Acne vulgaris is an extremely common condition that affects teenagers, adults, and sometimes even infants (baby acne). Although this condition is most common in teenagers, it can appear in adults as well, especially in women along the jawline. It is characterized by different types of blemishes like papules, pustules (pimples), comedones (whiteheads and blackheads), and sometimes cysts.
Cystic acne is one of the more severe forms as it is the most likely to leave permanent scars. Cystic acne often means that more aggressive treatment like Accutane is warranted and that laser treatment may be needed to address acne scars.
Typical areas of involvement are the face (forehead, chin, cheeks, and nose), chest, back, and arms. Although extremely common, even mild cases can be unsightly and can be damaging to one’s self-esteem and emotional well-being. The most troublesome aspect of this condition is the potential for scars to occur, especially with cystic acne, as this can be extremely difficult to treat in some cases. Our dermatologist-led Edmonton acne clinic can address your pimples and blackheads, as well as acne scarring.
This condition is caused in part by a bacteria called Cutibacterium acnes (previously called Propionibacterium acnes). This bacteria helps to clog pores leading to an accumulation of sebum, which in turn causes inflammation. Other factors such as makeup, stress, heredity, diet, lifestyle, friction, and hormones can also contribute to clogging your pores.
Getting rid of acne is not always easy. Treatment can be broken down into internal treatments and external treatments. Internal treatments include medications such as oral antibiotics, birth control pills. and Accutane, while external treatments include topical antibiotics, laser, Isolaz, and photodynamic therapy (PDT).
At our dermatoloigst-led Edmonton acne clinic, we first treat patients with active acne using a step-wise approach, depending on severity. If mild, we can start with a topical antibiotic, or a topical retinoid like tretinoin if the patient has comedones. If more severe, we can use oral antibiotics like doxycycline and minocycline, or birth control in women. Some women will respond to medications that block the testosterone receptor such as spironolactone. Some other popular treatments include chemical peels, HydraFacial MD, blue light, radiofrequency, or laser.
If you just have one spot, our doctors can do a spot treatment with a tiny injection of cortisone to clear that spot in many cases. However, care must be taken to avoid injecting too much cortisone to avoid indenting the skin.
If very severe (e.g. cystic acne), we will often use Accutane, Clarus, or a new version called Epuris. Epuris , Clarus, and Accutane are very similar as the active ingredient in all of these is isotretinoin, but Epuris has one major advantage–it can be absorbed without taking it with a fatty meal (which is the ideal way to take Accutane). The problem with Accutane and Epuris is that they have a list of potentially significant side effects, which include birth defects, extreme dryness, elevated cholesterol and triglyceride levels, and depression. Despite theses risks, it is often prescribed for persistent cases and cystic acne.
Acne can also leave unsightly scarring. Fortunately, there are many treatments available to treat acne scarring at Nakatsui Dermasurgery (formerly Groot DermaSurgery). Learn more about your scar treatment options here.