Severe Acne is a Heartbreaker
I saw a polite, soft-spoken boy this week with severe cystic acne.
“How long have you had acne?” I asked.
“For about two years.”
“Have you been treating it?”
“Yeah. Actually I’ve spent so much money on acne medication that my mother made me get a part time job to start paying for it,” he replied. Read more
Bacteria Secretes Sticky Glue, Causing Acne
Propionibacterium acnes (P.acnes) is the bacteria found in acne. A new study in the Journal of the American Academy of Dermatology has shed some light on how it wreaks its damage.
P. acnes lives in a biofilm, an aggregation of bacterial organisms and sticky extracellular substance, that allows it to stick to the wall of the hair follicle. This sticky substance also causes the skin cells to stick together, limiting their ability to shed. These stuck-together skin cells (keratinocytes) then block the hair follicle, forming a keratin plug and trapping the natural oils (sebum) below the surface. When the pressure from this trapped oil builds up, a pimple is born. The acne bacteria then live happily encased in their protective biofilm, trapped in the follicle.
This is why combination therapy is most effective against acne; if you don’t break up the keratin plug on the skin’s surface, then antibacterial medications cannot penetrate and won’t work.
Proactiv® works by employing an mild acid to break up the plugged pores and an antibacterial to kill the P. acnes. Prescription acne therapy works similarly. I often prescribe a retinoid, like Retin-A, to break-up the keratin plugs and an antibiotic, like benzoyl peroxide or clindamycin, to kill the bacteria.
Unfortunately, even with the appropriate combination therapy, it still takes up to 12 weeks to clear up your acne. On the up side, if you follow this regimen daily, you really will see results.
Burkhart, CG and Burkart, CN. Expanding the microcomedone theory and acne therapeutics: Propionibacterium acnes biofilm produces biological glue that holds corneocytes together to form plug. J Am Acad Dermatol 2007;57:22-4
What’s a Good Acne Concealer?
A patient asked me this morning, “What is a good acne concealer?”
This comes up often. In fact, it was a recent post at The Makeup Minute blog. I often recommend Neutrogena’s SkinClearing® oil-free concealer. Concealers are commonly oil based and can further clog your pores, worsening your acne. 
This Neutrogena product is oil free. It also contains salicylic acid which helps the skin to exfoliate, unblocking the hair follicle and allowing for the trapped sebum to come to the surface. This helps speed-up the healing.
They come in different shades to match your skin color and even have a concealer with a green tint — the green color helps to offset the underlying red color of the spot, making it look more like your natural skin tone.
New Acne Medication for 2008
The FDA has approved a new topical medication for acne: dapsone gel.
The Benabio Guaranteed* 2008 Acne Cure (*If You Use It, That Is)
Do you use Proactiv®? Many of my acne patients have tried it. Some felt it helped, others felt it didn’t. Proactiv was developed by two dermatologists; its success lies not in the actual product but in the way they have you use it.
It is an absolute truth that almost any acne treatment works and almost every acne treatment fails. It depends on one thing: Do you actually use it?
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A new dermatology blog from Dr. Benabio.
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