Why is important to address acne in teenagers?

Acne is most common among teenagers.  Just when our appearance becomes so important and we want to look our best, acne can begin. Some teens seem unfazed by acne. For most teenagers, however, this especially visible skin problem can be upsetting. Many studies show that having acne tends to lower self-esteem. Kids who have acne can also be bullied.

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It often causes whiteheads, blackheads or pimples, and usually appears on the face, forehead, chest, upper back and shoulders.

Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.

Presentation

Acne signs and symptoms vary depending on the severity of your condition:

• Whiteheads (closed plugged pores)
• Blackheads (open plugged pores)
• Small red, tender bumps (papules)
• Pimples (pustules), which are papules with pus at their tips
• Large, solid, painful lumps beneath the surface of the skin (nodules)
• Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

 Causes

Four main factors cause acne:

• Excess oil production
• Hair follicles clogged by oil and dead skin cells
• Bacteria
• Excess activity of a type of hormone (androgens)

Factors that may worsen acne

These factors can trigger or aggravate acne:

• Hormones. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production.
• Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.
• Diet. Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse.
• Stress. Stress can make acne worse.

 Things that do not cause or worsen acne

• Greasy foods. Eating greasy food has little to no effect on acne. Though working in a greasy area does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or promotes acne.
• Hygiene. Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
• Cosmetics. Cosmetics don’t necessarily worsen acne, especially if you use oil-free makeup that doesn’t clog pores (noncomedogenic) and remove makeup regularly. Nonoil cosmetics don’t interfere with the effectiveness of acne drugs.

Acne Treatment at AgeFocus

The goal of our Acne Program is to:

• Control your acne
• Avoid scarring or other damage to your skin
• Make scars less noticeable

A combination of weekly visits for skin care by our estheticians and a home care program help accomplish these goals. Sometimes acne medications are required to further reduce oil production, speed up skin cell turnover, fight bacterial infection or reduce inflammation — which helps prevent scarring. With most prescription acne drugs, you may not see results for four to eight weeks, and your skin may get worse before it gets better. It can take many months or years for your acne to clear up completely.

Treating Acne Scars

Ice Pick Scars

Ice pick scars are deep, very narrow scars that extend into the dermis. The skin looks as if it has been pierced by an ice pick or sharp instrument. Ice pick scars seem to make a small, thin, deep hole into the skin. Some may look like a large, open pore.

How They Develop: Ice pick scars develop after an infection from a cyst or other deep inflamed blemish works its way to the surface. Skin tissue is destroyed, leaving a long, column-like scar.

Treatment for ice pick scars: Punch excision is a common ice pick scar treatment. During the procedure, your physician takes a small, cookie-cutter like tool to cut out the scar. The skin is then glued back together to heal. Punch grafting is done for larger, deeper ice pick scars. Just like with punch excision, the scarred tissue is removed from the skin. The hole is then filled with a graft of skin (usually taken from behind the ear).

We prefer to treat them with subcision. This is a simple surgical procedure, done under local anesthesia as an out-patient. A needle is inserted parallel to the skin, cutting the fibrous base of the scar that is pulling down on the skin from below. Once the bands have been cut, the skin looks smoother. Immediately after subcision, radiofrequency treatment with Venus Viva helps to rebuild collagen and prevents collagen bands to reoccur. It also treats all surrounding skin for a very smooth appearance. For the first treatment we also use Platelet Rich Plasma or exosomes. The following treatments are a month apart using Venus Viva, 4 to 8 additional treatments are usually needed.

Boxcar Scars

Boxcar scars are round or oval depressions with steep vertical sides. Wider than ice pick scars, boxcar scars give the skin an uneven, pitted appearance.

How They Develop: When an inflammatory breakout destroys collagen, the tissue is lost. The skin over this area is left without support, creating a depressed area. Boxcar scars can be superficial to severe, depending on the amount of tissue lost.

Treatment for Box Scars: A quick and easy treatment for boxcar scars, are dermal fillers. These are injected into the scar, helping to raise depressed areas of the skin leaving it more even with the surrounding skin surface. This is only a temporary solution (10-12 months), because the filler will be absorbed. For a more permanent solution we prefer to use Platelet Rich Plasma (PRP) or exosomes and nano fractional radiofrequency. This will rebuild collagen and will remodel the acne scars. Several treatments are needed until desired effect is obtained (4-8).  PRP or exosomes are usually needed only in the first treatment.

Rolling Scars

This type of scarring causes rolling or wave-like depressions across otherwise normal-looking skin. Rolling scars differ from boxcar scars in that they aren’t sharply defined. The skin itself looks uneven and craggy.

How They Develop: Rolling scars arise when fibrous bands of tissue develop between the skin and the subcutaneous tissue below. These bands pull the epidermis, binding it to deeper structures of the skin. It is this pulling of the epidermis from within that creates the rolling appearance of the skin.

Treatment for Rolling Scars: Rolling scars are best treated with subcision. This is a simple surgical procedure, done under local anesthesia as an out-patient. A needle is inserted parallel to the skin, cutting the fibrous base of the scar that is pulling down on the skin from below. Once the bands have been cut, the skin looks smoother. Immediately after subcision, radiofrequency treatment with nano fractional radiofrequency (Venus Viva)  plus PRP or exosomes helps to rebuild collagen and prevents collagen bands to reoccur. It also treats all surrounding skin for a smooth appearance. Several treatments are needed until desired effect is obtained (4-8).  PRP or exosomes are usually needed only in the first treatment.

Hypertrophic and Keloid Scars

Hypertrophic scars are raised, firm scars that grow above the surface of the skin. Hypertrophic scars caused by acne are most often found on the torso, especially in men, but they can happen anywhere on the body. Hypertrophic scars are more common after a deep wound or trauma.

Keloids are a more severe type of raised scar. They differ from hypertrophic scars in that keloids grow larger than the original wound. They can send out raised, lateral shoots that expand much farther than the wound itself and can continue to grow long after the original wound has healed. Some people are more prone to developing keloids.

How They Develop: Unlike ice pick and boxcar scars, hypertrophic scars are not caused by a loss of tissue. Rather, they develop because of an overproduction of collagen. In the case of keloids, it’s like the skin doesn’t know that the wound has healed and continues to produce collagen.

Treatment for Hypertrophic Scars and Keloids: It is best to treat them as soon as possible, especially if you know that you are prone to this type of scars. If cortisone or silicone creams are not helping, we use small injections of cortisone follow by 4-8 treatments with nano fractional radiofrequency. Usually we are able to obtain good results even in old scars, the scar itself will not disappear, but it will become flat and blend better with surrounding skin.