Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that one applies to the skin and a light to activate the sensitizer. Levulan (aminolevulinic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can treat some rosacea patients. The use of PDT in rosacea is off-label, since it is primarily designed for regular acne. PDT works at reducing the inflammation; PDT is performed in a physician's office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease-free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.
Some patients elect combination therapies and notice an improvement by alternating metronidazole and azelaic acid: using one in the morning and one at night. Sodium sulfacetamide (Klaron lotion) helps reduce inflammation. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin). Topical ivermectin cream (Soolantra Cream, 1%) is also available.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
If you’ve made a concerted effort with over-the-counter regimens and/or diet and still aren’t seeing results, a dermatologist is absolutely worth it. There are many levels of care: Prescription retinoids (Retin A, Tazorac, Differin et al) and/or topical antibiotics are the mildest, along with blue-light treatments like Isolaze, which kill bacteria and clear pores, with virtually no downtime. Light lasers like Clear and Brilliant can clear pores and treat the red and brown tones left by old acne lesions. “Some patients think they’ve got a severe problem, when they really only have a few pimples, surrounded by red and brown marks from old breakouts,” notes Anolik. Oral antibiotics represent a more aggressive (and unsustainable long-term) solution; birth control pills and hormone-mitigating medications like Spironalactone and Deldactone can get many more-severe patients’ acne under control. Most aggressive is Accutane; while it can be severely drying and can cause birth defects if taken during pregnancy, it represents a cure for truly-severe acne cases, says Anolik. “Used correctly, it is something of a miracle for people who’ve tried everything and failed,” he says.
Toning. After you wash and exfoliate you should apply a toner to the face that will help tighten the pores so oil and dirt cannot become trapped and create a home for harmful bacteria. Toners designed for acne sufferers are readily available at drugstores, but you can also apply products like apple cider vinegar or witch hazel. Apply toners with cotton balls and allow them to sit on the skin rather than rinsing them away.
Lasers. Your dermatologist can use a laser to remove the outer layer of your skin, contour areas of acne scars, or lighten redness around healed acne lesions. Various types of lasers are used, depending on whether the acne scar is raised or flat. More than one laser treatment may be required and, depending on the laser used, you may need to several days to heal.

What you can do differently: For starters, stop going to tanning beds. Period. And if you are in the sun, make sure to slather on a titanium dioxide- or zinc-based sunscreen (these are natural sun protectants and their formulations usually contain fewer chemicals, so they won't break you out as easily), and wear a sun hat or ball cap to shield your facial skin from harsh rays.
You may have heard the age old question, "does makeup cause acne?". While wearing makeup can exacerbate acne flare ups, it is not necessarily the case. Some support the fact that that cosmetics can fill up your pores, worsen pimples, and prevent your skin from “breathing”. The truth is, whether or not makeup worsens acne is highly individualized. While excessive use of foundations, concealers, and other cosmetics can work their way into and block up your pores, making sure to clean your face of such products before working out or going to bed lessens the likelihood of makeup blockages.

Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.
If you wear tight clothing when working out or don heavy equipment for sporting purposes, you may have experienced Acne Mechanica. This type of acne is prevalent among athletes, students, and soldiers, and is directly caused by excessive heat, pressure, and covered skin. It also may be triggered by consistent rubbing of different materials against the skin. This type of acne can be alleviated by changing out of sweaty gear and clothing and showering immediately after a workout. It’s also important to clean gear of acne bacteria and prevent friction by ensuring a comfortably tight fit. If you believe your acne flare up has been caused by a tight or heavy uniform, wearing a clean, cotton t-shirt underneath can help absorb the sweat and keep your skin protected.
Lowering stress levels can have an immediate beneficial effect on the appearance and frequency of acne breakouts. It’s important to maintain a regular exercise routine, get enough sleep every night, and practice stress control methods. Meditation has been shown to alleviate the effects of various skin conditions like eczema and psoriasis, and could have a positive effect on the symptoms of acne.

Not only can the sun prolong PIE appearance, it can lead to premature aging including sun spots, fine lines, and wrinkles. UV damage is DNA damage. Sunscreen is an anti-aging must for all ages young and old--preventing future skin cancer. It is the fountain of youth in a bottle. Prevention is better than treatment. There is no such thing as safe tanning, as tanning is the result of sun damage.

Rosacea (ro-zay-sha) is a common, acne-like benign inflammatory skin disease of adults, with a worldwide distribution. Rosacea affects an estimated 16 million people in the United States alone and approximately 45 million worldwide. Most people with rosacea are Caucasian and have fair skin. The main symptoms and signs of rosacea include red or pink facial skin, small dilated blood vessels, small red bumps sometimes containing pus, cysts, and pink or irritated eyes. Many people who have rosacea may just assume they have very sensitive skin that blushes or flushes easily.


Toning. After you wash and exfoliate you should apply a toner to the face that will help tighten the pores so oil and dirt cannot become trapped and create a home for harmful bacteria. Toners designed for acne sufferers are readily available at drugstores, but you can also apply products like apple cider vinegar or witch hazel. Apply toners with cotton balls and allow them to sit on the skin rather than rinsing them away.
90. If you’re going to pop a pimple at home, do it the right way. Sterilize your hands and a small needle with rubbing alcohol, then gently puncture the whitehead of the pimple, just enough to break the skin. Using a clean cotton swab, press on either side of the pimple until it’s drained. Cover with a bandage to keep the area clean while it’s healing.
Doctors usually diagnose rosacea based on the typical red or blushed facial skin appearance and symptoms of easy facial blushing and flushing. Rosacea is  underdiagnosed, and most people with rosacea do not know they have the skin condition. Many people may not associate their intermittent flushing symptoms with a medical condition. The facial redness in rosacea may be transient and come and go very quickly.
The exact cause of rosacea is still unknown. The basic process seems to involve dilation of the small blood vessels of the face. Currently, health researchers believe that rosacea patients have a genetically mediated reduction in the ability to dampen facial inflammation that is incited by environmental factors such as sunburn, demodicosis (Demodex folliculorum in the hair follicles), flushing, and certain medications. Rosacea tends to affect the "blush" areas of the face and is more common in people who flush easily. Additionally, a variety of triggers is known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. Changes in the weather, like strong winds, or a change in the humidity can cause a flare-up. Sun exposure and sun-damaged skin is associated with rosacea. Exercise, alcohol consumption, smoking, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year's holidays.

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.
No one factor causes acne. Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a "blackhead." The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a cyst.
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