"If you occupy the area [under the skin] with a cyst, it destroys fat around it. Once the cyst goes away, the loss causes indentation," Dr. Karolak explains. A boxcar scar is a depression that has hidden scar tissue, which acts like an accordion pulling the scar downward. Subsicion is one solution for these deeper scars. Subsicion uses a sharp needle to go under the surface and break up that scar tissue. Then, you can fill it in with fillers made specifically for acne scars like Bellafill. Or you can do a fat transfer. "One of my favorite treatments for volume loss is fat transfer, which allows me to take inject a patient's own body fat instead of synthetic filler," says Dr. Karolak. Another treatment for boxcar scars is punch excision where the indented area of the scar is removed and the edges are pulled together with a suture. These treatments are often followed up with a collagen-boosting laser treatment.
Oral antibiotics: Doctors may start treatment with tetracycline (Sumycin) or one of the related "cyclines," such as doxycycline (Vibramycin, Oracea, Adoxa, Atridox, and others) and minocycline (Dynacin, Minocin). Other oral antibiotics that are useful for treating acne are cefadroxil (Duricef), amoxicillin (Amoxil, DisperMox, Trimox), and the sulfa drugs.
Common acne, known medically as Acne Vulgaris, is generally caused by hormonal changes in the body, and its onset usually can be found in teenage years when puberty rears its head. Acne is directly attributed to the rise of androgen hormone levels. The production of these hormones rise when a child begins puberty, and is the reason much acne is prevalent in adolescence. As androgen levels rise, the oil glands sitting directly underneath the skin enlarge and produce increased levels of oil, also known as sebum. When pores are filled with excessive sebum, it can cause surrounding skin cells’ walls to rupture and create a breeding ground of P. acnes bacteria. As the sebum attempts to push out of the pore, it can attach to this infectious bacteria and dead skin cells, causing a blockage that begins the formation of a pimple. According to Medical News Today, dermatologists purport that almost three quarters of 11 to 30-year-olds will deal with acne at some point, but acne breakouts can continue on into adulthood, and have been observed in patients in their fifties.
You've probably seen those tiny glass jars filled with liquid and some solid sediment at the bottom—sometimes it's pink, sometimes it's white, and (in the case of my favorite product) sometimes it's flesh-tone. The solid in the jar is usually a mix of drying ingredient like camphor, sulfur, and zinc oxide, but many brands throw in a few little extras. Cult-favorite Mario Badescu Drying Lotion adds calming calamine and exfoliating salacylic acid to their formula, while my favorite, End-Zit Acne Control Drying Lotion, keeps it simple, but comes in several shades so that it conceals your breakout while it treats it.
Cysts, which are also called blind pimples, are the very worst kind of acne. Basically, cysts are made up of sebaceous content (again, a gross combination of oil, dirt, and bacteria) that's trapped beneath the skin and has no way out—so they just live and grow under the skin, causing both a bump and, in some cases, pain. "These take longer to resolve on their own, are less responsive to topical treatments, and over time may lead to scarring," says Dr. Chwalek. Um, no thanks.
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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