Rena Levi is known for her sensitivity towards clients with severe acne and problem skin. In 1968 she moved from Israel to the U.S. and studied with Christine Valmy at the European Esthetic Skincare Institute. In 1975, she opened the Rena Levi Skin Care Salon in New York City. In 1980, she moved to Albuquerque, NM, where she managed the skin care center for Eleganza Salon and further developed and refined her practice. It was there that she became well known for her ability to treat what many considered impossible skin, while also teaching budding estheticians and skin practitioners at the same time, including the then-president of the New Mexico Board of Cosmetology. Here, Levi shares with us one of her most popular facial protocol treatments for treating clients with moderate to severe acne.

Isotretinoin: Accutane was the original brand name; there are now several generic versions in common use, including Sotret, Claravis, and Amnesteem. Isotretinoin is an excellent treatment for severe, scarring, persistent acne and has been used on millions of patients since it was introduced in Europe in 1971 and in the U.S. in 1982. It should be used for people with severe acne, chiefly of the cystic variety, that has been unresponsive to conventional therapies like those listed above. If taken in sufficient dosage, it should eliminate the need to continue the use of prescription drugs in most patients. The drug has many potential serious side effects and requires a number of unique controls before it is prescribed. This means that isotretinoin is not a good choice for people whose acne is not that severe but who are frustrated and want "something that will knock acne out once and for all." In order to use the drug, the prescribing physician, the patient, and the supplying pharmacy must be enrolled in the online "iPLEDGE PROGRAM." Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for five to six months at a dosage that has a high likelihood of preventing the return of acne. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, substances related to cholesterol, which often rise a bit during treatment but rarely to the point at which treatment has to be modified or stopped.

When you think about it, consistently reaching for your go-to face towel every day is like reusing a dinner napkin over and over again. Using dirty towels can harbor bacteria, and they can even introduce new bacteria to your skin, which may lead to more pimples. Thankfully, this doesn't mean you need to reach for a new towel every single time you wash your face, according to Dr. Melissa Kanchanapoomi Levin, board-certified NYC dermatologist and clinical instructor at NYU Langone and Mount Sinai Hospital. As long as you're truly washing off all of your makeup, you can stick to switching out your towels on a weekly basis.
When it comes to scarring, many doctors will tell you that prevention is key. Wearing sunscreen daily is critical, says Heidi Waldorf, a New York City-based dermatologist, and this one from Elta MD is her favorite. "It contains niacinamide, which reduces inflammation, and it's oil-free, which makes it excellent for daily use for acne-prone patients," she says.
How big of a scar you'll be left with after a blemish (if any at all) depends on the depth of the breakout, Schlessinger says. "As our pores become engorged with oil and form a blemish, the pore may swell and collapse the follicle wall," he says. "The depth of the resulting lesion determines the severity of the scar. Shallow lesions usually heal quickly and leave little-to-no scarring, while deeper lesions spread to nearby tissue, causing a more pronounced scar."
No one factor causes acne. Acne happens when oil (sebaceous) glands are activated at puberty, stimulated by male hormones from the adrenal glands in both boys and girls. Oil is a natural substance which lubricates and protects the skin. Under certain circumstances, cells that are close to the surface block the openings of sebaceous glands and cause a buildup of oil underneath. This oil stimulates bacteria, which live in everyone's skin and generally cause no problems, to multiply and cause surrounding tissues to become inflamed.
Like acne on your face, back acne occurs when your pores become blocked with oil and dead skin cells.. Exfoliating your back regularly might help remove these dead skin cells and pore-clogging debris before they have a chance to block pores. However, you want to take care not to scrub too hard, especially if you are experiencing an active breakout. Use a soft cloth to gently brush away surface impurities as you shower.
Avoid touching or rubbing your face, since that can make acne worse. Try to keep your cell phone from touching your face, too. Use earbuds instead of having the phone against your skin. Also, don't lean your face on your hands, which may carry oils and germs that can irritate blemishes. Sweat can also make acne worse. Sweaty after exercise? Wash up.
Common knowledge would dictate that most people are aware that certain foods, and in turn, the nutrients they contain, can be beneficial for specific body parts. For example, healthy bones require calcium and vitamin D; our hearts function better when we eat certain seafood that is rich in omega-3 fatty acids. However, this does beg the question as to what food promotes healthy skin?
Sometimes, your gynecologist can share insight into your acne, especially when it comes to deciding if birth control could help your breakouts. The FDA approves of Estrostep, Ortho Tri-Cyclen and Yaz to combat acne, but the trick is to be patient, as it can take up to four months to start seeing results. "This plan of attack works best when paired with whatever topical treatments you’re already using to treat your acne, like Proactiv, benzoyl peroxide, salicylic acid, etc," advises dermatologist Dr. Elizabeth Tanzi.
There are simple things you can do on your own to help prevent adult acne and keep it from getting worse. First, wash your skin once or twice a day with a non-drying, non-comedogenic cleanser that won't clog your pores. Look for cosmetic products labeled oil-free, non-comedogenic and non-acnegenic (unlikely to cause acne breakouts). In addition, avoid heavy skin creams or hair products which may aggravate your skin condition.
"Put it this way: It is so common that pimples are meeting wrinkles," dermatologist Neal Schultz, M.D., creator of Beauty Rx Skincare, tells SELF. "For the last 10 to 20 years, adult acne has been increasing. It can even go into your 50s, right to menopause." If you had acne as a teen, chances are, you've got oily skin that's prone to breakouts. But even if you didn't, it's still possible you'll end up with adult acne.
Topical (external) applications: Antibacterial cleansers come in the form of gels, creams, and lotions that are applied to the affected area. The active ingredients that kill surface bacteria include benzoyl peroxide, sulfur, and resorcinol. Some brands promoted on the Internet and cable TV (such as ProActiv) are much more costly than identical and sometimes more potent products one can buy in the drugstore.
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