Prevention First - Cause and Prevention of Acne

Causes | Prevention | Treatment | Acne Scars

The subject of our first newsletter is acne. Acne is an inflammatory disease of the skin. It is most common and severe in the teenage years but can continue into adulthood. Acne leads to skin redness, pimples and blackheads. When uncontrolled, acne can eventually lead to scarring.

Causes of Acne
Acne forms along a hair follicle and its associated sebaceous gland. Sebaceous glands produce a substance called sebum. The hormonal changes of adolescence increase the size of sebaceous glands and increase sebum production. The following steps lead to the development of acne.

An overabundance of dead skin cells block hair follicles and cause a buildup of sebum. Sebum combines with the dead skin cells to form a plug of the follicle. The cause of the overabundance of dead skin cells and plugging is unknown.
A normal facial bacterium known as Propionibacterium causes acne to begins growing excessively in the increased sebum leading to inflammation of the follicle.
The inflammation leads to a breakdown of the follicle. When the follicle breaks down, the fatty sebum and skin cells erupt to the surface and form a pimple.
Excess moisture and skin irritation further increase the inflammation.

Prevention of Acne
Prevention of acne requires a stepwise treatment plan to reduce the amount of dead skin cells and sebum, preventing the plug from forming.

Special facial washes help to reduce skin oiliness and sebum production. Washes that contain salicylic acid do the best job. Washes that contain alpha hydroxyl acids (AHA) add to the effect. These acids also help to clean out follicles and begin the exfoliation of dead cells.
Skin exfoliating scrubs help prevent the buildup of dead skin cells and help prevent the blockage of the hair follicles. Higher concentrations of the acids mentioned above can be added two to three times a week to further remove dead skin cells and decrease sebum production.
Avoidance of oil based cosmetics helps to prevent acne. Unfortunately, some of the products used to cover pimples actually worsen the problem. The use of mineral cosmetics such as Jane Iredale avoids this problem. Mineral sunblocks can be used by men to cover pimples.
Avoiding moisture such as perspiration also helps prevent acne. The facial washes and exfoliates above help control excess moisture. Using the acid washes above after exercise or sweating can help. Care must be taken to avoid excessive dryness using OIL-FREE moisturizers.
Avoiding skin irritation from excess scrubbing, helmets, pads and bras also helps to prevent acne. The use of OIL-FREE moisturizers can also reduce the effects of skin irritation.

Prevention First provides a complete line of medical grade cosmeceuticals that help in each area. Contact our office for a consultation to determine the best treatment plan for you or your loved one.

Treatment of Acne
When prevention fails, the treatment of acne begins with the appropriate use of all of the cosmeceuticals used for prevention. Several other treatments are then added. These treatments are often used in combination. Since acne blemishes take 8 weeks to mature, any treatment must be tried for at least 2-3 months. They should always be added to the prevention regimen.

Benzoyl peroxide works as a topical antibiotic and helps prevent the follicle plug. Benzoyl peroxide is sold as Desquam, Oxy 10 and several other names. Skin dryness and peeling are the major side effects.
Topical retiniods such as tretinoin, Differin and Avage can be effective for individual pimples but are usually ineffective when inflammation is present. Skin dryness and worsening of acne can occur.
Antibiotics can be used topically or orally. Commonly-used antibiotics are erythromycin and doxycycline. Both can cause stomach to become upset. Skin rashes and discoloration can also occur.
Microdermabrasion and chemical peels decrease the overabundance of dead skin cells and help prevent and dislodge follicle plugs. Transient skin redness and temporary skin peeling (peels) are side effects.
Infra-red lasers such as Aramis reduce the size of sebaceous glands, decrease skin oiliness and decrease bacterial growth. Redness lasting a few minutes after the procedure and mild discomfort are side effects.
Oral isotretinoin or Accutane is highly effective in severe acne. It works by blocking sebum production, inflammation and the overgrowth of dead skin cells. Unfortunately, Accutane has a long list of side effects. Skin and mouth dryness, itching and joint pain are common. Accutane also frequently raises cholesterol and triglyceride levels. The most concerning side effect is depression, which can be severe.

Prevention First can provide all of these treatments. We prefer the low side effects of microdermabrasion, chemical peels and the Aramis laser. Aramis can greatly reduce acne in three to six treatments.

Acne Scars
Acne scars can be significantly reduced using a combination of techniques. The Aramis laser builds up collagen at the base of the scars and pushes them up from the inside. Even deep, "ice pick"-type scars can be improved. Microdermabrasion and chemical peels decrease the depth of the scars, smooth the skin and help to even skin tone. Intense pulsed light can decrease abnormal pigmentation and redness. Prevention First provides all of these procedures for our patients. A no-charge consultation can help determine the best regimen for you.

Prevention First is excited to provide vitamins and supplements that are prepared using Good Manufacturing Process (GMP). GMP is the standard required by the FDA for all prescription and over-the-counter drugs. Supplements are not required to meet this standard, and, until recently, none have. Carlson Labs now produces products using GMP and sold only through physicians. Prevention First is now providing Carlson Lab products. Vitamins and supplements will be the subject of our next newsletter.

We hope you find this newsletter helpful. Please let us know your thoughts.

Sincerely,

Bill J. Johnson, MD, MMM

Click here to to go resource books on diet, nutrition and health. Learn when to see the doctor, and what causes symptoms.