Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

Medical Treatment For Acne – What We Can Do About Pimples, Blackheads, Whiteheads, Cysts

Posted by admin on August 10th, 2013

“Many adults suffer from acne, which can lower one’s self-esteem. If your skin (and your confidence) is affected by acne, I can help. Make an appointment to come in and see me and together we can come up with a plan to banish your acne for good; at the very least, we can improve your complexion substantially and change the way you feel when you look in the mirror”.

-Dr. Zimilevich, MD

What is acne, and what causes it?

Acne is caused by clogging of the skin’s pores. Normally, when skin cells die, they rise to the surface of the pore and are then shed. When your skin produces a lot of sebum (the oil that moisturizes your skin), the skin cells that have died clump together within the pore and become trapped inside. Our skin is colonized by bacteria known as P. acnes; this bacteria can get inside clogged pores, which provide the perfect medium for bacterial growth, which causes the pores to become red and inflamed. When inflammation occurs deep within the pore, a nodule or cyst can form.

Acne is not just pimples (pustules)- many other skin blemishes can form, including blackheads, whiteheads, cysts, nodules and papules. Acne can form on the face, the neck, the shoulders, the upper arms, the chest, the back and the buttocks. Some people have acne in one place only, while others have acne is numerous places. However, facial acne is what concerns most people due to the importance that we place on appearance in today’s society.

Adult acne is more common in women due to hormonal influences; in fact, some women get adult-onset acne during menopause. Acne can be a side effect of some medications and may be caused by certain medical conditions.

In addition to the darkened areas of skin that can occur after acne has healed and the scars that can left behind from cysts and nodules, many people with severe acne suffer from low self-esteem and depression. People with severe acne may be withdrawn and socially isolated because of their appearance or, more accurately, because of the way they feel about their appearance.

What can I expect when I come to see you about my acne?

If you come in to see me because you have acne I will need to take a detailed medical history, particularly if you have new-onset acne. Certain medical conditions, such as diabetes, adrenal disorders and PCOS (polycystic ovarian syndrome, a common female metabolic disorder) can cause or worsen acne. I will also need to know what medications you are taking, in case one of your medications (i.e., steroid medication, seizure medication) is contributing to your acne. If you are a women, I will ask you about your cycles and whether there is a noticeable relationship between your period and your acne breakouts.

I will need to examine the areas affected by acne closely. Sometimes rashes and other skin conditions mimic acne, and what you think is acne may not actually be acne at all. I will look closely at your skin and ask you to tell me what skin care regimen you are using and what skin care products and beauty aids you use that may be contributing to your acne.

Treatment options

Once we determine that your skin problem is indeed acne, we can talk about treatment options. There are several options available:

• antibiotics– oral and topical antibiotics can kill the bacteria that invade clogged pores. The most frequently prescribed antibiotics are minocycline, doxycycline, tetracycline, erythromycin and clindamycin. All antibiotics can have adverse side effects and some should not be used during pregnancy. We can discuss the pros and cons of antibiotic therapy and decide whether oral antibiotics are right for you.
• oral contraceptives– some women have acne that flares in relation to female hormones that influence sebum production in the skin. Some women benefit greatly from birth control pills, but it may take time before you notice a difference in your skin. Birth control pills are not right for all women, so we can discuss your risk profile before deciding whether oral contraceptives might be helpful for you in controlling your acne.
• spironolactone (aldactone)– this drug is actually a diuretic used to rid the body of excess fluid and control high blood pressure. This medication controls fluctuations in the body of the male hormone testosterone and can be useful for women who suffer from hormonal problems who also have acne. It may be used in combination with oral contraceptives. If you take spironolactone, you will need to have your blood pressure checked regularly, as well as have an occasional blood test to check levels of potassium in your blood.
• specialized skin care– I can recommend a skin care regimen based on your skin type to help in controlling your acne. I can teach you about what to look for on labels when choosing skin care products so that you are not throwing your money away on products that won’t do much for you except empty your wallet.

If you suffer from acne that is ruining your self-esteem, make an appointment to come in and see me. With treatment, acne can be controlled successfully.

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