Acne Treatment & Rosacea Treatment

- With Multiple Modalities

Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms.  Seventeen million Americans currently have acne, making it the most common skin disease in the country.  While it affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it.  Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress, often extensive enough to affect one's grades or social standing. Timely and effective treatment can often reverse these trends and put the patient back on track.

Sebaceous glands are attached to hair follicles in the skin on the face, neck, back and chest.  They produce an oily substance called sebum, which normally reaches the skin surface through the opening of the follicle (pore).  When follicles become plugged, sebum cannot reach the surface of the skin.  This blocked sebum promotes the growth of bacteria (Propionibacterium acnes, or P. acnes) beneath the skin, which in turn produce chemicals and enzymes that attract white blood cells, causing inflammation.  Eventually the follicle wall breaks down and the sebum, skin cells and bacteria erupt to form lesions or pimples.  These are the visible effects of acne.

Treatment for acne and scarring varies depending on the type and severity of lesions, skin type, age and lifestyle. On the average results are visible in four to six weeks.  Options include:

• Modalities to reduce stress (medical & physical)
• Antibiotics, both topical and oral (often with the new mini-dose approach)
• Retinoids (Vitamin A-type medications) such as Tazorac® and Atralin®
• Isotretinoin (Accutane®, and others) for severe, disfiguring, nodulo-cystic acne.
• Punch excisional surgery for deep "ice-pick" pitted scarring
• Soft tissue fillers (Juvedérm™, Radiesse™)
• Laser resurfacing and for scarring
• Microdermabrasion for smoothing

Patients with mild acne can supplement treatment at home by washing with a medicated cleansing bar. Dr. Graham’s patients enjoy the convenience of obtaining a number of these specialty products in our office.

Rosacea is an acne-like chronic skin disease in adults. It causes redness and swelling on the face and eyelids. The scalp, neck, ears, chest, and back may also be affected. Symptoms range from red acneiform lesions, lines and visible blood vessels to dry or burning skin and a tendency to flush easily. Many people find that the emotional effects of rosacea such as low self-confidence and avoidance of social situations are more difficult than the physical ones. Rosacea can affect anyone and typically appears in adults ages 30-50. Triggers are both physical and food-related. Rosacea can be controlled with topical and oral medications, although a complete cure remains elusive.

Laser Skin Resurfacing

A favorite procedure among our patients is laser resurfacing. We use an erbium 1490 nm laser. It smoothes surface imperfections such as acne scars, discolorations, and fine wrinkles. This is a virtually painless procedure needing only topical anesthesia. It takes approximately twenty minutes. Afterwards, there is a sunburn-like effect which peels for one or two days. It is possible to return to work the following day. Because the laser is fractionated, the procedure is performed in 3-4 sessions at monthly intervals. This allows us to use less penetrating energy, thus reducing pain and avoiding the need for bandaging. Results are seen after the 2nd or 3rd session. The sequence can be repeated every 6-12 months as desired.  The risk of burning or scarring is minimal. Our precautions include: only performing laser treatments to patients in excellent health, pre-treatment for those with a history of cold-sores or fever blisters, and not performing the procedure if you are pregnant. We ask that you stop all photosensitizing medications for two days prior to your procedure. A list of these medications is provided at your consultation visit.

Fatty Tumor Removal

Lumps under the skin, anywhere in the body, are often referred to as fatty tumors. The medical term for these are lipomas. While they are often genetically-linked, over time, these usually benign tumors can grow, become uncomfortable, and press on nerves or vital structures. The majority of them are amenable to removal in the office under local anesthesia, either with a very small incision or occasionally with a cannula (small, hollow instrument). Although they are often not covered by insurance, the methods we use make their removal usually very affordable.

back to top