You will be given a complete skin assessment and your acne severity will be documented using and progress pretreatment acne photos.
The presence of scars or deep cysts means more aggressive therapy will be required.
An Acne Skin Treatment Plan containing your personalized acne correction program specific to your skin’s needs will be developed. Of course, your acne severity and response to therapy will determine the number and types of treatments and therapies.
Common Prescription Medications Used to Control Acne:
• Doxycycline or Minocycline Antibiotics – This cuts the bacterial accounts in the reddish pimples. More importantly it cuts inflammation. This is needed only for those with active inflammation such as pink or reddish active pimples. Its effectiveness is only on reddish or inflamed pimples. Areas without inflammation, such as blackheads, will not be affected.
• Accutane (isotretinoin) – This is what I call the nuclear option. Accutane therapy is extremely effective, extremely toxic and extremely expensive. Side effects are many, including severe birth defects if a pregnant woman is on it, high triglycerides, peeling skin, dry skin, depression and suicide. Some people think it may cause chronic bowel problems. At our office, we will occasionally recommend Accutane in patients with obviously severe acne not responding to other therapies. Insurance will usually cover this. There are only 2 therapies that produce long term reduction in acne lasting for months or years after the therapy is stopped, PDT and Accutane.
• Hormonal Therapy in Women – Many hormonal therapies are used in females to help acne. Metformin is often useful in women with irregular periods and polycystic ovary syndrome. Birth control pills and spironolactone are more potent and useful in almost all women. A 30-50% or more reduction in acne after 2 months of therapy is typical, especially when both are used.
• Retinoid creams or gels – Retin-A (tretinoin), Differin (adapalene), retinol, Tazorac (tazarotene), Epiduo (adapalene and benzoyl peroxide mixed) are commonly used and of the topical therapies the retinoids are the most effective.
• Retinol and adapalene are OTC, but the others require a prescription. These may dry the skin.
• Benzoyl peroxide – can be bought OTC and sometimes by prescription; it may dry out the skin. There are only moderately effective.
• Topical antibiotics like clindamycin – often helpful, but only moderately effective.
• Topical salicylic acid (usually 2%) – often helpful, but only moderately effective. Available OTC.
Procedures to reduce active acne include PDT (photodynamic therapy), acne cyst drainage and lasers and are discussed in other areas of the web site.
Insurance will generally cover acne medical visits and acne prescription medications. However, they almost never pay for light therapies, radiofrequency therapy, laser therapy, over the counter acne products and scar reduction therapy.
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