Here are Dr. Schweiger's Top 5 ways to clear active acne and achieve an acne-free complexion:
Isolaz: The Isolaz acne treatment works in two ways simultaneously; it uses a gentle vacuum to clean our your pores, and uses a broad-spectrum light to kill the acne-causing bacteria inside your pores.
Prescription medications: Prescription medications work significantly better than OTC acne treatments, as they are proven to address acne in ways that OTC formulations do not. Your dermatologist will help you to determine the best prescription medication for your acne. Prescription acne medications are often combined with in-office treatments, such as laser treatments or chemical peels, for the best and fastest results.
Blue Light Therapy: Blue light therapy is a no-downtime procedure that kills the acne-causing p. acnes bacteria on your skin. It is often combined with other in-office treatments, such as the Isolaz or Photodynamic Therapy. Many of our patients also choose to use blue light at home, through handheld blue light devices, such as the Tria and Tanda.
Photodynamic Therapy: Photodynamic Therapy starts with the application of a light-sensitizing medication called aminolevulinic acid to your skin. After the medication absorbs for a set amount of time, blue LED light is used to activate the medication and kill the p. acnes bacteria on your skin. Photodynamic Therapy provides a more aggressive treatment than blue light therapy alone, though some people experience mild redness and peeling for a couple of days after their visit.
Chemical Peels: Chemical peels utilize peeling agents to remove dead skin cells that would otherwise clog your pores. Additionally, certain chemical peels can address the dark marks left behind from old acne lesions (called post-inflammatory hyperpigmentation) and improve the general appearance of your skin.
Why isn't my ProActiv working?
Acne expert Dr. Schweiger explains that, "ProActiv is an excellent product, containing an effective concentration of benzoyl peroxide for the treatment of acne. However, acne is multifactorial, meaning that it is caused by a variety of factors. In order to effectively treat acne, we must address many of the factors that lead to the development of acne. Benzoyl peroxide kills the p. acnes bacteria, which is the bacteria that causes acne, but does not decrease sebum production or sebum buildup in the pores. Additionally, research tells us that combinations of benzoyl peroxide and clindamycin (an antibiotic) kill the p. acnes bacteria more effectively than either ingredient on its own. For patients who do not see clearance of their acne within 4-6 weeks after beginning to use ProActiv products, I recommend visiting your dermatologist for evaluation. It is important to begin proper treatment for acne promptly, in order to prevent the development of permanent scars.
Many patients need a more aggressive acne treatment than ProActiv can deliver. These patients will benefit from a consultation with a dermatologist, who may recommend oral antibiotics or in-office laser and light-based therapies. Lastly, some patients are unable to tolerate the use of benzoyl peroxide products; benzoyl peroxide is a potentially drying medication, which must be used properly in order to prevent dryness and irritation on the skin. Your dermatologist can recommend moisturizers, to prevent dryness, which will not contribute to the formation of new acne lesions on your skin."
Click here to learn more about ProActiv and other benzoyl peroxide treatments.
Stopping by your dermatologist's office for a cortisone shot is the single most effective and safest method of getting rid of a new pimple on your skin. Dr. Schweiger notes that, "At the Clear Clinic, we reserve a number of same-day appointments for patients who need to stop by for a cortisone injection. These patients understand that this is the only method of flattening their pimple within 24-48 hours, without increasing your risk of scarring."
Cortisone shots work because acne is an inflammatory reaction of the skin to the p. acnes bacteria. Cortisone shots contain a diluted concentration of a cortisone-like medication called triamcinolone, which is anti-inflammatory. By injecting an anti-inflammatory medication directly into an inflammatory reaction, we can obtain a strong anti-inflammatory effect, which flattens pimples on the skin within 24-48 hours for most people.
The injection itself is not painful; we are careful to use the smallest needles possible for this particular medication. After having a cortisone shot, you will not notice any immediate changes on your skin. You may return directly to work or social engagements, and may even apply makeup to cover up the area prior to leaving the office. Most people begin to notice the effects of the cortisone shot by time they wake up the following morning.
Click here to learn more about how cortisone shots work.
As you contemplate your New Year's resolutions, starting the year with clear skin is certain to make your list. Maybe this will be the year that you visit a dermatologist to clear your pesky acne, or perhaps this will be the year that you finally stick to a consistent skin care regimen. Whatever the goal, here are a few acne beating tips to start the new year with clear skin:
Wash your face in the morning and the evening: Washing in the morning helps to clean oil and debris from your skin that accumulated during the evening. Washing at the end of the day removes oil and dirt from the day's activities. If washing twice a day is too drying for your skin, switch to a gentle cleanser (such as Cerave Hydrating Cleanser) that delivers moisture to your skin as you cleanse.
Pack your gym bag with a salicylic acid cleanser: Use a salicylic acid cleanser to the face and body after exercising, in order to clean the skin and prevent clogged pores from exercising.
Pay attention to your hair: Hair products, such as gels and creams, can transfer to your skin and clog your pores. Men and women with bangs must take special care to keep hair products off of their skin.
No picking: Picking at your acne causes more inflammation on the skin, which can lead to the development of acne scars.
It can be tempting to skip your copay and face acne alone. However, the truth is that, most people with acne cannot get rid of acne with over-the-counter treatments alone. By the time you have tried a few drug store products (and still have new acne breakouts!) you could have paid for your copay twice over. That is why we recommend visiting a dermatologist or dermatology physician assistant as soon as you begin to experience acne. Dr. Schweiger explains that, "Even patients with very mild acne can benefit from starting a prescription acne medication or medical regimen. After examining your skin, and determining exactly what type of acne you have and reviewing the specific needs of your skin, an acne specialist can design a regimen for you that will help to clear your acne quickly. It is important to treat all degrees of acne promptly, in order to prevent permanent scars from developing."
During your initial consultation, we review the needs of your skin and recommend both prescription medications (covered by insurance!) and in-office treatments that will help to clear your acne quickly. For mild acne, often a single topical prescription cream or a short series of in-office treatments will curb the problem. More severe acne will require a combination of different treatments, often including both topical and oral medications, and in-office treatments. Our goal is to determine the treatment plan that will clear your acne as quickly as possible, while staying within your budget and scheduling constraints.
Click here to schedule an appointment with an acne specialist in Manhattan.
Upon arriving for your visit, we will ask that you cleanse your skin, in order to expose clean skin to the blue LED light. Makeup and moisturizers can block the skin's absorption of the anti-bacterial blue light and decrease the effectiveness of your treatment.
After your skin is clean, we will then position the chair into a reclined position and place protective goggles over your eyes.
The blue LED light is then placed directly over your face (or the area of the body being treated.) We will set a timer on the light and step out of the room during your treatment. During this time, you will be able to nap, relax, or simply listen to music. You will feel no pain or discomfort during the procedure, only a gentle warm sensation.
After the treatment period is over, we will return to the room to remove the blue LED light and to help you remove your protective goggles. At this time, we will give you sunscreen to apply, and you may apply makeup prior to leaving the office if you wish.
Blue LED light therapy is often used in combination with Isolaz acne treatments, Photodynamic Therapy, and red LED light therapy for the best treatment of acne. During your initial consultation, we will determine the best schedule of treatments for your skin and the type of acne that we are helping you to treat.
Deep pitted acne scars are a permanent reminder of old acne, and can distract from the appearance of clear skin. Perhaps you have been battling acne for years, or perhaps your deep pitted acne scars are from newer acne breakouts. Either way, deep pitted acne scars do not resolve on their own.
Dr. Schweiger explains that, "The most effective treatment for deep pitted acne scars is a treatment called the Fractional CO2 laser. For most patients, one treatment is sufficient to produce up to 75% improvement in deep acne scars. Alternative treatments for acne scars include the injection of dermal fillers to fill in the pitted skin, subcision to break up the scar tissue pulling down on the skin, and deep chemical peels to stimulate collagen production."
Fractional CO2 laser treatment for deep pitted scars works by sending laser energy through the skin to ablate the scarred superficial skin, and stimulate the skin's own collagen production. Most patients require only one treatment with the Fractional CO2 laser. Some improvement is seen quickly, even before your two week follow up appointment. However, the full improvement will be realized a few months after the treatment, once your collagen has had a chance to turnover and repair the areas of acne scarring.
It is important to restart your anti-acne regimen after treating your acne scars, in order to prevent the development of acne scars in the future. Treatment with the Fractional CO2 laser is permanent; the improvement that you experience will never go away.
Click here to learn more about Fractional CO2 resurfacing for deep pitted acne scars.
There are so many steps in your skin care routine already, why do you need to exfoliate? The truth is that exfoliating is good for acne prone skin for a variety of reasons. Dr. Schweiger explains that, "Using a gentle exfoliator on a regular basis is helpful for managing acne prone skin and preventing the development of new acne bumps. A gentle exfoliator will clean dirt and debris from your skin, before it becomes trapped in your pores. Once excess oil and debris becomes trapped in your pores, it can attract acne-causing bacteria and lead to the development of acne. Additionally, using an exfoliator helps to remove dead skin cells for the purpose of improving the appearance of your skin. Dead skin cells can make your skin appear dull; gentle exfoliation can brighten your skin and improve its tone."
It is important to use an exfoliator that has been developed for use on the face. Many exfoliators have been developed for use on the body, and may cause irritation to the delicate skin on your face. At Clear Clinic, we often recommend the Clarisonic cleansing brush. This brush not only cleans the pores, but removes six times more dirt than traditional cleansing methods. While cleansing your skin, the gentle oscillation of the brush provides an exfoliating effect. Daily use of a cleansing brush can eliminate the need for an additional exfoliating product.
For our patients who are looking for a more effective exfoliation of dead skin cells, we recommend monthly microdermabrasion treatments. Microdermabrasion uses a diamond-tipped head to remove dead skin cells and clean out debris from the pores, more effectively than at-home treatments.
Clindamycin is an acne treatment that has been used for many years. In fact, a large percentage of patients that we meet with at the Clear Clinic have tried Clindamycin in the past. When used as part of a comprehensive acne regimen, Clindamycin is an effective and easy-to-use topical acne medication.
Dr. Schweiger explains that, "Clindamycin is an antibiotic that is commonly used in topical formulations for the treatment of acne. Clindamycin targets the p. acnes bacteria, which is the bacteria on your skin that leads to the development of acne. By killing the p. acnes bacteria, Clindamycin prevents the development of inflammatory acne lesions. One nice feature of Clindamycin is that it is most often very well-tolerated; it does not cause the dryness and irritation that we see with some other acne medications."
Clindamycin works best when combined with another topical medication, such as benzoyl peroxide (commonly prescribed brands include Duac, Benzaclin, and Acanya) or tretinoin (brand names include Veltin and Ziana.) The combination medications including Clindamycin offer a more effective treatment for acne than Clindamycin alone. Additionally, these formulations prevent the p. acnes bacteria from becoming resistant to Clindamycin. Examples of formulations of Clindamycin alone include Clindamycin lotion, Clindamycin gel, Clindamycin pledgets, and Clindareach.
Most formulations of Clindamycin should be applied 1-2 times daily. Your dermatologist will give you specific instructions for use of Clindamycin when you are first prescribed the medication. Clindamycin is only available by prescription; it is not available in over-the-counter formulations.
Click here to learn more about other topical medications used in the treatment of acne.
There are so many treatment options available for acne, it is often difficult to know which treatment would be the most beneficial to you. At Clear Clinic, we feel that the more information you have, the better we will be able to treat your acne together. While our acne experts will help to guide you to the most effective treatments for your acne, it is helpful for you to understand how these treatments work.
Dr. Schweiger explains that, "The Isolaz acne laser is one of the best anti-acne procedures around. It works by using two different anti-acne mechanisms simultaneously. While a gentle vacuum cleans oil and debris from your pores, a broad-spectrum anti-bacterial light kills the acne-causing bacteria on your skin. The result is faster clearance of your current acne and fewer acne bumps in the future. The broad-spectrum light can also help to lighten dark spots and redness on the skin from old acne."
The Isolaz laser treatment takes approximately 15 minutes. It is not painful (it feels like a soft pinch) and does not cause any downtime after the visit. We often recommend the Isolaz laser treatment in combination with other laser acne treatments, such as Photodynamic Therapy or LED light therapy. For patients with congested pores and comedonal acne (often referred to as blackheads and whiteheads), we often recommend Isolaz treatments in combination with medical extractions and chemical peels. However, each patient's skin is unique and must be evaluated carefully prior to beginning any treatment regimen.
Click here to learn more about the Isolaz laser treatment for acne.
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