Acne Treatment in Lehi, Utah
Acne, the most common skin condition in the United States, affects nearly 85% of individuals at some point in their life, crossing all racial and ethnic backgrounds. While it can appear at any age, puberty often marks its onset, characterized by the development of comedones (blackheads and whiteheads), inflamed pimples, and even deeper cysts. These unwelcome blemishes can manifest on the face, neck, chest, back, shoulders, and even upper arms. Beyond the physical discomfort, acne can also bring significant psychological baggage, including permanent scarring, poor self-image, and even depression and anxiety.
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What Causes Acne?
The precise cause of acne remains elusive, but four key factors play a crucial role in its development
Follicular hyperkeratinization
Follicular hyperkeratinization
This fancy term simply describes the abnormal clumping of skin cells lining the pores, forming a plug on the surface and leading to the formation of microcomedones, the precursors to acne lesions.
Sebum overload
Sebum Overload
Androgens, our sex hormones, are to blame for this one. They stimulate the growth and activity of oil glands, leading to excessive sebum production.
cutibacterium
cutibacterium
This bacteria thrives within the hair follicle-oil gland unit, where it orchestrates a complex dance of mischief. It produces enzymes that rupture comedone walls, triggering both inflammatory and non-inflammatory immune responses, leading to further inflammation and stickier skin cells.
Inflammation
Inflammation
The degree of inflammation, often influenced by genetics, plays a pivotal role in determining the severity of acne and the formation of scars.
What can trigger an acne flare?
Several additional factors can influence acne, including:
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Genetics
Familial predisposition can significantly increase your risk of developing acne.
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Diet
Certain foods, like dairy and high-glycemic index foods, can trigger or worsen acne for some individuals.
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Menstruation
Hormonal fluctuations during the menstrual cycle can contribute to acne flares.
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Stress
This modern-day plague can exacerbate acne by triggering the release of stress hormones that affect oil production and inflammation.
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Medications
Some medications, such as corticosteroids and lithium, can list acne as a potential side effect. Similarly, medications that affect hormone levels can flare acne.
Acne Treatment Options
There are many different treatment options to combat acne. It is important to find a dermatologist you trust and listens to your unique desires for treating acne. At Smart Skin Dermatology we use the full spectrum of acne treatments from topicals to Accutane. We can help you find the treatment option that is right for YOU.
Over the counter topicals
Ideal Candidate
The ideal candidate for OTC topicals is a young teen experiencing their first acne lesions, or the adult with the occasional minor acne breakout. Over the counter treatments help, but definitely have a ceiling. As soon as these are not clearing the acne, it is time to see a dermatologist for a prescription solution to avoid acne scarring.
Treatment details
A good over the counter treatment regimen will consist of a morning and night routine. Morning washing with a salicylic or benzoyl peroxide wash and using a retinol at night such as over the counter Differin.
Prescription topical medications
Ideal Candidate
The ideal candidate for prescription topicals is the teenager or adult suffering from "minor acne". Many patients can be cleared with just a prescription topical regimen. Usually there is little to no cystic acne present for these individuals.
Treatment details
This is usually the first step anytime you see a dermatologist for the first time. Treatment will usually consist of an antibiotic lotion (clindamycin lotion) every morning. This is followed by a prescription Retinoid such as tretinoin lotion/cream/gel every night.
Oral antibiotics
Ideal Candidate
The ideal candidate for prescription oral antibiotics is the average teenager with "moderate" acne. Usually with some cystic component but not "severe". These individuals will sometimes clear with topicals alone, but with some acne that is persistent. Stepping up to an oral solution is important to avoid scarring.
Treatment details
There are many different options of antibiotics to choose from, but the most common is doxycycline. Usually an oral antibiotic is taken twice a day. You can expect to be on the medication for an average of 3-6 months. Goal is to avoid longterm antibiotic use. This treatment regimen may also contain prescription topicals as well.
Oral hormonal medications
Ideal Candidate
The ideal candidate for oral hormonal acne medications are females who see a large flare with their period or for adult female cystic jawline acne.
Treatment details
The two popular treatment options in this category are oral birth control pills and spironolactone. Oral birth control pills usually taken as a contriceptive may improve or worsen acne so choosing the right one is important. These are taken daily. Spironolactone is a diuretic medication that has been shown to be very helpful for adult female acne. This is also taken daily. Both therapies may be combined with other treatment options.
Isotretinoin "Accutane" therapy
Ideal Candidate
The ideal candidate for Accutane is anyone with severe acne, the patient who does not clear with other oral therapies, or anyone who is just "done" with having acne. Getting on Accutane early is the best way to prevent acne scarring.
Treatment details
Isotretinoin therapy, or the more common trade name "Accutane", will typically last an average of 5-6 months. Most patients will only require one round of Accutane. Treatment will usually start at a low dose and slowly increase while monitoring side effects of overall dryness. Visits are required every month and are tracked with a government program called iPledge. No other acne products or treatments are usually done in combination with Accutane.
Aviclear laser
Ideal Candidate
The ideal candidate for a Aviclear Laser acne treatment series is someone who has failed Accutane, someone who struggles with taking medications or putting on topicals, or the patient who wants a permanent solution to once without the need to take medications. These ideal candidates are also not scared away by the out of pocket non-insurable nature of Aviclear therapy.
Treatment details
The Aviclear laser targets and eliminates oil glands. Treatment is typically performed on the face but may also be done on the back or shoulders. Treatment is always done in a series of 3 treatments. Read more about Aviclear laser here. Other cosmetic treatments may also help with acne but are less effective especially for severe acne. These include chemical peels and hydrafacials among others.
Extractions "derm clean up"
Ideal Candidate
The ideal candidate for extractions is someone with comedonal acne better known as "white heads" & "black heads". Extractions are great at a quick removal of existing acne to make other therapies more successful.
Treatment details
Extractions should only be done by a trained professional and only after being recommended by a dermatologist. Popping acne usually spreads bacteria and only worsens acne. In some unique cases, extractions are recommended. special tools are used to gently remove build up in oil in a controlled setting to minimize chance of scarring. More info on Derm Clean Ups here.
Steroid "kenalog" injections
Ideal Candidate
The ideal candidate for acne steroid injections is someone with 1 to 5 cystic lesions. Ideally this therapy is used for a few troublesome cysts and is not recommended with any sort of frequency.
Treatment details
Steroid injections decrease inflammation and shrink the acne cyst. This can provide some relief from painful acne lesions. Triamcinolone, or trade name Kenalog, is the steroid used. The concern with doing this too frequently is that there is a risk of devoting the skin where an injection is performed. It also does not address the source of the acne itself.
Acne medications - What do they do?
There are a lot of options. Here is more info on the major ones we recommend.
Types of acne
Acne Vulgaris: This is the general term for common acne and encompasses all the types listed below. Individuals can experience a combination of different lesion types at the same time.
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Pustular Acne:
Pustules are similar to papules but contain pus, which is a mixture of inflammatory cells and bacteria. They appear as small, raised bumps that are typically red at the base and have a yellowish or whitish center. Pustules are also a form of inflammatory acne.
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Papular Acne:
This type is characterized by small, raised, red or pink bumps on the skin. These papules are inflamed lesions and are often tender to the touch. They occur when the walls of the hair follicle rupture, allowing sebum, bacteria, and dead skin cells to irritate the surrounding skin.
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Comedonal Acne:
This is considered mild acne and is characterized primarily by comedones, which are clogged hair follicles. There are two main types of comedones:
- Open Comedones (Blackheads): These appear as small, dark spots on the skin's surface. The darkness is due to the oxidation of sebum and melanin (skin pigment) upon exposure to air, not dirt.
- Closed Comedones (Whiteheads): These are small, flesh-colored or whitish bumps that occur when the hair follicle is completely blocked beneath the skin's surface.
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Nodular Acne:
Nodules are large, firm, often painful lumps that develop deep beneath the skin's surface. They are a more severe form of inflammatory acne and result from significant inflammation and infection deep within the hair follicle. Nodules can persist for weeks or months and often lead to scarring.
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Cystic Acne:
This is the most severe form of acne. Cysts are large, pus-filled lesions that are deep, painful, and often feel soft or fluid-filled. Like nodules, they result from a severe inflammatory response within the hair follicle. Cystic acne frequently leads to scarring and can be challenging to treat.
Types of Acne Visits
Seeking professional dermatological care early is paramount in managing acne effectively. Early intervention can prevent or minimize unwanted complications, particularly scarring, which can be challenging to treat. We will create of a personalized treatment plan tailored to your unique needs and helps you achieve clear, confident skin.
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If you need help with your acne, we can help
Acne FAQ
Does acne go away with age?
On average, Yes. Many people will experience a natural resolution of their acne as they age out of their teenage years, it's not a universal guarantee.
Acne often shows significant improvement as individuals transition from adolescence into adulthood. This is largely due to the hormonal fluctuations that are a primary driver of acne development during the teenage years typically stabilizing. As hormone levels, particularly androgens, decrease and become more balanced, the overproduction of sebum (oil) by the skin's sebaceous glands tends to lessen. This reduction in oil, along with a potential decrease in skin cell stickiness, can lead to fewer clogged pores and subsequent breakouts.
However, it's important to understand that acne can persist well into adulthood for many individuals. Adult-onset acne is a recognized condition and can be influenced by a variety of factors beyond just typical adolescent hormonal shifts. These factors can include ongoing hormonal imbalances (such as in women due to menstrual cycles, pregnancy, or polycystic ovary syndrome), stress, certain medications, genetics, and even lifestyle choices.
