For the first time since I have been writing this blog, today I am not going to write about the history of this clinic, but I am going to write about something that people come to this clinic to treated for. Acne is a major problem to many people both young and old in the United States, as well as the world. The interesting thing is that many people are devastated by a single zit on their face, while others seem completely content with a face full of scarring cystic, nodular acne, sometimes referred to as ‘Pizza Face’. The patients that do not care about their acne I don’t see, or they are brought in by their mothers and I give them free samples of the best prescription acne creams available and then they don’t use them, because they don’t care. But then there are the patients, both male and female that come in, obviously embarrassed by their acne, heads down, excessive cover-up make-up, longer hair to cover their faces, and a bag of all the cleansers they have tried. This is when they say, ‘We have even tried ProActive!” I admit ProActive is good at one thing, marketing! These cleansers along with all the others that are trying to copy the marketing success of ProActive, like Nuetragena’s SkinID, Melalueka’s Zap It, and many others are great cleanser, but they don’t get to the root of the problem and sometimes actually aggravate the acne. The basic causes of acne include four issues, excessive sebum production ( too much oil ), abnormal keratinization ( dead skin cells not exfoliating properly), Propionibacterium acnes ( the bacteria that contributes to acne ), and inflammation ( anything that irritates the skin ). Most of these problems have more to do with genetics than with anything that someone is doing wrong to their skin. Excessive oil can be slowed somewhat by topical creams both prescription and over the counter. Exfoliating has alot to do with genetics and the climate you live in. P. acnes can be treated with antibiotics. Inflammation is the tricky one. Many of the creams, cleansers, and spa treatments for acne acually cause inflammation that results in more acne! I hear patients tell me all the time that they tried one of the cleansers they see on TV and it seemed like it worked at first, but then their acne came back worse. I used to work at a clinic where we did microderm abrasions and chemical peels for acne, I would have them done on myself so that I could tell people what to expect. Everytime I had it done, my skin would look and feel great for about 3 days, then I would break out and I was in my 30’s. I know there are people that have been very happy with the results they have had with different spa treaments. I also realize that there are people that maybe happy with the aggressive cleansers from TV, I probably don’t see them, because they are happy with their skin. What I think is happening in terms of inflammation is that many of these cleansers and treatments dry the skin, speed up exfoliation, and make the skin temporarily feel smooth and clear, but then our bodies sense this change and increase oil (sebum) production to compensate, resulting in more acne. I recommend simple, gentle cleansers like Cetaphil and Cerave, that are actually much less expensive and easier to find and buy. That is all for today.