículo. Los vellos crecen debajo de la piel, y también pasan a través del folículo para llegar a la superficie. Dentro de los folículos, el sebo transporta células de piel muerta hasta la superficie de la piel. Cuando se tapa un folículo, se crea un grano o espinilla.

La mayoría de los granos o espinillas se encuentran en la cara, el cuello, la espalda, el pecho y en los hombros. El acné no es una amenaza grave para la salud, pero puede dejar cicatrices.

¿Cómo se desarrolla el acné?
¿Quién tiene acné?
¿Cuál es la causa del acné?
¿Cuál es el tratamiento para el acné?
¿Cómo deben cuidar la piel las personas con acné?
¿Qué cosas pueden empeorar el acné?
¿Cuáles son los mitos acerca de las causas del acné?
¿Qué investigaciones se están haciendo sobre el acné?

¿Cómo se desarrolla el acné?

A veces, el vello, el sebo y las células de la piel se juntan y crean un tapón en el poro. La bacteria que está presente en el tapón causa hinchazón. Cuando el tapón comienza a deshacerse, se forma una espinilla.

Hay muchos tipos de granos. Los más comunes son:

  • puntos blancos – están debajo de la superficie de la piel
  • puntos negros – suben a la superficie de la piel y se ven negros (el color negro no se debe a que el poro esté lleno de mugre)
  • pápulas – son pequeños bultos de color rosado y pueden ser dolorosos al tocarlos
  • pústulas – son rojas por debajo y tienen pus por arriba
  • nódulos – están dentro de la piel y son grandes, dolorosos y sólidos
  • quistes – son profundos, dolorosos, están llenos de pus y pueden dejar cicatrices.

¿Quién tiene acné?

El acné es la enfermedad de la piel más común. Personas de todas las razas y de todas las edades pueden tener acné. Sin embargo, el acné es más común en adolescentes y en jóvenes. Alrededor de un 80 por ciento de todas las personas entre las edades de 11 y 30 años tienen brotes en algún momento. Aún así, algunas personas tienen acné hasta después de los 40 y los 50 años.

¿Cuál es la causa del acné?

No se conoce la causa exacta del acné. Los médicos creen que estos factores pueden causarlo:

  • aumento hormonal durante la adolescencia (esto causa que las glándulas produzcan tapones más a menudo)
  • cambios hormonales que ocurren durante el embarazo
  • comenzar o dejar de tomar píldoras anticonceptivas
  • factores hereditarios (si sus padres tuvieron acné, usted también lo puede tener)
  • ciertos medicamentos
  • maquillaje grasoso.

¿Cuál es el tratamiento para el acné?

El acné es tratado por dermatólogos, médicos especializados que atienden los problemas de la piel. Con el tratamiento se intenta:

  • sanar las espinillas
  • evitar que se formen nuevas espinillas
  • prevenir cicatrices
  • ayudar a reducir la vergüenza que causa el acné.

La mejor manera de prevenir las cicatrices es comenzar un tratamiento a tiempo. El médico le puede sugerir medicamentos con o sin receta. Algunos medicamentos contra el acné se aplican directamente a la piel. También existen pastillas que usted puede tomar. El médico le dirá si debe usar más de un medicamento.

¿Cómo deben cuidar la piel las personas con acné?

A continuación algunas maneras de cuidar la piel si tiene acné:

  • lávese la piel con delicadeza. Use un limpiador suave en la mañana, en la tarde y después de hacer ejercicios. Restregarse la piel no evita el acné. Esto puede empeorar el problema.
  • trate de no tocarse la piel. Apretar, pellizcar o escarbar las espinillas puede dejar cicatrices o manchas oscuras en la piel.
  • aféitese con cuidado. Si usted se afeita, puede usar una rasuradora eléctrica o una navaja para ver cuál le funciona mejor. Si usa una navaja, asegúrese de que la hoja esté afilada. Lávese la cara con agua y jabón antes de ponerse la crema de afeitar, esto lo ayudará a ablandar la barba. Aféitese con cuidado, y sólo cuando sea necesario.
  • evite estar bajo el sol. Muchos medicamentos para el acné pueden causarle quemaduras de sol a algunas personas. Quedarse bajo el sol por mucho rato puede causar arrugas en la piel y aumenta el riesgo de cáncer de la piel.
  • escoja su maquillaje con cuidado. Use sólo maquillaje libre de grasa. Busque la palabra “no comedogénico” (noncomodogenic) en la etiqueta. Esto significa que el maquillaje no le tapará los poros. Algunas personas tienen acné aún al usar estos productos.

¿Qué cosas pueden empeorar el acné?

Algunas cosas que pueden empeorar el acné:

  • cambios en los niveles hormonales de niñas adolescentes y mujeres adultas durante los dos o siete días antes de su periodo menstrual
  • presión causada por un casco de bicicleta, mochilas y cuellos apretados
  • contaminación y la alta humedad
  • apretarse o pellizcarse las espinillas
  • restregarse la piel demasiado duro.

¿Cuáles son los mitos acerca de las causas del acné?

Existen muchos mitos acerca de las causas del acné. Tener la piel sucia y el estrés no causan acné. El chocolate y las comidas grasosas no le causan acné a la mayoría de las personas.

¿Qué investigaciones se están haciendo sobre el acné?

Los científicos están buscando nuevos tratamientos para el acné incluyendo:

  • nuevos medicamentos contra el acné
  • maneras de prevenir que se tapen los poros
  • maneras para evitar que la hormona testosterona cause acné.

Para más información acerca del acné y otras condiciones relacionadas:

cInstituto Nacional de Artritis y Enfermedades Musculoesqueléticas y de la Piel (NIAMS, según sus siglas en inglés)
Institutos Nacionales de la Salud (NIH, según sus siglas en inglés)

1 AMS Circle
Bethesda,  MD 20892-3675
Teléfono: 301-495-4484
Llame gratis: 877-22-NIAMS (226-4267)
TTY: 301–565–2966
Fax: 301-718-6366
Correo electrónico: [email protected]
Website: http://www.niams.nih.gov

NIAMS apoya la investigación y la capacitación de científicos y otros profesionales de la salud que ofrecen tratamiento y ayudan a prevenir enfermedades de los huesos, músculos, articulaciones o coyunturas y de la piel. También, NIAMS intenta promover el conocimiento sobre las causas de estas enfermedades, a la vez que ofrece al público información relacionada.

La información que aparece en esta publicación se resumió en un formato de fácil lectura, y se tomó de una publicación más extensa del NIAMS. Para pedir la versión en inglés, Acne Q&A, por favor llame al NIAMS a los números que están arriba. Par ver el texto completo o para ordenarlo en línea, visítenos en la Web: http://www.niams.nih.gov.

Ofrecemos algunas de nuestras publicaciones en español en formato impreso. Para solicitar ejemplares por correo, use el formulario electrónico.