All types of breakouts
Dr. Kellett, can you tell us about breakout conditions and how they are treated?
Acne is a very common skin condition caused by bacteria-induced inflammation in the hair follicles and sebaceous glands (skin oil glands). It is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, and cysts. Light acne is generally treated with topical agents like benzoyl peroxide acid which kills the bacteria and promotes sloughing of skin cells in the affected area, and/or salicylic acid which is effective in opening up clogged follicles. When the inflammation is more severe, your doctor may prescribe a topical or oral antibiotic, or a hormonal pill. In cases where acne is very stubborn or scarring develops, a strong drug called isotretinoin can be used. This potent retinoid antioxidant promotes skin cell turnover but has serious side effects and is a teratogen (causes birth defects if taken by a pregnant woman). For faster results, a dermatologist can offer photodynamic therapy in conjunction with a drug called Levulan and Blue Light.
Rosacea, or acne rosacea, is a chronic inflammatory disorder of the sebaceous glands and blood vessels, the cause of which is unknown. Symptoms include redness, small, visible blood vessels on the face, flushing, and blushing. Although it can look a lot like acne, blackheads are almost never present. Inflammatory rosacea is treated with either topical or oral anti-inflammatory agents or antibiotics, depending on the severity of the condition. If redness or blood vessel appearance is a concern, laser or intense pulsed light treatments are the best option.
Lastly, psoriasis is characterized by the formation of scaly, silvery plaques that can affect any area or even the entire body. Unfortunately, in the case of psoriasis, the affected area can be itchy and the skin may crack which causes quite a bit of discomfort. Although the exact cause of psoriasis is unknown, there is growing evidence for a role of the immune system. Psoriasis is generally treated with topical agents including corticosteroids or vitamin D analogues, which reduce the inflammation and itching and prevent the rapid buildup of dead skin cells. Other available therapies include ultraviolet light, oral medications and biologic therapies.
What makes daily skin care challenging for individuals with these conditions?
Often these patients have specific factors in their skin that increase its sensitivity; this must be kept in mind when determining a skin care regimen. In many cases, the wrong product can exacerbate the condition and worsen the skin’s appearance. For example, an acne sufferer will want to avoid products that can clog pores, opting rather for noncomedogenic (non-clogging) products. Or, in the case of rosacea, many products may simply be too harsh. Therefore, selecting an appropriate cleanser or moisturizer can go a long way in making the skin look better.
What is the best approach to skin care for people with breakouts?
We have many product choices. If you suffer from psoriasis or rosacea, mild products are key. Cleansers and moisturizers designed for sensitive skin are your best bet as they are gentle enough not to aggravate or trigger a breakout. Avoid foaming cleansers which can be overly drying. Acne sufferers, on the other hand, should use an exfoliating, non-foaming gel cleanser to remove and wash away dead cells. You should also always opt for a water-based, oil-free gel moisturizer, and avoid white creams or cream-based sun blocks which will clog pores and worsen your condition.
Your dermatologist is a great resource for treatments that offer more dramatic results such as diamond peels and intense pulsed light treatments. These in-office procedures gently exfoliate the skin, decrease inflammation and improve redness, which is beneficial in all three conditions.
Acne, rosacea, and psoriasis are chronic conditions with no known cure, but with proper management you can minimize breakouts and improve your skin’s appearance. The best thing that you can do if you are affected by one of these conditions is to consult a dermatologist for a proper assessment and management plan so that people notice you and not your pimples.
–From “Skin Care for People with Breakouts” by Laura Segall, PhD., Patient’s Guide to Medical History, January, 2008.