
Let's talk about a common problem that we can help with.....acne. Acne vulgaris is a common problem in adolescence that can continue or leave long lasting changes through adulthood. It most commonly occurs on the face and back but can cause problems almost anywhere. It occurs in these places most commonly because of glands that produce a large amount of oily material. The pores become "plugged" with this thick, oily material and bacteria (germs) get in the mix causing inflammation and pimples. It occurs when hormonal levels are peaking, thus the high rate during adolescence but adult acne is also a common problem.
Certainly, acne is not a life threatening condition but it can ruin self esteem and lead to life changing and permanent skin damage. It can cause scarring and pitting of the skin that will carry through life in severe cases. Many of us have mild and sporadic breakouts that are only a minor problem, but for some, acne is a curse that can ruin social interactions and make us very self conscious.
At Total Body Surgical we take a systematic approach to the treatment of acne. I like to evaluate at the initial visit how severe the problem is and what potential for permanent skin damage there is. If the problem is not severe, we start with a good skin cleanser that contains salicylic acid to remove the oil the skin is producing. I like the clarifying cleanser made by Skinceuticals. We also like benzoyle peroxide products for a topical kill of bacteria. Retinol or tretinoin is also used topically to help the skin turn over quicker. This is usually our first line of treatment for even the worst cases. For more severe problems I will add a topical antibiotic gel or start treatment with an oral antibiotic at low doses to decrease the inflammation and lower the bacteria count. These steps will usually make the condition improve a great deal, at least enough to make it tolerable. If not, the next step we use is the Cutera 1064 laser. The laser genesis treatment is painless and quick with no down time. We use the laser to gently warm the skin to a temperature that eliminates the bacteria causing the problem. This is usually very effective and allows the other treatments to take hold. It is also a good way to get ready for special events...treat a week or so before and have a clear face!! These treatments can be done at 4-6 week intervals and are very affordable.
Now for the severe cases...the dreaded Accutane!!! I am very careful when I choose patients to use this medication. They must be reliable and have good supervision from a parent. The i-pledge program must be followed as well which gives good counseling about pregnancy prevention while on the medicine. Accutane IS a great drug...it works almost universally. It can, however, have some severe side effects that are not very common (regardless of what the lawyers on TV portray). It can cause depression leading to suicidal thoughts, headaches that can be severe, birth defects if you become pregnant or make someone pregnant while on the drug, very dry lips and skin, dry eye....and the list goes on. Most treatment regimens start at full dose and after clearance of the acne we switch to a lower dose program which seems to be effective. Any of the above problems that become severe may require a stoppage of the medicine.
I have found that most individuals will require a minimum of 6 months of Accutane and some may need more than one course of the medicine.
For those with permanent acne scarring we offer the Pearl laser. You must be off of Accutane for a minimum of 6 months to qualify but these resurfacing treatments help tremendously to soften the scarring. Down time is around 4-5 days and treatments can be repeated to desired effect.
If you need help with acne...give us a call at 918-786-7780...we'll be glad to give you the help you need. Don't forget our laser hair removal...$50/treatment/area special too!!