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Acne is the most common skin condition that affects about 50 million Americans, of all ethnicities. Acne affects 85% of people between the ages of 12 and 24 and over 20% of adult women in their 30s and 40s.

Acne Vulgaris is the most common form of acne. Acne vulgaris has significant social and psychological effects. Studies report that severe acne can affect a person’s quality of life, self-esteem and mood. While acne is not a permanent condition, it can be disfiguring. Scarring is a permanent complication of acne vulgaris.

What is acne?

Acne is a complex skin condition that causes the formation of papules, pustules, nodules and cysts. It begins with the oil glands in the skin and the hair follicles on the face neck, back and chest.

The oil glands produce a substance called sebum. Sebum carries dead skin cells to the skin’s surface through the hair follicles and normally they are sloughed off. However, when the body makes a lot of sebum the dead skin cells clump together inside the pore and become trapped.

Sebaceous plugs are called comedones, are noninflammatory and appear as whiteheads or blackheads. Acne is inflammatory. It occurs when the bacteria called P. acnes invade the clogged pores creating inflammation, redness, swelling, pimples and hyperpigmentation. If the infection goes deeper in the skin, it causes acne nodules and cysts.

What causes acne?

Acne is a complex disease that involves a combination of factors including hormones, inflammation, abnormal skin cell growth, excess production of sebum, overgrowth of bacteria inside clogged pores, stress, diet, certain medications and a genetic predisposition.

Hormone changes during puberty, birth control pills, and hormone flares during a monthly period, and around menopause stimulate increased oil production. Stress hormones also stimulate oil glands to increase oil production and clogs pores. Other triggers include high humidity and sweating.

There are many effective products to treat acne.

How is acne diagnosed?

Dr. Zeena will discuss with what may be causing your acne including your hormones, and family history of acne, how you care for your skin and how your condition is affecting you. She will examine your skin to rule out other skin conditions such as rosacea that look like acne.

When she determines you have acne, she will grade the acne from grade one to four with four being the most severe type. When there are just a few whiteheads, blackheads, and pimples it is considered mild acne. Noninflammatory and mild inflammatory acne often heal without leaving a scar. Moderate and severe acne frequently leave scars. Cystic acne is severe and the most common type of acne that affects teenagers and results in scarring.

How is acne treated?

Treatment options are determined by the severity of acne. The goal of medical treatment is to control and treat acne to prevent scarring and limit the extent and duration of acne. Dr. Zeena will instruct you on the best way to keep your skin and hair clean to prevent clogged and infected pores and recommend or prescribe medicated cleansers.

Dr. Zeena may prescribe oral or topical antibiotics to kill the bacteria. Topical retinoic acid and prescription strength benzoyl peroxide will reduce oil production and open clogged pores. Retinoids also help repair scarring and hyperpigmentation. Women with hormonal acne may be treated with birth control pills. Accutane may be prescribed for patients with severe nodular acne.

In office dermatologic treatments for severe acne include:

  • Laser genesis can decrease inflammation and help shrink oil glands as well as help with pigmentation and scarring.
  • Photodynamic therapy. This is the use of a special light or laser in combination with a topical medication to reduce oil production and bacteria.
  • Hydrafacial opens pores and removes dead skin cells.
  • Chemical peels open pores to treat blackheads and acne papules and can improve mild scarring.
  • Steroid injections can reduce inflammation and promote healing.
  • Low level light therapy can decrease P. acnes and overall inflammation

Treatment will help to clear the skin, prevent new breakouts, and reduce the risk of scarring. Combination therapy has been found to be more effective in treating acne than monotherapy. Contact Dr. Zeena in New Orleans, Louisiana to schedule a consultation and discover all your treatment options.

At a Glance

Dr. Zeena Al-Dujaili

  • Double board certified in dermatology and Mohs Surgery
  • Fellowship trained in cosmetic dermatology
  • Authored several chapters in clinical textbooks and peer-reviewed publications
  • Learn more

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