Acne & Acne Scarring Treatments
in Palo Alto, Fremont, Union City & Newark, California
COSMECEUTICALS AND SKIN THERAPIES USED IN THE TREATMENT OF ACNE AND ACNE SCARRING
Depending on the nature of your particular condition, a variety of treatment options are available.
A normal follicle looks like this:
For reasons no one completely understands, follicles, often called pores, sometimes get blocked. Sebum (oil), which normally drains to the surface get blocked, and bacteria begins to grow. Both whiteheads and blackheads start out as a microcomedone. The picture below is a microcomedone:
Acne Treatment
Acne is a disease of the sebaceous gland of the skin. It is caused by clogged pores, increased sebum production and the presence of bacteria. This leads to a thickening or inflammation of the lining of the follicle, which results in different levels of acne including:
- mild acne known as blackheads and whiteheads
- semi-severe acne involving inflammatory papules and pustules
- severe acne known as nodules and cysts, which can lead to acne scarring
bizCONCEPT™
The clearACTIVE acne treatment process, developed by Dr. Donald Lee at BIZMed Spa, combines the latest proven acne treatments and technology, physician-only cosmeceuticals and best practices to deliver superior clinical outcomes – without relying heavily on prescription drugs.
Palomar Lux 1540™ Laser
To treat acne where it begins, the Palomar Lux 1540 laser uses a patented wavelength to penetrate the skin's layers to the depth where sebaceous glands are located. The laser thermally alters the reactors in the sebaceous gland, reducing oil and bacteria production, thereby reducing the size of the gland and the number of resulting acne lesions. Using the Palomar Lux 1540 also results in a significant reduction in skin oiliness. This is of particular interest to patients that experience problems while wearing makeup.
To treat acne, a series of four to five procedures is administered, usually two weeks apart. Results are gradual with an approximate 20% reduction in the number of lesions after each treatment. The unique contact cooling of the Palomar Lux 1540 laser coupled with topical anesthesia makes the treatment virtually painless and no associated side effects, ensuring patient comfort and greater compliance.
Omnilux Acne Blue Light Therapy
Since cases of acne are as individual as the person, some therapies are better suited for certain individuals. The Omnilux is another option for patients who suffer from acne. Omnilux's specific blue light interacts with the bacteria in acne lesions. When the bacteria absorb the blue light, it causes a chemical reaction within the bacteria and the bacteria dies. The red light of the Omnilux can be used separately or with the blue light to lower the level of inflammation, irritation and redness in the skin.
Omnilux acne treatments are recommended twice a week for four weeks (eight treatments total). The blue and red light treatments are completely painless with no known side effects. In fact, most patients fall asleep during the 20 minute procedure. Although not all pimples will clear completely, a significant reduction in the number of inflamed pimples will be noticed. Some patients will notice results as early as after the first two treatments. Omnilux blue and red light treatments in conjunction with Palomar Lux 1540 laser acne treatments provide optimal results.
Treatment of Acne Scar
The scar treatments that are currently available include:
Collagen injection
Collagen, a normal substance of the body, is injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars. Collagen treatment usually does not work as well for ice-pick scars and keloids. Collagen derived from cows or other non-human sources cannot be used in people with autoimmune diseases. Human collagen or fascia is helpful for those allergic to cow-derived collagen. Cosmetic benefit from collagen injection usually lasts 3 to 6 months. Additional collagen injections to maintain the cosmetic benefit are done at additional cost.
Dermabrasion
This is thought to be the most effective treatment for acne scars. Under local anesthetic, a high-speed brush or fraise used to remove surface skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced in depth. Dermabrasion does not work for all kinds of scars; for example, it may make ice-pick scars more noticeable if the scars are wider under the skin than at the surface. In darker-skinned people, dermabrasion may cause changes in pigmentation that require additional treatment.
Skin Tightening
This new technique is a surface form of dermabrasion. Rather than a high-speed brush, skin shaping uses aluminum oxide crystals passing through a vacuum tube to remove surface skin. Only the very surface cells of the skin are removed, so no additional wound is created. Multiple procedures are often required but scars may not be significantly improved.
Laser Treatment
Lasers of various wavelength and intensity may be used to recontour scar tissue and reduce the redness of skin around healed acne lesions. The type of laser used is determined by the results that the laser treatment aims to accomplish. Tissue may actually be removed with more powerful instruments such as the carbon dioxide laser. In some cases, a single treatment is all that will be necessary to achieve permanent results. Because the skin absorbs powerful bursts of energy from the laser, there may be post-treatment redness for several months.
Frequently Asked Questions: Laser Acne Treatment
(Blue Light/Red Light)
How does it work?
The low powered and gentle blue light is selectively absorbed by the acne causing bacteria. The bacteria becomes inactive. Red light is used to stimulate the body's mechanism to heal the treated areas. Red light also reduces inflammation and redness in the skin.
What areas can be treated?
All parts of the body can be treated, but the blue light / red light treatments are primarily used for the face and upper back.
How long does the procedure take?
20 minutes for blue light alone and 40 minutes for both blue and red light treatments.
Is it painful?
No. You may feel a warm sensation. Blue and red light treatments are painless and easy.
Is it safe?
Complications are extremely rare. In less than 1% of cases, skin lightning or darkening may occur. It is advisable to wear sunblock when in the sun during the month following laser treatment.
How many treatments are required?
It depends on the severity of acne. Typically 8 treatments in intervals of 2 treatments per week (4 weeks total) are recommended.
What results can I expect?
Some see a difference in as little as 1 - 2 treatments. Although 100% of the acne symptoms may not be cleared, a significant reduction in new pimples should be noticed.
Can the Blue/Red light treatments be combined with other treatments?
Yes, it can be combined with other technologies that improve the surface of the skin, such as skin shaping and chemical peels as part of an overall skin care regimen. Your Doctor can discuss the various options appropriate for you.
Is it permanent?
Clinical studies have shown that the results can be permanent, however maintenance treatments may be recommended to maintain the results.
Are there any side effects?
Mild "blushing" of the skin may occur for those with sensitive skin that lasts for a few minutes. No other side effects are known.
Can I still wear make-up?
Yes. You can immediately apply make-up after the treatment.
Acne
Acne is a common skin condition that afflicts most people, to a varying degree, during the teen years. However, the disease is by no means restricted to this age group; adults in their 20's or 30's may have acne. Don't think that because acne is common, treatment is unnecessary. Waiting to "outgrow" acne can be a serious mistake. Medical treatment can improve your appearance and self esteem, and prevent the development of lifelong scars.
The Cause of Acne
Acne is actually caused by a combination of several factors:
- Rising hormone levels during adolescence cause enlargement and over activity of the oil glands in the skin.
- The canals that bring this oil to the surface become blocked with keratin (a protein that is part of the skin).
- When these oil glands are overactive and the canals are blocked, the bacteria that normally live on the skin and in the oil become trapped. They subsequently multiply, and cause inflammation and irritation.
Cleansing and Cosmetics
Even though you may be told to wash frequently, acne is not a disease caused by dirt. For example, the blackness of a blackhead is not dirt, but is due to the accumulation of the normal skin pigment in the oil gland ducts.
Wash your face with a mild antibacterial soap recommended by your dermatologist twice a day. If one's skin is very oily, it may be washed more often. Over washing or scrubbing tends to irritate the skin and will make acne worse. Therefore, do not use any abrasive cleaners or cleansing pads.
Shampooing is also important in acne therapy. The oilier your hair is, the more often you should shampoo it. Also, it is best to keep hair off the face as much as possible to avoid hair oils.
For covering blemishes, many preparations have been formulated to match skin color. These cosmetics should be water based (i.e. the first ingredient on the label should be water). Most cosmetics and skin products that are safe to use on acne-prone skin will say “non-comedogenic”, “oil free” or “won't clog pores.” Look for these labels on your facial products. Greasy applications such as Vaseline, cocoa butter, cold cream, and vitamin E oil should be avoided. If the face is dry, your dermatologist can recommend a moisturizer for your type skin.
Diet
The idea that acne can be brought on by an unhealthy diet has been debated for years. For the last 30 years the conventional wisdom has been that diet plays no role in most cases of acne. While many Dermatologists still
believe this to be true, another view is emerging. Doctors were surprised to learn that acne is virtually unknown in some remote jungle tribes. These people live off the land without the modern staples of beef, dairy,
wheat and sugar. On the other hand, the age when acne first emerges is
getting younger for teens in the USA along with the age of puberty.
Could something in the modern diet be the culprit? Some say yes, because eating the wrong things can let loose the wrong kind of hormones. These hormones activate the oil glands in your face. High levels of hormones are present in cow's milk, since most dairy cattle are pregnant. The idea that milk is an essential part of everyone's diet is probably wrong. You can easily get your calcium, vitamin D and protein from other foods, or from supplements. It may take 6 months off all dairy products before any improvement can be seen, but about 1 in 3 say this helps their acne quite a bit.
Another theory blames sugar and excess carbohydrates. These push your body to pump out insulin, which can throw off other hormones as a result. Some overweight women with acne have hormone imbalances and excess insulin. In these women bringing the insulin level down corrects the hormone levels and acne. While there is no proof sugar and carbohydrates are important in most cases of acne, there is also no doubt sugar and excessive carbohydrates are not good for you. Eating healthy foods is a good idea for acne sufferers.
There are still others who blame particular foods for their acne. Chocolate and nuts are commonly mentioned, but these don't seem to play a role in most people's acne. The importance of diet may vary between individuals, but the idea that diet plays no role in acne is probably on the way out.
Treatment of Acne
Acne need not be feared as something untreatable. In recent years many effective forms of therapy have been developed. Dermatologists want to prevent scars that acne can leave. Years of untreated acne can leave a lifelong imprint on a person's face and can have an effect on his or her self-image. While acne may not be curable, it is usually controllable.
Since acne has many forms, your dermatologist designs an individual approach to care for successful control. Thus, the course of therapy will vary according to such factors as type of acne; it's severity and extent, and the patient's day-to-day activities.
Mild acne is treated with one or a combination of topical medications. The purpose of these is not only to treat existing acne lesions, but also to prevent new blemishes from forming. Therefore, these are applied over most of your face, not just directly on the present pimples. In addition, in some people these creams may cause the face to become a little dry, pink or feel taught. This is normal. If your face becomes too irritated or 'raw' feeling, don't stop the creams, just decrease the frequency of application (i.e. apply every second or third day).
Moderate and severe acne is usually treated by topical medicines with the addition of oral antibiotics. Since different combinations work better for some patients than others, you are usually evaluated every four to six weeks until the acne is well controlled.
In addition to this conventional therapy, your dermatologist may recommend one or more of these treatments to speed healing and clearing of your acne:
Acne Surgery: This procedure greatly speeds acne clearing and appearance by manually removing blackheads and whiteheads. A round loop extractor is used to apply uniform smooth pressure to dislodge the material. Inserting a pointed instrument to carefully expose the contents loosens lesions that offer resistance. This may be combined with skin shaping, which helps to remove dead skin on the face and open up smaller blocked pores.
Intralesional Corticosteroid Therapy: If one or several painful acne cysts develop, fast relief is available with this relatively painless procedure. Each cyst is given a single injection of a dilute cortisone solution, using a very tiny needle.
Accutane Therapy: In 1982 a new oral medication, isotretinoin, became available for the treatment of patients with severe acne not responsive to conventional treatments. The duration of treatment is usually five to six months, and one such course is often curative of severe acne forever. Use of this medication does require a thorough understanding of its side effects and precautions (e.g. the prevention of pregnancy).
Treatment of Acne Scarring
Prior to correcting acne scarring, it is generally advisable to wait until acne activity has been low or absent for several months. Scars improve with time as the body softens their appearance. The color contrast is often the most troublesome aspect of resolving large acne blemishes. These lesions may leave a flat or depressed red scar that is so obvious; patients mistake the mark for an active lesion. The color will fade and approach skin tones in 4 to 12 months. Many patients are self-conscious about the pitted and crater like scars that do not fade. These remain as a permanent record of previous severe acne. Your dermatologist may a variety of procedures to you to remove or revise these marks:
Chemical Peel: Superficial acne scarring, and irregular pigmentation of the skin are easily treated with this technique. Chemical agents are applied to the skin, which cause the outer layer to be removed. Different chemicals and concentrations are used, depending on ones skin type and degree of scarring.
Laser Resurfacing: More prominent scarring from acne is best treated by this technique. The top several layers of skin are removed with this high energy light. This action evens out the skin to give it a smoother, more pleasing contour.
Punch Excision and/or Grafting: Some narrow pitted scars are too deep to be removed by dermabrasion. These can be removed with a surgical instrument called a punch. The resulting defect is closed, either primarily or with a tiny skin graft, with gratifying results. Sometimes this procedure is followed by chemical peel or laser resurfacing for patients with a mixed type of scarring.
Collagen Implantation: Patients with a few soft depressed scars with smooth edges respond well to collagen. This natural protein is injected under the lesion to elevate it to the level of the skin.
