Acne is a medical skin disease that affects both men and women at various levels of severity. It typically appears during puberty on skin — usually the face, back and chest — with prevalent sebaceous follicles. Known medically as acne vulgaris, it ranges from occasional flare-ups of a few pimples to chronic breakouts.
Due to the range of symptoms, prevention and acne treatment are case specific.
Acnes results when follicles are clogged. Environmental factors, whether from excessive dirt built up or makeup, are a main culprit. Other factors also play a role, such as cellular level process. This includes hyperkeratization, hormones, genetics and stress.
With hyperkeratization, this disorder entails excessive keratin production within the hair follicles’ interior linings. Acne results when cells in the area clump together and form blockages around the sebaceous duct.
Hormone fluctuations also play a large role in acne during adolescence, pregnancy, polycystic ovary syndrome, Cushing’s syndrome and menopause. Two hormones hormones that contribute to acne include androgens (testosterone, dihydrotestosterone and dehydroepiandrosterone sulfate) and insulin-like growth factor 1 (IGF-1).
Excessive androgen triggers excessive sebum production, resulting in clogged pores. IGF-1 stimulates the same glands, but it’s the result of diet choices that prompt more insulation production.
Genetics also play a key role in acne. Those who develop acne at an earlier age that also results in numerous lesions usually have other family members who experience it.
Stress also contributes to acne flare-ups due its taxing effects on the immune system, although a direct correlation is still unknown. However, cells that produce sebum have receptors for stress hormones.
Acne has five different types of “bumps” inclusive of:
- Cystic lesions
Acne can be addressed with topical products, medication, lifestyle changes and laser therapy. Options include:
- Benzoyl peroxide: cleansing, lotion, cream and gel solutions effective for mild acne; kills the bacterium P. acnes
- Antibiotics: erythromycin, clindamycin and tetracycline topical or oral medication for severe cases
- Hormone treatments: oral contraceptives to reduce androgen levels
- Topical retinoids: tretinoin (Retin-A), adapaline (Differin) and tazarotene (tazorac) normalize follicle cycles and minimize blockages
- Oral retinoids: isotretinoin (vitamin A derivative) reduce oil secretion; brand names include Accutane, Amnesteem, Sotret and Claravis, but all are reserved for severe cases due to numerous side effects and complications
- Phototherapy: uses light (red and blue, 405 – 420 nanometer) to generate free radicals within the bacteria; organisms self-destruct
- Photodynamic therapy (PDT) and Levulan: uses blue light (or the VBeam) and a topical photosensitizer to treat acne; rejuvenates facial skin
- Laser: light waves burn away the follicle sac and sebaceous gland so eruptions cannot occur; induces the formation of oxygen within the bacterial cells, leading to their destruction
LIGHT & LASER THERAPIES AVAILABLE IN LOS ANGELES
Phototherapy light therapy is an ideal treatment solution for those with moderate acne. It reduces acne lesions by 64 percent with 405 – 420 nanometer, 76 percent with 660 nanometer. Dr. Sanusi Umar offers photodynamic light therapy as a preferred acne treatment due to its efficacy, low side effects and simple treatment regimen. A typical treatment timeframe is weekly sessions over four to eight weeks.
Photodynamic therapy (PDT) is used with Levulan, a topical photosensitizer. Levulan is applied 30 to 45 minutes prior to each therapy. For use with the blue light, sessions are done at seven-day intervals for a total of four treatments. For use with the 585 – 595 nanometer laser, sessions are done each four weeks for a three to four treatment regimen. After PDT, sunburn-like effects are common and require patient downtime.
Dr. Umar offers the Spectra VRMIII laser as his preferred laser treatment. It’s highly effective for the treatment of severe and cystic acne. Sessions are performed every two to four weeks for a three to four treatment regimen. Skin improvement is usually noticeable after the first session, with acne clearing by the end of treatment. To prevent reoccurrence, a six-month maintenance session is suggested.
With the numerous options available to treat acne, speak with a dermatologist to address specific issues and plan a course of action. Dr. Umar offers consultations and solutions for acne treatments, in addition to treatment options for numerous skin conditions.