Acne scar treatment: Injections of steroids can flatten keloid scars, according to Dr. Elbuluk. When they are discolored or red, there is some active inflammation in the skin. “The goal is to make the inflammation go away,” she says, “and certain lasers, such as pulsed dye laser, can improve any discoloration by targeting blood vessels.” Cryosurgery freezes the scar tissue, causing it to slough off, but this can cause pigmentation problems of its own among people with darker skin, who are already at higher risk for keloids. Prevention has an important role to play for anyone who is prone to keloids, she says. Using a scar-minimizing treatment like Mederma and/or silicone gel scar sheets before scars form can help stave off a keloid. Vitamin C serums such as Kiehl’s ‘Clearly Corrective’ Dark Spot Solution, Perricone MD Vitamin C Ester Serum, Skinceuticals C E FERULIC® vitamin C serum, or Kiss My Face C The Change (Ester C Serum) can also reduce pigmentation around a keloid scar.
Exfoliating cleansers and masks: A variety of mild scrubs, exfoliants, and masks can be used. These products may contain salicylic acid in a concentration that makes it a very mild peeling agent. These products remove the outer layer of the skin and thus open pores. Products containing glycolic or alpha hydroxy acids are also gentle skin exfoliants.
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.
Mix and match: "Since acne scars vary, so do treatments. Depending on the individual, I often use a multimodal approach to treating acne scars. First, I might use Fraxel treatments to smooth out the skin texture. Then, I often use a combination of the fillers Restylane and Belotero to lift the depressed scars. Finally, I perform a few punch excisions to surgically remove any deep scars that may remain," says Dr. Bowe. There are also topical treatment options for active breakouts that help prevent scarring, which can be used to get out ahead of things.
What to know about hormonal imbalances While it is natural to experience hormonal imbalances at certain times in life, such as puberty, menopause, and pregnancy, some hormonal changes are related to underlying medical conditions. This article looks at the causes and symptoms of hormonal imbalances in men and women, as well as treatment and home remedies. Read now
The hair follicles, or pores, in your skin contain sebaceous glands (also called oil glands). These glands make sebum, which is an oil that lubricates your hair and skin. Most of the time, the sebaceous glands make the right amount of sebum. As the body begins to mature and develop, though, hormones stimulate the sebaceous glands to make more sebum.
Another potential skin saboteur is sugar, because it raises your insulin level. More and more evidence shows that insulin may boost those oil-triggering male hormones, Dr. Schultz explains. Stick to low-glycemic foods—ones that have complex carbs like whole grains, which break down slower in the body and cause less of an insulin spike. Your health will be better for it, too.
Can’t use the good stuff: The best medications for clearing acne include topical retinoids like Differin and Retin-A. The strong chemicals that are used in exfoliants can cause severe inflammation and sun irritation when combined with these medications. This means that you will have to choose between facials or proper medications. The choice is yours.
Acne scars, on the other hand, are formed when there is damage to the skin which leads to abnormal collagen production, and usually appear raised or bumpy. "There are two types of acne scars: depressed and raised. Depressed scars may look like pits or craters, and raised scars may be firm and tender," explains Dr. Zeichner, who notes that unfortunately, these are permanent.
Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.
Dermal fillers: "Certain scars can be filled with a substance that elevates the depressed areas, like hyaluronic acid. This can make the surface of the skin more even and get rid of shadows," says Dr. Bowe. Until recently, fillers weren't a lasting solution. But now, if you're over 21 years old, Bellafill is the first FDA-approved dermal filler designed for permanently correcting moderate to severely dented acne scars. Unlike other fillers, it contains two different ingredients to help improve acne scarring. "It's 20% polymethylmethacrylate (PMMA), which helps your body make more protein to allow itself to heal," says Dr. Shah. "PMMA are tiny balls that sort of act as a scaffolding. Most fillers degrade over time, but since PMMA cannot be absorbed into the body, this offers a permanent result," she says. The other 80% is collagen. The procedure takes about 20-30 minutes, and while you may need a touchup a couple months later, some people just need the single treatment, says Dr. Shah.
Temporary skin fillers have been used for years for acne scar treatment, but a permanent dermal filler was approved for use by the FDA just last summer. Designed to remove moderate to severe acne scarring, Bellafill is made up of 80% collagen to replace lost volume and 20% polymethylmethacrylate, which helps your body heal by boosting protein production.
The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) permanently and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps, or papules, that often resemble teenage acne. Acne rosacea and adult acne are other names for rosacea. One of the most unpleasant aspects of rosacea is the overgrowth of dermal tissues producing a "phymatous" change in the skin. This appears as a thickening and permanent swelling of the facial tissues. A bulbous nose called rhinophyma is an example of this change.
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.
Photodynamic therapy (PDT) is a procedure that treats precancerous cells, in addition to other types of cancer cells. The medical treatment does this with the help of a photosensitizing drug and a light source that activates the applied drug, destroying cancer cells. PDT is approved to treat non-small cell lung cancer, esophageal cancer, and Barrett's esophagus. It's used to treat actinic keratosis, as well as acne, rosacea, skin cancer, sun damage, oily skin, wrinkles, warts, psoriasis, and enlarged sebaceous glands.
Treatment of acne scars: For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.