Access Dermatology

Acne is Common and Treatable :

Acne is extremely common in teenagers, but affects all ages, including younger children and adults. It is a multistage process, which begins when your hair follicle pores become plugged with excess oil ("sebum") and dead skin cells, causing blackheads and whiteheads ("comedones"). Bacteria such as Cutibacterium acnes (C. acnes, also known as Propionibacterium acnes) colonizes these plugged pores, causing small red bumps ("papules") and pus-filled pimples ("pustules"). In some individuals, an over-reactive inflammatory response to the bacteria causes larger, deep, painful lumps ("nodules" and "cysts"). Acne can cause emotional distress and physical scars. There are excellent treatments available, but the key is to start treatment early.

Acne Triggers :

Hormonal changes during puberty causes the sebaceous glands to enlarge and make more sebum. Menstrual cycles in adult women and hormonal changes during midlife can lead to acne flares.
Certain medications including corticosteroids, testosterone and lithium.
Diet. High-glycemic foods and other dietary factors worsen acne. We provide our updated Diet and Lifestyle Guidelines pdf with useful recommendations for all initial acne consultations.
Stress can worsen acne by affecting sebum production and the body's inflammatory response.
Picking, squeezing, or popping your acne will exacerbate it and increase your risk for scarring and dark spots called post-inflammatory hyperpigmentation.

Topical Treatments :

There are several excellent over-the-counter (OTC) and prescription options which we utilize based on the severity of your acne, your skin type, and your preferences.

Cleansers and creams with benzoyl peroxide or sulfur are effective at reducing harmful bacteria.
In people with sensitive skin, we use other topicals, including clindamycin, Amzeeq (minocycline), Aczone (dapsone), and Finacea (azeleic acid).
Retinoids help reduce plugging of the pores and are a core treatment. Our toolbox includes Differin (adapalene), Retin-A (tretinoin), Arazlo (tazarotene), Aklief (trifarotene) and combination products.
Winlevi (clascoterone) is a new cream that decreases sebum production.

Dr. Shraga has extensive experience in using all of these treatment options to maximize clearing of acne and minimize potential side-effects.

Oral Treatments :

If the acne is more severe, we may employ oral medicines.

Specific vitamin supplementation and low-dose Doxycycline, which has anti-inflammatory effects, but doesn't kill bacteria, are milder oral treatments with few side-effects.
Full-dose antibiotics with Doxycycline, Minocycline, and others, are more effective, but may cause stomach and bowel side-effects, and negatively affect the gut microbiome. Seysara is a newer antibiotic that is more specific for acne, and has less adverse effects on our gut microbiome.
Spironolactone is an excellent oral medication for women with hormonal acne. It is a diuretic (makes you urinate more frequently), and can cause fatigue and may affect potassium levels in certain individuals, which may require monitoring by a blood test. It cannot be used in men due to the potential side-effect of breast enlargement.
Accutane (isotretinoin), a Vitamin A derivative, is the strongest and most effective treatment option, even for the most severe and recalcitrant scarring acne. It is also the only medical treatment that can result in a permanent cure of acne. Accutane requires monitoring blood tests and monthly visits during the typical 6-8 month course. When used properly, it can be a safe and life-changing medication.

Acne Specialist in New Jersey

This website uses cookies.