Dermatologist Dr. Glenn Kolansky offers advice on the best acne treatments and products.
It is stressful, embarrassing, and many teens and even adults are being treated differently for it. There is no need to jump to extremes in order to deal with this problem, though, since there are many great non-surgical acne treatments available.
On the quest to find the answers about resolving this skincare issue, I contacted Dr. Glenn Kolansky, a board certified dermatologist currently practicing in New Jersey. He offers his tips for the best acne treatments and products as well as expert advice about teenage acne.Allison: How would you compare over the counter acne treatments such as Proactive to treatments that can be bought at drugstores? Dr. Kolansky:Proactive is just OTC strength benzoyl peroxide and salicylic acid, which are the same products drugstore brands use. These are mild products, but have benefits because they clean the skin and kill bacteria. They are especially beneficial when the patient is not using anything to clean their skin. Just the act of cleaning the skin, decreasing dirt and oil, has shown a benefit in acne treatment.
Medicated acne treatments containing retinoids work in both inflammatory and non-inflammatory acne lesions because they have anti-inflammatory and comedolytic activity and modulate keratinocyte proliferation. Topical antibiotics can reduce inflammatory responses from acne.
Often most products are very similar. Just using these products can provide benefit, but often prescription strength medication, retinoids or antibiotics are necessary.Allison: How do antibiotic acne treatments work? Dr. Kolansky: Antibiotics such as the tetracycline (minocycline and doxycycline) decrease acne bacteria, but there is concern of bacterial resistance, so combination therapy may decrease this risk. Tetracyclines have also been shown to have anti-inflammatory effects. Dr. Kolansky: Acne scars can be improved with fractional and abalative laser treatments. Fractional lasers may require multiple treatments and the healing time is usually 3 to 5 days.Allison: What are your best suggestions for non-surgical treatments for teens to help get rid of acne scars?
Abalative laser, including the erbium-yag and the CO2 laser, require fewer treatments, but have more down time. Pulse dye lasers can be used to reduce the erythema, or redness, remaining from acne.Allison: Can you explain how pixel lasers work to get rid of acne scars? Dr. Kolansky: The pixel laser can soften acne scarring. It is a fractional laser that creates micro-injury to stimulate collagen. It can provide benefit for mild to moderate acne scarring. Deep scars, or ice-pick scars, may require deeper lasers or other methods for skin improvement. Redness can be decreased or softened with a pulse-dye laser such as the V-Beam by Candela, with resulting improvement in texture. Allison: How do blue light treatments with or without levulenic acid work? Dr. Kolansky: Blue light therapy is a new treatment option for acne patients. Propionbacterium acnes produce porphyrins as part of their normal metabolism. It is thought that when blue light hits the acne at a wavelength of 405 to 420 nm, photoexcitation of the porphyrins generates free radicals that are bactericidal against P.Acnes. Blue light may also have anti-inflammatory properties as well. There are home blue light devices that when used along with other treatments can be an effective acne treatment option.
Aminolevulinic acid (ALA) is applied to the skin and accumulates in sebocytes. When the ALA is applied to the skin, it is converted to protoporphyrin IX. It is then activated by blue light. In one study used twice weekly for four consecutive weeks and patients achieved inflammatory lesion reduction of 59 to 67 percent. Many patients tend to keep this response for 6 months or longer. However, many of these studies have been with a small group of patients.Allison: Are there any mail order acne clearing scams that we should look out for? Dr. Kolansky: Most all mail order treatments bill your credit card on a monthly basis and send the medication even if you do not need it. Allison: Are there any other suggestions that you can give to teens that are having acne issues? Dr. Kolansky: Teenagers should not squeeze or pick at their pimples as this may result in scarring. Treatment by a professional, sooner rather than later, often results in clearing of the skin with less scarring. Different acne treatments may work better for different patients.
The thought that acne is part of being a teenager is simply not true, and early treatment is the best option. It is also important to remember that treatment even when little acne remains can keep your skin clear. A good skin care routine, including washing after sports or athletic activities as soon as possible, may result in fewer breakouts. When you seek acne treatments, check that a dermatologist is actually treating you.