Posts Tagged ‘Acne’
Acne is a disease state in which skin cells that line a hair or sebaceous follicle are shed, but fail they to make it to the surface of the skin to be sloughed away. An acne lesion begins when sebum (oil) causes skin cells to stick together and clog a follicle. When oil and dead skin cells collect in the follicle, bacteria quickly multiplies, specifically Propionbacterium (P.acne bacteria). The bacteria causes the release of free fatty acids, which irritate the follicle and cause inflammation.
We usually refer to acne lesions simply as blemishes or pimples, however there are specific names used for acne lesions. A non-inflammatory acne lesion is known as a comedo that develops when a hair follicle has become clogged with dead skin cells and oil. When bacteria infects an acne lesion and the follicular wall ruptures it is known as an inflammatory lesion. An inflammatory lesion is elevated and the skin surrounding it is usually red and sensitive.
A non- inflammatory, very tiny hard blockage under the skin. It is the smallest acne lesion and is not visible at the skins surface. This is the beginning stage of a blocked follicle. Micro-comedones develop into open or closed comedones as trapped sebum (oil) increases.
Closed Comedones (Whiteheads or Milia)
A small non- inflammatory bump at the surface of the skin. Dead skin cells and oil become trapped inside the follicle, and the opening to the follicle is closed.
Open Comedones (Blackheads)
A small non- inflammatory, plug at the surface of the skin. Dead skin cells and oil block the opening to a follicle creating a plug. Unlike a whitehead the opening to the follicle is open, allowing the dead skin cells and sebum at the opening to be exposed to oxygen. When exposed to oxygen the dead skin cells and sebum (oil) will oxidize and appear black. Blackheads develop in follicles that are large.
Inflamed small red or pink bumps on the skin with out an opening. Papuals do not contain pus, however they can develop into a pustule or a nodule. As a papule becomes more inflamed pus will form and it will develop into a pustule, if the lesion is deep it will develop into a nodule.
An inflamed, pus filled acne lesion. Pustules are what are commonly called pimples and the white or yellow center is often called a “head”. A pustule is surrounded by a circle of red inflamed skin.
Nodules & Cysts
Nodules and cysts are large inflamed acne lesions that develop deep within the skin. They are severe forms of acne that often cause scars. You should never attempt to pop or extract cyst or nodules, they need to be treated medically.
A large, solid, inflamed, pus- filled lesion that is located deep within the skin. A nodule will feel firm because the puss hardens inside the lesion. The body’s immune system responds by trying to keep the bacteria from spreading and skin cells will grow or wrap around the follicle. Nodules are often referred to as cysts.
A large, soft, inflamed sac -like lesion that is located deep within the skin. Cysts are filled with fluid or a semi-fluid that consists of white blood cells, dead skin cells, and bacteria.
The main objectives in treating acne are to reduce oil production, bacteria, inflammation and to alter keritinization (build up of skin cells). The exact treatment will depend largely on the degree of acne being treated. The treatment for acne will depend on the grade or severity of the condition.
Dead skin cells called are shed into the follicle and are then carried to the skins surface and are sloughed off. Sebum (oil) can cause the skin cells to become cohesive or sticky and then they clump up in what is known as cohesion. The follicle will become blocked when skin cells are not shed properly, this is why treatments that exfoliate dead skin cells and increase skin cell turn over are recommended for acne. The goal is to exfoliate dead skin cells and prevent and break up existing cohesion “clump of skin cells”.
- Microdermabrasion: Not recommended for “active” moderate to severe acne
- Chemical Peels
- Tretinoin ( Retin-A)
- Topical AHA/ BHA: Retinols/ Vitamin A, Glycolic Acid, Salicilic Acid
- Azelaic Acid, also has an antimicrobial effect
Sebum (oil) production
Those prone to acne often produce excessive amounts of sebum (oil). When there is an increase in Androgen hormones such as testosterone, the oil glands become larger and produce more sebum (oil)
- Oral contraceptives can help to reduce the effects androgen hormones in women thus reducing oil
- Acne laser treatments
- Blue Light RF: When Blue light is combined with RF energy it causes sebaceous gland atrophy (shrinks the oil gland) which decreases oil production.
- PDT Photodynamic Therapy With Levulan ALA: When used with IPL will also treat hyper-pigmentation, rosacea, broken blood vessels
Some bacteria is normally present on the skin, including P. acne bacteria (Propionibacterium acnes). There is an increased level of bacteria in acne. Bacteria thrives in an eviroment that is deprived of oxygen so products that intoduce oxygen into the skin work to fight bacteria, this includes benzoyl peroxide. The use of oral antibiotics for acne is usually only recomended for short term use because the body can become tolerant to antibiotics. It is also believed that long term use of oral antibiotics contributes to acne cysts.
- Oral Antibiotics: Tetracycline, Minocycline
- Topical Antibiotics: Tetracycline, Erythromycin, Clindamycin
- Benzoyl Peroxide
- Blue Light Therapy
- High Frequency ( not as effective as blue light, often used after acne extractions)
The P. acne bacteria releases lipase which converts the lipids in the sebum (oil) in to free fatty acids which irritant the skin and cause inflammation. Reducing bacteria will in turn reduce inflammation, because the bacteria contributes to the free fatty acids that irritate skin.
- Salicylic Acid: Topical salicylic acid treats acne by reducing swelling and redness
- Nicomide: A member of the Vitamin B family, also used for rosacea. Topical version available over the counter.
- Zink Oxide: Look for sunblock and mineral makeup with zinc oxide, it has anti-inflammatory properties in addition to being a physical UVA/ UVB
- Croyo-Slushy: anti-bacterial, anti-inflamatory and mild exfoliation properties
“It is easier to stay out of trouble than get out” Mark Twain
Corecting acne scars can be very challanging and expensive, you are always better off treating and controlling acne thus preventing acne scars. Acne cysts are most likely to cause scars, a diluted corticosteroid injection can be used to reduce cysts and inflammation.
Post Inflammatory Hyper-pigmentation (PIH) is name used for the dark spots left by acne or other skin lesions. The skin responds to inflammation by stimulating the melanocyte to over produce pigment cells. PIH can be prevented, treated and controlled with the use of topical products like hydroquinone and tretinoin. Topical Hydroquinone 4% is a prescription strength cream used to “suppress” the melanocyte which can help to prevent PIH and treat existing hyper pigmentation.
Depressed and ice pick scars are usually treated with a “leveling treatment” such as laser resurfacing or a deep chemical peel like the Obagi Blue Peel. Injectable fillers are also used to plump skin and reduce acne scars. Combining a leveling treatment with fillers will provide better results. As the skin ages, the loss of elasticity and collagen will cause acne scars to look worse. Anti-aging treatments and good sun protection can help slow this process. A facelift will also improve the appearance of acne scars because it tightens the skin.
Before you start an acne treatment
Many of the treatments and products mentioned in this post are prescription strength drugs or medical treatments. There are contraindications for some acne treatments, so it is important to consult with your doctor or skin health professional before starting an acne treatment program. Woman that are pregnant or nursing need to consult with their doctor before using ANY acne treatments, as many are not approved for use in pregnant or nursing women. The content provide in this post is intended to be informative and does not replace medical or professional treatment.
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We are recruiting new players
Medical Estheticians Kristy Harris and Stephanie Willis have added a high performance skin treatment to the playbook. Acne blemishes are a skin violation, that can leave even the hottest player on the sidelines and the “Player Facial” is the official clear skin treatment.
The Player Facial
We kick things off with Blue Light RF acne treatment. Intense Pulsed Blue Light teams up with RF energy to defeat acne causing bacteria and shrink oil glands. The next step is a deep pore cleansing treatment followed up with a treatment mask designed to battle acne breakouts. Then a microdermabrasion treatment will remove dead skin cells that threaten to block pores. In this skin treatment we will extract acne pimples and black heads, followed with a pass of high frequency to ensure quick skin healing. Finally, a Cryo-Slushy is made at the time of treatment and gently swiped over treated skin, to work against acne causing bacteria, tighten pores, reduce inflammation and enhance skin exfoliation.
90 minutes $225 * Gratuity not included.
Recommended For: Normal-oily and acne prone skin. Not recommended for anyone that is pregnant, on actuate or severe cystic acne.
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Blue Light RF is an acne treatment that works to kill acne causing bacteria and shrink oil glands, reducing oil production. Blue light can be done alone or added to other skin treatments like facials and chemical peels to enhance results.
Blue Light has a very short wavelength of about 450-495nm, and is used to treat acne because it has the ability to kill acne causing bacteria in the skin. There are two basic types of blue light treatments used to treat acne, passive blue light and direct contact blue light. Passive blue light involves sitting in front of or laying under a blue light for a specific amount of time. Direct contact blue light uses a a hand piece with a crystal tip, which is applied directly to the skin by the laser technician. Both types of blue light can be used alone or used to activate Levulan for Photodynamic therapy. Blue light treatments are not painfull and do not require any amount of down time.
Blue Light RF uses a combination of Intense Blue Light Energy (similar to IPL) and Radio Frequency with direct contact. The synergistic optical energy is effective in treating two key factors involved in acne, bacteria and oil production. The blue light works to kill P. Acne bacteria while the RF energy causes sebaceous gland atrophy (shrinks the oil gland) which decreases oil production.
How many treatments are needed.
When done alone as an acne treatment, a series of blue light treatments are recommended. The exact treatment protocall will depend on the grade of acne being treated. In most cases a series of 8 treatments are recomended, 2 treatments a week for 4 weeks. When levulan is used treatments are done less frequently.
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High Frequency is a tool that is used by Estheticians in facials and skin treatments. It is often used to treat or prevent acne skin lesions, as well as aid in healing. It is especially useful after acne extractions. If you have ever had a facial, there is a good chance your facialist used a hand held high frequency device to treat your skin.
High frequency uses a violet ray, however when it is passed through a neon gas the light will appear as red or orange. The mild oscillating electrical current passes through the glass electrode to the skin for a thermal effect. The method most commonly used by skin professional is known as the “direct current application”, where the electrode is applied directly to the skin or over a mask. When treating an acne lesion, your esthetician may also use a technique known as “sparking”, this is when the high frequency is held slightly away from the skin to create a gentle spark. Both methods are gentle and painless. The high frequency increases blood circulation and the dilation of underlying vessels also helps to eliminate toxins. When applied directly high frequency has a germicidal action, fighting acne-causing bacteria. Treatments only take a few minutes and are usually added into a facial or other skin treatments. High Frequency skin treatments are very gentle, many clients even find it relaxing.
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Cryotherapy, also known as acne slush, has been used in dermatology for over 25 years. This dry ice treatment helps reduce acne, acne scars and shrink pores. Cryotherapy uses a cryogen or dry ice “snow ball” that is created at the time of treatment. Liquid Co2 is made into a snow ball and wrapped in gauze or cheese cloth and then dipped into acetone to create a slush. The slush is then lightly swiped over the treated areas. Cryotherapy has anti-bacterial and anti-inflamatory properties making it ideal for acne prone skin. Cryotherapy can be done alone to treat acne, as often as once a week. Cryotherapy is known to cause mild exfoliation, so a “cryo-slushy” is often added to skin treatments like chemical peels to enhance results.
Warning – Cryogen treatments need to be done in a medical setting. Never try to do a cryogen treatment yourself at home, dry ice/ cryogen can severely burn skin. Skin professionals have special tools and training for handling cryogen.
Cryotherapy is also called Co2 slush, cryoslush, cryo-slushy, crytherapy, cryogenic therapy and acne slush.
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Want Cleaner Pores?
It seems as if everyone that walks into the clinic is concerned with clogged pores. There is only so much a skin profesional can do when we only treat your skin every 4 weeks for a one or two hour treatment, espesially if you don’t want to look completly beat up. I always recomend that clients maintain their skin at home with proper cleansing and exfoliating between profesional treatments. You can exfoliate daily with topical products that contain AHA’s and use your Clarisonic cleansing brush daily.
Clarisonic designed a deep pore cleansing brush head that can be used with any of the Clarisonic brushes. If you are not yet familiar with the Clarisonic Skin Cleansing System, it is a cleansing brush that uses sonic frequency of more than 300 movements per second to gently, yet thoroughly remove 6X more makeup and 2X more dirt and oil than cleansing with your hands alone. Other cleansing brushes that simply rotate do not work the same way the same way as Clarisonic’s brush does with it’s oscillating bristles.
As if the sonic frequency, oscillating movement wasn’t impressive enough the Deep Pore Cleansing Brush Head uses an advanced dual-action motion to clean hard-to-reach areas. There are several brush head options that can be used with your Clarisonic, the Deep Pore brush head is recognised by it’s blue inner bristles. The Deep Pore brush head is ideal for oily and acne prone skin, however anyone who is concerned with cleaning the pores can also use it. If you have large pores, then this is an absolute skin must have! The brush head will run you around $25. each and it is recommended that you replace brush heads every 3-4 months. The Clarisonic Sonic Cleansing Brush is $195. and comes with a starter brush head.
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What are these little bumps that appear on the skin, and how do you get rid of them?
These little bumps often look similar to a pimple, however they don’t go away on there own and acne treatments are not going to get rid of them. Clients will often ask me to “extract” these little bumps, thinking that they are acne comedones. They are actually Sebaceous Hyperplasia and they can not be extracted, however they can be treated.
What is Sebaceous Hyperplasia?
Sebaceous hyperplasia is a skin disorder of the sebaceous (oil) glands, basically it is an enlarged oil gland. The sebaceous gland can over grow. When the sebaceous gland becomes enlarged it protrudes to the surface of the skin and is visible as a as soft, small papule, that is depressed in the center.
The exact cause is unclear, however it is commonly seen on people with oily skin and there also appears to be a hormonal link. Genetics, sun exposure, aging, and acne are also believed to be a factor in the development of Sebaceous Hyperplasia. Only a doctor can diagnose skin lesions, if you suspect you have a sebaceous hyperplasia it is a good idea to see a dermatologist. Basal cell carcinoma and sebaceous hyperplasia can look similar, so a proper diagnosis is needed.
Skin Cancer – Basal Cell Carcinoma
Treatment For Sebaceous Hyperplasia
It is not medicaly necassary to treat Sebaceous Hyperplasia, however many people choose to remove them for cosmetic reasons. It is important to remember that even after treating the sebaceous hyperplasia, there is a good chance it will grow back. You may want to consider treatments that produce results and are also cost effective, as you will likely need to repeat them at some point in the future.
There are several treatments that can be used to treat or remove sebaceous hyperplasia including: TCA (Trichloroacetic Acid), laser treatments, (PDT) photodynamic therapy with Levulan, cryotherapy, cauterization and electro desiccation with a hyfracator. Using a topical tretinoin (Retin-A), can also be useful, although it will not remove the lesion. Isotretinoin (Accutane) is also used to treat sebaceous hyperplasia. In some cases minor surgery may be recommended to remove the “bumps”.
After removing the lesion, I like to use Levulan, Photodynamic Therapy (PDT) to help control sebaceous hyperplasia, because it shrinks the oil gland.
My preference is to first remove the “bumps” that are on the surface of the skin, and then follow up with products or treatments that are designed to shrink the oil gland, to help prevent it from growing back. If you have several, I recommend to start by treating one first, as a test to see how you respond. There is a possibility of hyper-pigmentation or hypo-pigmentation, those with darker skin are at greater risk for these complications.
If you have Sebaceous Hyperplasia that you would like treated, you can schedule a consultation with an Esthetician at
Paradise Valley Skin Klinic. 480 421-1701
Hollywood bombshells Marilyn Monroe and Elizabeth Taylor are said to have shaved their face. Shaving offers more benefits than hair removal, it is an excellent form of exfoliation, especially when done professionally. Dermaplaning treatments are popular among Hollywood A-Listers
Dermaplaning also known as epidermal leveling, microplaning or bladeing, is a gentle form of manual exfoliation. A surgical blade is used to gently scrape facial skin removing the outer most layers of dead skin cells as well as fine facial hair, leaving skin completely smooth and baby soft. Exfoliating the skin stimulates the production of new skin and allows for better absorption of topical skin products. Dermaplaning can be done as an independent treatment or used to enhance other treatments such as chemical peels.
Dermaplaning is completely painless in-fact most people say it feels good and there is absolutely no down time. Treatments only take about 30 minuets and regular blading treatments are scheduled about 3-4 weeks apart.
How does the hair grow back?
Despite popular belief, the hair does not grow back thicker. Fine facial hair is known as Vellous hair and when it is shaved, cut or removed it grows back the same way. If there is any dark, coarse facial hair present, I usually recommend laser hair removal. Dermaplaning can be used to remove coarse facial hair, but keep in mind that it will grow back the same way.
What if I have acne?
I don’t recommend dermaplaning for acne skin. Acne begins in the hair follicle and when the hair is removed it can aggravate or stimulate acne breakouts. Microdermabrasion is another form of manual exfoliation, and it is more appropriate for acne prone skin.
Best Of Both Worlds AZ, is proud to presents “The Celebrity”
The Celebrity is the Best of Both Worlds Az signature facial, designed by Medical Estheticians Kristy Harris and Stephanie Willis. You will truly have the “Best Of Both Worlds” as you enjoy the luxury and pampering of a spa facial while still receiving the benefits of a medical treatment.
Best Of Both Worlds AZ, proudly presents “The Celebrity” a multitasking treatment, featuring the best aspects of a full cast of facials. We open with a thorough Clarisonic cleansing under steam, followed by an AHA/ Intensive Resurfacing mask. Dermaplaning and diamond tip microdermabrasion of the face, neck and chest give a leading performance as they gently exfoliate removing dead skin cells. Extractions and high frequency are then utilized to combat acne. A cooling Rejuvenating mask formulated with hyaluronic acid is applied, to sooth and hydrate skin. Cold Derma-globes are gently rolled and massaged over the skin to reduce redness, inflammation and contract pores. The treatment is completed with a soothing oxygen treatment, designed to nourish and revitalize skin with the use of pure oxygen that is infused with vitamins and minerals. The entire experience is further complemented with a paraffin hand treatment and a relaxing massage of the face, neck and shoulders. The Celebrity skin is healthy, radiant and sure to demand an encore.
120 minutes / $275. * Gratuity not included
The Celebrity Facial is offered exclusively at Paradise Valley Skin Klinic.
Shapiro Aesthetic Plastic Surgery, Paradise Valley Skin Klinic
5410 N. Scottsdale Rd., Ste F-100
Paradise Valley, AZ 85253
Imagine a skin treatment that has the ability to treat sun damage, rough skin, freckles, skin discolorations, redness, broken blood vessels, rosacea, acne, kill acne causing bacteria, reduce oil glands, minimize pore size, improve appearance of some acne scars and treat precancerous Actinic Keratose. Believe it or not, such a treatment does exist! The skin treatment I am referring to is PhotoDynamic Therapy (PDT). PhotoDynamic therapy is a non-invasive, non-ablative treatment with little to no down time.
PhotoDynamic Therapy (PDT) is a 2 part skin treatment that uses the light activated drug therapy, Levulan (aminolevulinic acid) also known as ALA. Levulan is a topical agent that is used to photosensitize the skin prior to light based treatments such as IPL (photofacial) and blue light acne treatments.
Adding Levulan (ALA) to a photofacial IPL treatment, is a bit like putting your photofacial on steroids. The Levulan photosensitizes the skin, allowing the IPL energy to be better absorbed by the targeted pigmented and vascular chromophores. This results in a higher level of correction of freckles, sunspots, skin discolorations, broken blood vessels and redness compared to photofacial alone. Although, Levulan in it’s self does not penetrate to dermal layers of the skin, the heat and inflammatory response caused by PhotoDynamic Therapy does reach the Papillary dermis. This heat stimulates the fibroblast to produce collagen.
PhotoDynamic Therapy is unique because Levulan is absorbed by abnormal cells, such as those of Actinic keratosis (AK’s). Aminolevulinic acid is also absorbed into the oil glands and hair follicles. When the Levulan is activated by the appropriate light or laser it damages the oil glands and reduces P. acne bacteria. Acne can be affectively treated by using Levulan to pretreat the skin before IPL (photofacial) or Blue light treatments.
How is the treatment done?
First your skin is pretreated with an acetone scrub, to remove oil from the skin’s surface. Sometimes microdermabrasion is also preformed before the Levulan is applied. Microdermabrasion will remove dead skin cells and cause blood vessels to dilate, which will result in a more effective treatment with IPL. After the skin is prepped the Levulan Kerastick is cracked open and applied to the skin. Aminolevulinic acid (ALA) doesn’t sting or burn like acids used in chemical peels. The ALA is left on the skin to “incubate”. The incubation time can be anywhere from 1-8 hours, a longer incubation time can cause more reaction as well as more correction. Non-facial skin generally requires a longer incubation time. Once the Levulan is applied, you must avoid sun exposure for 40 hours. Topical anesthetic may also be used. After the Levulan has been on for the determined amount of time, the skin is then treated with IPL and/or Blue Light. The light will activate the ALA. Blue Light is used specifically to treat acne and can be done alone or with IPL.
The degree of post treatment reaction will depend on the amount of skin damage and how aggressive the treatment is done. The Luvulan can be left to “incubate” longer, before it is activated for a more aggressive treatment. Those with a lot of sun damage or active acne can expect to have more reaction. Some people will experience little to no side effects. Similar to photofacial, pigmented spots will become temporarily darker, until they flake and peel off. The treated area will likely appear pink or red for the first few days and peeling may also occur and last for up to 7 days. Some may also experience mild swelling that lasts a couple days. It is important to avoid sun exposure for the first 40 hours post treatment, sun block will not protect skin against photosensitivity reactions caused by visible light. Sun exposure can cause stinging, burning, redness and swelling to the treated area.
How many treatments are needed?
The amount of treatments needed will depend on the skin condition and level of correction desired. There is significant improvement with each treatment. Some people may be satisfied with a single a treatment, however for optimal results a series of treatments are recommended. Treatments can be scheduled as soon as 3- 4 weeks apart.
Schedule a consultation to determine if you are a candidate for PhotoDynamic Therapy, and set up a treatment plan.