517-336-1200
3496 East Lake Lansing Road | East Lansing, MI 48823

WHAT IS ACNE?

In order to understand acne, one must first become familiar with the simple anatomy of hair follicles. Every hair on our body grows from a single hair follicle (see below), and attached to the hair follicle are oil glands, responsible for secreting sebaceous oil onto the shaft of growing hair. Lining the inside of each follicle are keratinocytes that secrete a waxy protein called keratin. This keratin serves to naturally protect the inside of the hair follicle from the growing shaft of hair. Excessive keratin and sebaceous oil are naturally excreted through the opening pore of the hair follicle.

During our teenage years, an increase in hormone levels (called androgens) leads to over-stimulation of the oil glands and keratinocytes. If too much waxy keratin is produced, then the hair follicle may become plugged and a subsequent build-up of sebaceous oil accumulates in the follicle. This is what we all know as a white-head (comedone). The visible white plug is the accumulated keratin wax, and the underlying bump is the trapped sebaceous oil. If the white keratin plug ruptures and is exposed to oxygen, it oxidizes and turns gray or black (black-head). It is important to understand that the formation of white-heads and black-heads is independent of bacterial involvement.

There are certain bacteria that live on the skin surface called Propionibacterium acnes (P. acnes). This bacteria loves sebaceous oil and if it manages to find its way into the trapped areas of sebaceous oils, it will use the oil as a food reservoir and a breeding ground. It is at this point that simple white-heads and black-heads become inflamed and acne comedones now take on a cystic appearance (cystic acne vulgaris).

We strongly encourage our patients to avoid squeezing/popping their pimples, especially the cystic ones. In some cases, it may seem like a rewarding experience to promote volcanic activity with your pimples, but doing so may lead to two different forms of long-lasting scars. If pimples or acne cysts rupture through the surface of the skin, they subsequently tear the skin and lead to "ice pick scars". If pimples or cysts rupture underneath the surface of the skin, this may lead to a cratering effect of the overlying skin, resulting in crater scars. Sometimes, the appearance of the scars becomes much worse than the appearance of the preceding pimples.

With this understanding that acne is multi-factorial, it becomes easier to appreciate that the management of acne has to be comprehensive to address each factor (excessive sebaceous oil production, keratin plug formation, and bacterial involvement)

ACNE TREATMENTS

Remember that most individuals with severe acne did not develop acne overnight. To expect acne to disappear overnight is unrealistic. The goal of successful acne management is to address each causative factor of acne (listed above) so that new acne lesions do not develop and the skin spends more time healing old acne scars.

Our in-office acne treatments involve a combination of medical acne facials and phototherapy. Medical acne facials involve rehydrating the skin with warm steam to promote dilation of hair follicles followed by a Clarisonic skin scrubbing. Our acne specialist will then use specialized techniques to unclog acne comedones and cysts to minimize trauma to the skin, which may have otherwise resulted in self-induced skin scars. Larger cysts are also treated with an anti-inflammatory steroid medication to hasten the recovery by decreasing inflammation. A mild chemical peel is then utilized to further remove old skin cells to allow the skin to breathe much better. Patients are then exposed to ClearLight phototherapy to eradicate facial skin bacteria utilizing a specific wavelength of light energy. Depending on the severity of an individual’s acne, medical acne facials are scheduled every 4-8 weeks.

After active acne is under control, it’s now time to focus on old acne blemishes and scars with our exfoliation procedures, including medium-depth chemical peels and/or microdermabrasions. The goal of these procedures is to consecutively remove layers of dead skin cells that have been disfigured from old acne lesions. Exfoliation procedures give the skin a much softer and healthier appearance, while at the same time, decrease the amount of future break-outs. Again, aggressive exfoliation procedures are not performed until active acne is under control.

We take a very selective approach to topical and oral medications prescribed for our patients. Our topical medications are all custom-compounded with up to 5 different ingredients based on the needs of our patient. Depending on the severity of acne, some patients may also be placed on oral antibiotics to help decrease cystic flare-ups of acne. Because acne is largely hormone-influenced, we may initiate prescribe medications to suppress the hormonal stimulation.

Future plan of care is constantly adjusted based on the severity of an individual’s acne. Patients are constantly being educated on their condition and we strive to make our treatment programs very straightforward.

HOW ABOUT ACCUTANE® AND SIMILAR MEDICATIONS?

Because of the side-effect profile of these medications, it is exceptionally rare for us to prescribe Accutane or Accutane-like medications. However, in the rare event that one of our patients does not respond adequately to the treatments listed above, we may consider these patients to be candidates for these medications. Both, Dr. Manuel Garcia and Kim Garcia PA-C are both fully knowledgeable about these medications and the side effect profiles. They are both registered with the iPledge Program, allowing them to prescribe these medications when they feel the benefits outweigh the risks.

back to top

If you would like to schedule a consultation, please complete the following:

Name: E-Mail: Phone Number:

Request a consultation.

A member of our staff will be contacting you to arrange your consultation appointment.