Acne affects up to 50 million people in the United States, according to aad.org, making it the most common skin condition in the country. Characterized by prominent pustules, papules, and diffuse redness, the condition can severely impact a person’s appearance and self esteem. Fortunately, there are ways to effectively manage this stubborn condition today.
Dr. Douglas Wu, a board-certified dermatologist at Cosmetic Laser Dermatology in San Diego, recently hosted a webinar to discuss acne and acne scarring. His detailed, informative account helps you understand why acne occurs and which treatments are most effective in minimizing the breakouts and producing smoother, more beautiful skin.
The Science Behind Acne
Dr. Wu explained in his webinar that the skin is made up of three basic layers: the epidermis (skin’s surface), dermis, and subcutaneous fat. However, the actual structure of the skin is more complex than these three basic layers.
The top two layers of skin consist of an oil gland, pore, and hair shaft. It is in these three components of the skin that acne can develop. The oil glands produce an oily substance known as sebum, which travels through the pore to the surface of the skin. Sebum lubricates the skin, giving it a smooth, supple appearance. However, too much sebum can lead to oily skin that is more prone to acne breakouts.
A particular bacteria, propionibacterium acnes or p. acnes, are present on the skin’s surface. In most cases, the bacteria do not cause any symptoms. However, when the bacteria and excess sebum combine, this can lead to skin irritation, which may result in an onset of acne.
Too much oil in the skin can also clog pores, which may present as whiteheads and blackheads. Also known as comedones, these blemishes can appear anywhere on the face and are especially common around the nose, cheeks, and forehead. In addition to the face, you might find comedones on the back, chest, and neck.
How Can We Treat Acne?
Dr. Wu listed four basic goals of any acne treatment in his webinar:
- Target the p. acnes bacteria
- Modify the oil secretion from the glands
- Reduce redness that commonly accompanies breakouts
- Treat scarring that might occur after active acne is controlled
There are many paths to treating acne. The first line of defense is topical treatments, which can be found over the counter and by prescription. Topical products are also recommended once acne is under control, in order to maintain the positive improvement. Oral medications might also be prescribed if topical treatments are not effective. However, these substances have a high risk of potentially serious side effects.
Dr. Wu added laser and energy devices to the treatment list, which can target active acne and scars simultaneously for some patients. Photodynamic therapy (PDT) is one of these devices that effectively reduces active acne.
Photodynamic therapy is a light treatment that is combined with a topical agent to treat active acne. This procedure that we offer in our San Diego office addresses the bacteria, oil production, and skin redness in a single treatment session.
The light from the PDT targets porphyrins, which are small molecules produced by the bacteria. Porphyrins are highly adept at absorbing the light energy, which in turn destroys the bacteria. The topical medications used in a PDT treatment increase the number of porphyrins, making the treatment more effective.
A treatment session using PDT begins with the application of an exfoliation process that prepares the skin to receive the topical medication. Exfoliation may be performed using acetone wipes, microdermabrasion, or a laser device. Once the skin is ready, the topical medication is applied and left on the skin for 1-3 hours.
The next step of the procedure is known as the activation phase, where the PDT light is delivered into the porphyrins to destroy the bacteria and treat the oil gland. The procedure is relatively comfortable and downtime is minimal.
Dr. Wu explained that the skin will become quite red and peel some for the first few days after this treatment. He compared these side effects to a severe sunburn. After 3-5 days, the skin begins to return to its normal appearance and improvements can be detected as early as 10 days after the procedure. A series of treatment sessions is usually needed to achieve an optimal outcome.
Acne Scar Treatment
While some scars may be treated simultaneously with the active acne, residual scarring may need to be addressed once the active acne is controlled. Because acne is a highly inflammatory condition, it can cause skin damage that leads to noticeable scarring afterward. The loss of collagen in the dermal structure can create divots in the skin, which can make patients nearly as self-conscious as the active acne did.
While treatment of acne scars can be somewhat complex, Dr. Wu talked about the ways in which stimulating collagen growth can have a very positive effect. This can be achieved through energy devices that administer controlled injuries to the skin, resulting in a natural healing process by the body that triggers new collagen production.
One of the best collagen induction therapies for acne scarring is RF microneedling, according to Dr. Wu. This device adds the radiofrequency energy component to microneedling. The device releases bursts of energy at the end of each needle, which is much more effective in stimulating collagen production than microneedling alone. Because actual needles are used for this treatment, the procedure can be customized to the precise needs and skin tone of each patient.
Many patients say their RF microneedling was painless thanks to topical numbing cream. There is minimal downtime after treatment. Patients can expect side effects similar to PDT, with most redness gone within about three days. Improvements continue in the weeks following the procedure as collagen levels continue to increase.
The Right Treatment, At the Right Time, In the Right Way
Dr. Wu admits that acne and acne scarring are stubborn conditions that are often slow to respond to treatment. Combining a variety of lasers, energy devices, and injectable treatments often leads to the best results. Patients need specific and tailored treatment plans that can only be created by an experienced dermatologist with expertise in treating these challenging conditions. Dr. Wu explained that the right treatment, at the right time, and in the right way is the path to an optimal outcome.
Once the acne is controlled, a good skin care regimen using medical-grade products is essential to maintaining positive results. Your dermatologist will be able to advise you accordingly.
Schedule Your Acne Consultation at our Skin Care Clinic in San Diego Today
If you are ready to pursue the right treatment, at the right time, and in the right way, contact Cosmetic Laser Dermatology today to schedule your consultation.