Acne is one of the most common skin conditions affecting 9.4% of people worldwide, and you can bet that it is THE MOST popular complaint our dermatologists see in their offices. Many patients come in after having struggled for years on complex regimens of medications, but nothing seemed to work well. When I see an acne patient for the first time in my clinic, I tell them that I feel confident that together, we can clear his or her acne. What gives me that confidence? Experience, a whole armamentarium of medications to personalize the treatment (topical, over the counter, and prescription), and the belief that the patient will collaborate with me on this journey towards clear skin.
Because I’ve had all these experiences with patients, I know that a personalized treatment plan works, and that is the idea behind Glow Up, a revolutionary skincare service that delivers a comprehensive custom skin regimen designed for you by dermatologists that is unique to your skin needs.
First off, it is so important to note that there are many types of acne, and the treatment depends on your acne type. In a nutshell, there are (and you can get combinations of any of them):
1. Comedonal acne: These acne bumps look like your typical whiteheads (small white bumps), blackheads (bumps with an open black dot in the middle), and pustules (small pus bumps).
2. Inflammatory acne: This category of acne presents as red sometimes tender bumps that can last a few days and can leave small shallow scars
3. Nodulocystic acne: A more severe form of inflammatory acne, patients with nodulocystic acne get deep extremely painful large bumps and pus-filled cysts that last for weeks and leave deep scarring in the form of dark spots or dents in the skin
4. Hormonal acne: This class of acne is found in women who have acne flares around their periods (before, during, or right after), usually along the chin or jawline, but can also be on the cheeks and forehead.
As you can imagine, the treatment for your acne depends on what type of acne you have, and also the severity. There is no “one size fits all” in acne treatment; every patient I see gets a detailed personalized regimen that mixes over the counter products and prescription products for the best results. If you’re an infographic kind of person, check this out:
Comedonal acne: Comedolytics like salicylic acid, benzoyl peroxide, topical antibiotics such as clindamycin or erythromycin, and power ingredient tretinoin for busting blackheads and whiteheads are KEY to treating whiteheads and blackheads
Nodulocystic acne: same as treating inflammatory acne, but with a lowered threshold to escalate treatment to Accutane (oral retinoid) if needed. I decide with the patient when this jump in treatment is needed, depending on the severity of the acne. Is the acne leaving permanent scars, dark spots, dents in the skin? Is the acne severely affecting the patient’s life to the point where he or she is suffering emotionally and having breakouts daily? Those are the things I weigh when deciding when Accutane is appropriate.
(Side note: Accutane has many side effects, all of which I weigh very carefully prior to offering or discussing it with the patient. It is a serious medication which warrants monthly blood draws to make sure there are no internal side effects damaging patients’ other organs. That being said, it can be a miracle medication for those with severe acne who don’t have other contraindications to this medicine).
Hormonal acne: I’m not going to lie — this is one of my favorite classes of acne to treat, because I see dramatic results with my patients. Because hormonal acne stems from an over-abundance of male hormones, we can use a medication called spironolactone, a male androgen hormone receptor blocker. Spironolactone works incredibly well for hormonal acne, and most of my female patients tolerate it extremely well. We can also use oral birth control to help modulate male hormone levels in hormonal acne.
I tell all my patients it will take 6 weeks to start seeing results, and that they need to be patient and work with me to clear their skin. Compliance is key; many of the medications are not easy to take but patients will be rewarded if they push through.
There is a clear algorithm I follow and logical thinking process I go through when evaluating my patients with acne. With this treatment approach, and with the patients’ collaboration, I can help all my acne patients achieve clear skin. I have full confidence that Glow Up can do the same. I encourage you to sign up here for early access, and to start your journey towards glowing, blemish-free skin right now!