ACNE

    Acne is an inflammatory condition of hair follicles that is prompted by occlusion (clogging) of pores.  Treatments are thus directed at opening the pores and controlling the inflammation.  Acne is stimulated at puberty when increased oil production occurs under hormonal influence (particularly androgens such as testosterone).  Oil leads to occlusion and is a source of nutrients for bacteria that live on the skin.  When the bacteria feed on the oil they break it down into factors that cause inflammatory cells to migrate into the follicle.  Understanding these processes will help you understand the basics of acne treatment. 

    Treatments for follicular occlusion (clogged pores).  Follicular occlusion leads to whiteheads and blackheads.  Factors affecting this include oil production and a build up of dead skin cells around the opening of the follicle (the pore).  Treatments include keratolytics that break up these dead skin cells such as the common over-the-counter treatments benzoyl peroxide, salicylic acid, and glycolyic acid.  Treatments that break up oil include various cleansers.  The gold standard for treating follicular occlusion are the Vitamin A-derived topicals called retinoids.  Retinoids both decrease oil production and decrease the stickiness of dead skin cells around the pore.  Retinoids can be either over-the-counter topicals such as adapalene 0.1% or prescription topicals such as higher strength adapalene, tretinoin or tazarotene.

    Treatments for inflammation.  Anti-inflammatory strategies include antibiotics to decrease bacterial presence on the skin as well as products that work directly to inhibit inflammatory pathways.  Antibiotic therapies include many topicals such as the facial cleansers as well as benzoyl peroxide; prescription topical antibiotics include clindamycin, erythromycin, and azelaic acid.  Products that inhibit inflammation directly include the prescription topical dapsone.  When inflammation is severe, oral antibiotics are often considered.  The most common class of oral antibiotics is the tetracycline family which includes doxycycline and minocycline; tetracyclines are both anti-bacterial and have an ability to inhibit inflammatory pathways directly.

    Severe cases of acne: In cases in which the standard therapies have failed to control the severest form of acne (nodulocystic), isotretinoin, an oral retinoid commonly known by its previous brand name Accutane, can be considered.  Because of the many potential side effects of this medication, this drug should only be prescribed by the professionals in a dermatology office.

    Other strategies:

    spironolactone and certain oral contraceptives (OCPs) for women:  these reduce levels of pro-acne testosterone; these agents are particularly helpful for women who have acne in the beard area and who have pre-menstrual flares

    photodynamic therapy (PDT) (Blu-U): PDT can decrease oil production in the skin and appears to kill bacteria as well; it is used for moderate to severe acne

    As always, you can contact our office to answer any questions or concerns.

    Search Results
    Niagara Dermatology Associates
    ...This field deals with not only the medical conditions that affect the skin (like psoriasis, rashes, acne, skin infections and skin cancer), but we are skin surgeons dealing with both benign and malignant conditions of the skin (such as the treatment of cysts, moles or nevi and skin cancers like melanoma),as well as cosmetic dermatology or the cosmetic enhancement of the skin...

    Our Services
    ... Acne Age Spot Removal Facials/HydraFacial Laser Hair Removal Moles (Nevi) Psoriasis Rashes Rosacea Pediatric Dermatology Skin Cancers Warts BLU-U MOHS   Acne Acne is the most frequent skin condition seen by medical professionals...

    What is Psoriasis?
    What is Psoriasis...

    Pediatric Dermatology
    ... Take a look at some of the specific skin conditions pediatric dermatologists help treat below: contact dermatitis eczema psoriasis acne vitiligo hives warts hemangiomas birthmarks congenital skin conditions   Once your child has received an initial evaluation with one of the pediatric dermatologists at Integrated Dermatology of West Palm Beach, he or she will be prescribed a treatment plan that's specific to his or her dermatology needs...

    psoriasis
    PSORIASIS Psoriasis is a chronic skin rash that is characterized by red scaly lesions...

    skin cancers
    ...  The rate of transformation of actinic keratoses to full blown SCC is generally low, roughly 1 in 4,000 per year, but many factors can influence this rate: i) immune status is critically important with those having compromised immune systems such as transplant recipients having a 50X higher rate of AKs turning into SCCs (as well as a 100-200X higher rate of dying from SCC), other conditions that can affect immune status include having lymphoma/leukemia, being on chemotherapy or other immunosuppressive drugs, and AIDS, ii) continued sun exposure results in both increased risk for UV-induced mutations taking the AK the next step toward becoming an SCC but UV light also suppresses the immune system in the skin (this is why we use UV light to treat skin conditions such as psoriasis that are immune-mediated), and iii) some individuals probably already have some built-in mutations in them that facilitate the transformation of AKs to SCC, it is not uncommon to have some individuals with as many as 50 SCCs in a lifetime while others have had many AKs but no SCCs...

    skincancer
    ...  The rate of transformation of actinic keratoses to full blown SCC is generally low, roughly 1 in 4,000 per year, but many factors can influence this rate: i) immune status is critically important with those having compromised immune systems such as transplant recipients having a 50X higher rate of AKs turning into SCCs (as well as a 100-200X higher rate of dying from SCC), other conditions that can affect immune status include having lymphoma/leukemia, being on chemotherapy or other immunosuppressive drugs, and AIDS, ii) continued sun exposure results in both increased risk for UV-induced mutations taking the AK the next step toward becoming an SCC but UV light also suppresses the immune system in the skin (this is why we use UV light to treat skin conditions such as psoriasis that are immune-mediated), and iii) some individuals probably already have some built-in mutations in them that facilitate the transformation of AKs to SCC, it is not uncommon to have some individuals with as many as 50 SCCs in a lifetime while others have had many AKs but no SCCs...

    What is a Dermatologist?
    ...They treat everything from minor skin rashes, like hives, to chronic skin diseases, such as eczema or psoriasis...

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