The Acne Condition

Acne is a common condition that affects most individuals at some point during their lifetime. It refers to a wide variety of blemishes, including blackheads, whiteheads, pimples, large cysts and painful nodules. Although adolescence and the teenage years are when acne is the worst for most people, many adults experience regular skin blemishes as well. Acne is a particularly distressing skin condition because, most of the time, it affects the face. For most people, acne is an annoyance but remains controlled. However, for others, acne becomes more severe over time, leading to possible infection and scarring.

Causes of Acne

Several factors contribute to the development of acne. Hormones–specifically androgens–promote the creation of more acne-causing oil, which is why acne is worse during puberty. Additionally, severe acne can be hereditary, so individuals with a family history of serious acne should seek dermatological treatment as soon as possible. Lastly, stress and a poor diet exacerbate acne problems.

Diet and Acne

Ongoing research has proved that there is an association between diet and acne. A diet high in carbohydrates–especially simple sugars–can cause and worsen acne. Carbohydrate restriction makes the most sense for women with polycystic ovarian syndrome, or PCOS, because it helps to moderate excessive release of androgen hormones.

Other studies have found links between dairy products and acne, but the link is weaker. However, for patients that are already sensitive to dairy, milk products may aggravate their acne. If a patient does choose to eliminate dairy from their diet, we recommend supplementing with calcium and vitamin D.

How Does Acne Develop?

There are thousands of pores on your face, chest and back. All pores have oil glands, called sebaceous glands, attached at their base, which provide oils to moisturize the surface of the skin. However, sometimes oil glands become clogged by sweat, makeup, or dead skin cells. Blocked, visible pores are called blackheads. Sometimes these blockages occur underneath the surface of the skin and whiteheads develop.

If the pore doesn’t become unblocked, oil builds up and causes a rupture under the skin. This is when a pimple normally develops as a red, tender lesion. As white blood cells surround the lesion, the pimple becomes more noticeable. Given enough time, these lesions will usually heal by themselves, but the blockage continually damages the skin and can result in acne scarring. Additionally, blockages will occasionally go deeper into the tissue, creating large, painful, visible cysts that appear as flesh-colored or red lumps.

Acne Treatment

The Total Skin Center in the Kansas City area offers several treatment options to alleviate the symptoms of acne. Oral and topical medications are very effective for most forms of acne. In severe forms, a medication know as “Accutane” can show good results. Other treatments that are successful include chemical peels, light based treatments with blue light, laser treatments and combination therapies.

Photodynamic therapy (PDT) utilizes a photosensitizing agent (aminolevulinic acid or ALA) and a light source (Blu U) in order to treat a wide range of skin conditions ranging from inflammatory acne and sebaceous hyperplasia to precancerous lesions (actinic keratoses).

For our PDT protocol treating Actinic Keratoses, ALA is applied to the skin and allowed to incubate 90 – 200 minutes, depending on the treatment site. During incubation, the ALA is selectively absorbed by precancerous cells and by the bacteria that inhabit the skin and can cause acne. Once absorbed within those cells, a photochemical reaction occurs converting ALA into protoporphyrin IX, a light sensitive agent. Now that the target cells have “smart bombs” inside primed for activation by light, the Blu U light source is applied to the treatment area for 20 minutes, activating the medication.

While our patients experience minimal discomfort and achieve amazing results with our PDT protocol, it is very important to conduct strict light avoidance for 36 to 48 hours following treatment. Many patients will note a mild, sunburn-like reaction lasting for two to four days, the length of medication incubation time.