What causes acne?
Acne is so common most people suffer from it at some stage of life. Many factors contribute to acne eruptions:
- Hormonal changes
- Manipulating the lesions
- Clothing, laundry detergents and fresheners
- Hair & skin products
- Air pollution
- Humidity
- Inflammatory foods
- Allergies
- Ageing of the skin, decreased epidermal turnover
Acne is often caused or made worse by products we put on our faces in the pursuit of clear skin. In fact, even some preparations of tretinoin (Retin-A – a great drug to treat acne) contain the comedogenic ingredient isopropyl myristate, a thickener used in many skin care products, though it has been known for years to cause pimples. Identifying the cause of persistent acne despite doing “everything” can be challenging, and it can even occasionally be related to a food allergy.
Acne is an 8-week cycle:
Every pore on your skin is lined with the skin cells that need to slough off. Blemishes (blackheads and whiteheads) form when a pore becomes clogged with these cells and oils build up in the skin. Bacteria then grow behind the plug, creating a pustule. This can take weeks to become noticeable and weeks to erupt and weeks to resolve. Larger cystic acne can result when the contents of the pimple break down the wall of the follicle and spread into the adjacent skin.
The Acne Treatment Regimen must:
- Exfoliate dead cells and keep pores unclogged: alpha- and beta-hydroxyacids, chemical peels
- Kill bacteria that contribute to acne: salicylic acid, benzoyl peroxide, antibiotics
- Promote cell turnover and exfoliation, decrease sebum production, change the skin’s reaction to hormones and stress: Retinols and Retin-A
The Glow approach to Eliminating Acne: 3-Month Treatment Plan
Daily Regimen: (Each morning and evening) We recommend products specific to your skin type to include:
- Strong Glycolic Acid or Combined Glycolic/Salicylic Acid cleanser
- Acne toner
- Light non-comedogenic moisturizer to ensure barrier repair
- Evenings Retinol or Retin-A (tretinoin) or our Prescription Acne Triple Gel (contains tretinoin, clindamycin, benzoyl peroxide and niacinamide)
We use only products with pure ingredients and no fragrances or irritants. It takes a good 3 months to change your skin completely, but we usually see an improvement within days to weeks.
Medical Treatments to Clear Acne
- BBL (Broad-Band Light) or Intense Pulsed Light treatments (IPL) Therapy: decreases redness and kills bacteria
- Acne Facials including Glycolic/Salicylic Acid chemical peels: cleanse, exfoliate, extractions, clears pores, kills bacteria
- VI Peel Purify: medical depth peel with multiple ingredients specifically designed to penetrate the skin and clear cystic acne
A three month program combining these treatments along with steady adherence to the Regimen should eliminate acne in most people.
Resistant Acne
Over 90% of our patients respond to our 3-Month treatment plan. But what about acne that seems to resist all efforts to defeat it? That’s time to evaluate allergies to products or foods. The most common allergy causing acne is to cow-milk and its products (whey and casein). Often, resistant acne disappears after a strict trial off of all cow-milk products (milk, yogurt, cottage cheese, cow-milk cheeses, ice cream, whey protein powders and all processed food containing whey or casein). This can be challenging because whey is packaged into so many processed foods. If cow-milk is not the culprit, consider a strict anti-inflammatory diet. If acne improves, foods can be added back in one-by-one over time. This can be difficult without help from a professional. We are happy to help– we trouble-shoot acne every day.
What to Avoid:
- Picking! It can cause scarring and hyperpigmentation– which are much harder to treat.
- Over-washing and harsh scrubs– this breaks down the skin’s barrier and can cause red eroded areas that do not heal well. Again– scarring is much harder to treat than acne itself. Acne is not caused by dirt!
- Sweat left on the skin all day– exercise heats the body and a warm wet environment promotes bacterial growth. Always make time to go through your skin care regimen after a work-out. It takes less than 2 minutes!
A word about Accutane:
Accutane is a very effective drug for shrinking down the oil glands in the skin permanently, thus reducing or eliminating acne. However, Accutane is linked to a series of serious side effects, including bowel diseases like Crohn’s disease, liver damage, depression, and miscarriage and birth defects if taken during pregnancy.
In fact, women of childbearing age are required to enlist in a special pregnancy prevention program before beginning Accutane treatment. More than 7,000 lawsuits have been filed against Roche Pharmaceuticals, which stopped making Accutane in 2009, but generic versions of isotretinoin are still available. There are newer low-dose protocols now, which may reduce the toxic side effects. Therefore, low-dose accutane can be an effective treatment for severe refractory acne. For all these reasons, we regard Accutane as a treatment of last resort.
