INNOVATIVE TREATMENTS FOR ACNE AT ALL AGES
By Kimberly Moskowitz, MD
Are you among the 25 million Americans who prematurely breathed a sigh of relief thinking
you escaped the acne plague of adolescence only to wake up one day in your 20s, 30s or
even 40s with acne breakouts? Acne is the most commonly diagnosed skin disorder in the
United States and worldwide. It affects approximately 90% of all adolescents and 25% of all
adults. This unwelcome four letter word plagues 40 million teenagers and 25 million adults.
In all, 80% of the population will suffer from this condition at some point in their lifetime.
Acne is the condition describing plugged pores (blackheads and whiteheads), pimples, and
deeper lumps (cysts or nodules) that occur on the skin. It begins within hair follicles, which
contain tiny oil-producing glands called sebaceous glands. Sebaceous glands produce oily
sebum that travels up the hair shaft to the skin’s surface where it coats the skin and serves as a
natural moisturizer. Sebaceous glands are found everywhere on the skin’s surface except the
palms and soles. They are most densely concentrated on the face, scalp, chest, and back, which explains why acne is most
common is these areas. Acne occurs when sebaceous glands become overactive and produce sebum quicker than the skin can
shed it. When this happens, sebum along with dead skin cells and the acne causing bacteria P. acnes (Pripionibacterium acnes)
become trapped inside of the follicle. As the follicle fills and expands, a pimple is born.
60%). For women, several oral contraceptives decrease sebum
There are two basic t y p e s o f a c n e . T h e m o s t c o m m o n
production and reduce acne outbreaks. Finally, Accutane, the
i s n o n -inflammatory, comprised of whiteheads (closed
most potent biological inhibitor of sebum production has long
comedones) and blackheads (open comedones). Inflammatory
been used as the last resort and “big gun” for eradicating severe
acne is deeper and more severe and is often the result of picking
acne. Although effective, its potential for serious side effects
or popping whiteheads. This extrudes infected contents into
like birth defects and depression give physicians and patients
surrounding tissues resulting in reddened pustules, cysts, and
pause before prescribing or taking it.
deep painful nodules. If aggravated, both types of acne can lead
to deep scarring and a lifetime of remorse.
After years of agonizing over treatment failures and side effects
Despite myth, legend and folklore, acne is not caused by eating
of these medications, Laser and light treatments have become
chocolate (thank God), French fries, pizza, or bad hygiene.
synonymous with cutting edge technology and so, they are
Rather, it is believed to be caused mainly by fluctuations in the
lighting up the field of acne research. Laser and light sources
level of androgenic (male) hormones in the body. Although this
target the two main causes of acne – b a c t e r i a a n d
notoriously occurs during puberty, both men and women have
sebum production. Laser energy penetrates the skin where
androgenic hormones that fluctuate and cause acne at almost any
it decreases oil production by shrinking overactive sebaceous
age. These hormones stimulate the sebaceous glands to produce
glands. It also destroys and inhibits growth of the P. acnes
excess amounts of sebum, which causes dilation and
bacteria. A series of monthly or twice monthly treatments has
obstruction of the glands, overgrowth of P. acnes bacteria, and
been shown to reduce acne breakouts in more than 85% of
inflammation of the follicles and surrounding skin.
patients.
Laser light treatments also stimulate new collagen growth,
Because the above processes are occurring simultaneously,
which
improves acne scars and provides anti-aging benefits
effective acne treatments must target and cease each of these
In patients with more severe acne,
called
photorejuvenation.
abnormalities. For this reason, finding acceptable treatment
results
can
be
enhanced
by
pre-treatment of the skin with a
options is often as frustrating as the disease itself. In the
natural
substance
called
ALA
(Aminolevulinic acid). With this
United States alone, more than $1.4 billion is spent on acne
treatment,
known
as
Photodynamic
Therapy (PDT), A L A i s
treatments each year. If you are like most acne sufferers, you
absorbed
by
structures
in
the
skin
such
as sebaceous glands, P.
have tried creams, pills, washes, lotions and potions and
acnes
bacteria,
and
precancerous
cells.
Specific
wavelengths of
spent a small fortune on hopes of an immediate cure. The
Blue
light
activate
the
ALA
resulting
in
up
to
85%
clearance of
truth is that medications don’t act quickly and each treatment
acne,
sun-damage,
and
pre-cancerous
lesions.
h a s b e n e f i t s and downfalls. In mild acne, topical
Acne may be a rite of passage for adolescence, but one out of
therapies are helpful at reducing bacteria & sebum and
four individuals between the ages of 25 and 45 a l s o
unclogging pores but usually take months to see results and
e x p e r i e n c e acne breakouts.
At any age, acne can be
often irritate the skin. Oral antibiotics also decrease bacteria
devastating, leaving both physical and emotional scars.
and inflammation but must also be used for two to three
Although topical and oral medications will likely continue to
months before improvement can be expected.
play a role in controlling acne, lasers are making treatments
For most medications, continued treatment is required to keep
easier and more effective. As laser and light technology
acne from re-appearing.
Furthermore, acne that initially
continues to explode, acne sufferers are finally beginning to see
responds to topical or oral medicines may cease to do so
the light at the end of the tunnel.
over time because of growing antibiotic resistance rates (up to
Kimberly Moskowitz, MS, MD~ Cosmetic Vein & Laser Center~ 651 Grand Panama Blvd Suite 102 ~ (850) 233-0264
Board Certified, Phlebology & Internal Medicine ~ Skin and Laser Medicine Specialist; Medical Degree/Residency Georgetown University
www.skinandveins.com