Entries Tagged as 'Acne'

But I’m too old for zits! Adult Acne Solutions

posted on: June 6, 2016

Acne can be extremely frustrating, especially for adults. A few pimples when you’re a teenager, ok- most of us can accept that as normal. When you’re dealing with a Mt. Vesuvius-sized cystic pimple on your chin plus wrinkles, it just doesn’t seem fair.

Many adults who get acne never suffered with acne as a teenager. Some adults have been suffering with acne for decades. So why do adults get acne?

Reasons for adult acne

First off, women tend to get adult acne more often than men, so unfair. If you’re suffering from acne as an adult it is likely due to one of the following:

Crazy Hormones: Hormonal imbalance can lead to breakouts. Women tend to experience fluctuations around their period, during pregnancy, menopause or starting/stopping birth control pills.

Stress: When you’re stressed, your body produces more androgens (a type of hormone). These hormones stimulate more oil and hair follicles in the skin, which can lead to acne.

Family History: Yep, thank your mama for this one. Research suggests that some people have a genetic predisposition for acne.

Skin Care Products: Your thick anti-aging night cream could be making your acne worse. Make sure you are using moisturizers, cleansers and sunscreens that are “non-comedogenic”, aka won’t clog pores.

Medication Side Effect: Acne is a side effect of some medications. If you suspect that a medication is making your acne worse talk to the doctor who prescribed it for you. They may be able to change the medication you are on.

How to treat adult acne

Cleansers: Make sure you cleanse your skin every day. Don’t let dirt, grime, make-up and pollution build up and clog your pores.

Over the counter treatments: Using a face wash or applying an anti-acne gel can help kill bacteria and reduce oil, both of which are contributors to acne. Look for products at the drugstore with the following ingredients: Benzoyl Peroxide, Alpha Hydroxy Acids (AHAs), Salicylic Acid and Retinols. If you don’t see an improvement with your acne after 4-8 weeks, it is suggested to see a Dermatology professional to determine the most appropriate treatment.

Prescribed treatments:

Topical Treatments: There are probably 30+ different prescription topical treatments to choose from. We consider factors like your skin type, age and severity of acne when choosing the right cream for you.

Oral Medications: If you suffer from swollen, painful, cystic acne, a pill may be prescribed to help treat your acne from the inside out. Depending on my patients needs, I prescribe antibiotics, birth control (helpful for women with balancing hormones), or Isotretinoin (commonly known as Accutane).

More Than Just a Zit! The Ultimate Guide to Dr. Pimple Popper

posted on: July 14, 2015

Thanks to the coverage of Dr. Pimple Popper by way of Buzzfeed, UK Mirror, and more, we have now reached 205k followers on Instagram! Who would’ve thought that there were so many popaholics in the world? The idea for the Dr. Pimple Popper instagram was brainstormed when Dr. Sandra Lee and I were talking about how her most popular posts were on cysts and extractions. An instagram fully dedicated to these procedures seemed like the most logical step, hence Dr. Pimple Popper was born. There is more to this instagram account then just “popping pimples”. I thought it was time for a comprehensive guide to everything we’re “popping”. After reading this article you can consider yourself an Dr. Pimple Popper expert!

Check out Dr. Lee’s full videos on YouTube.

The Dr. Pimple Popper Instagram shows many different types of extractions using different tools and an array of “pimples”-all of which have specific terms. Below are definitions of the different terms of what we remove or “pop”.

 

Comedone: Open Comedone are also known as “Blackheads” (comedo is singular). Comedones are formed when cells lining the sebaceous duct build up and there is increased sebum production. In simplest terms it is a plug in your pore; made up of dead skin cells, oil, and bacteria.

Blackhead/Comedone Extraction

Dilated Pore of Winer:  Named after the Doctor who first desribed it, a dilated pore of Winer is a hair structure anomaly that appears as an enlarged solitary comedo. In layman’s terms-a big and usually old blackhead that hardened, one that has been building for years! Sometimes a stitch or 2 is required because the gaping pore needs help closing.

Dilated Pore of Winer

Lipoma: Lipomas are the most common soft-tissue tumor. These slow-growing, benign (harmless) fatty tumors form soft, lobulated masses enclosed by a thin, fibrous capsule. In non-med terms, Lipomas are typically a soft and rubbery glob of fat that does not cause pain. They usually remain the same size over time.Surgically Extracting Bumps on the Arms, Called Multiple Lipomatosis

Epidermoid Cyst: Epidermoid cysts are the most commonly found cysts and they contain a soft “cheesy” material made of keratin, a protein component of skin, hair, and nails. The surface of your skin (epidermis) is made up of a thin, protective layer of cells that your body continuously sheds. Most epidermoid cysts form when these cells move deeper into your skin and multiply rather than slough off. Think of it like a “snowball effect” of collecting more and more dead skin along the way.  A cyst appears as a domed-shaped, skin-colored growth that usually moves when touched and pressed upon. It may have a small opening in the center called a punctate.

Removal of a large epidermoid cyst, upper back

Pilar Cyst (Cyst on Head): Pretty common fluid filled growth that forms in hair follicles, most often found on the scalp. They are smooth and filled with keratin (that soft “cheesy” material I referred to in the Epidermoid cyst). In the animation below, the cyst is removed while the keratin stays intact in the sac, popping out like a garbanzo bean. Excellent removal!

Pilar Cyst Removal

Milia: Milia are very common, benign, keratin-filled cysts. Milia occur when dead skin becomes trapped in small pockets at the surface of the skin, forming a tiny little cyst.  An individual milium (the singular of milia) is formed at the base of a hair follicle or sweat gland. Milia appear as 1–2 mm white-to-yellow, dome-shaped bumps that are not painful or itchy. Many patients try to remove these themselves, thinking they are whiteheads, but they are difficult to remove without the help of a trained professional.

Milia Removal

TOOLS OF THE TRADE & PROCEDURES

“Punch” aka Biopsy Punch: This disposable biopsy instrument handles like a pen, with a grip at the top that allows you to twist, apply pressure, and drive the stainless steel blade into the skin with ease. It creates a very clean, perfectly round incision which leaves minimal scaring. This is best practice when excising a small cyst.

Punch biopsy on neck cyst

Comedone Extractor: The wire loop of this tool when pressed on the skin, creates a pressure which forces the blackhead (trapped sebum) up to the surface which then can be easily removed. Official Dr. Pimple Popper comedone extractors are coming soon!

Solar Comedones Extracted, aka Favre Racouchot

Forceps: Small forceps, which look like tweezers, are used to grasp fine objects. In the animation below, forceps are used to pull out the growth.

A Dilated Pore of Winer. For medical education- NSFE.

Excision: Simply put, to remove completely.  In the animation below, a pilomatricoma (benign tumor) is removed from behind the knee with dissecting scissors and a tug!.

Excision of a pilomatricoma behind the knee

I&D (Incision & Drainage): Slice and squeeze! Below is an animation of a cyst I drained

Incision & Drainage of cyst

Thank you for following! If any of our posts help answer your questions or demystify dermatology, then I am a happy Physician Assistant.

Dr. Pimple Popper: Your Guilty Pleasure

posted on: May 21, 2015

Untitled design (1)A few weeks ago, Dr. Lee and I were discussing one of the segments she had taped on The Doctors Show. Her most popular clips seemed to be the ones in which she was removing cysts or blackheads.

“Why don’t we create an Instagram account that only shows us removing things that pop? Blackheads, etc..?!” I asked her.

Thats when @drpimplepopper was born.

There is something deeply satisfying about watching the removal of these skin imperfections. What I didn’t realize was how many other people felt the same way! Almost overnight, @drpimplepopper gained thousands of followers (at time of publishing 154,000 are following these 15 sec. videos of guilty pleasure)

Our Instagram has touched all corners of the world thanks to coverage by Buzzfeed USA, The Guardian, Allure Magazine Blog, Cosmopolitan.com, Daily Mail UK, Irish Mirror, Huffington Post UK, Terra Brasil. Thanks to such exposure, we have been able to give back to one of Dr. Lee’s special patients, Mr. Wilson.

Mr. Wilson lost his wife recently, and for each visit while Dr. Lee squeezed him, he would share more of his story, which touched many viewers. Thanks to a Gofundme.com collection started by Dr. Lee, Mr. Wilson was gifted $6,800 to help his current financial situation, and brighten his day since his wife passed away.

 

If you haven’t already, make sure to follow @drpimplepopper, my personal account @whitecoattreatment as well as @drsandralee

 

Not a whitehead, but rather a Milia

posted on: May 15, 2015

Milia are small, pearly-white or yellowish bumps right under the skin which is actually a tiny cyst filled with a protein called Keratin. They are most commonly seen on the skin around the cheeks, nose, eyelids, forehead and chest but they can occur anywhere on the body.

Although harmless, they can be so annoying and darn near impossible for you to remove yourself. Often they will disappear on their own but that may take weeks or months to occur, and most people prefer not to walk around with this white bump on their face. While thick creams and ointments applied to the skin may cause milia, often we do not fully understand what causes them.

Screen Shot 2015-05-13 at 2.28.58 PM

How do we treat milia?

There are a few ways you can treat milia. What is not recommended is that you treat them yourself at home. If you try to squeeze or pick your milia this can lead to skin damage, scarring or infection. I will not even treat my own milia, as I find it difficult to do on myself. The problem with milia is there is no opening, like an easily extracted blackhead, so you have to create an opening to get it out. My go-to way to treat milia is by using a fine needle or light cautery to create an opening in the milia and then expressing the milia out with a comedone extractor. If milia become very widespread and persistent you can consider these options:

Chemical Peels: A light acid peel is applied to the skin for a few minutes and washed off. Over the next few days this will peel off the top layer of the skin and peel some of the milia off as well.

Microdermabrasion: This procedure utilizes the application of tiny rough grains to buff away the surface layer of skin where the milia are held.

How To Prevent Milia

If you are prone to getting milia follow these steps to prevent new ones from forming:

  • Avoid heavy cosmetics and creams- These products can block your pores causing more milia to form.
  • Apply a retinol/retinoid (rx) daily- They have exfoliating properties that turn over dead skin cells and keep your skin soft and clear.
  • Gently exfoliate your skin- My preferred method for gentle exfoliation is a Clarisonic brush. This product gently exfoliates your skin without causing further irritation.

Do you follow DrPimplePopper on instagram? You can see myself and Dr. Sandra Lee extract lots and lots of milia there!

Acne Treatment With The TriBeam Laser. Video

posted on: November 5, 2014

I discussed how lasers can work to treat acne in this previous post. Below is a video of the laser in action. First, a lotion is applied to the face that contains very small carbon particles, small enough in size to settle into the pores. With the first pass of the Tri-Beam laser, heat is generated within these particles, which destroy the bacteria, called P.acnes, which resides within our pores and cause acne. The second pass removes the carbon lotion on the surface of the skin by disrupting these tiny carbon particles, thereby superficially peeling the skin and efficiently cleaning out and shrinking the pores. It’s pretty neat to watch the carbon lotion being removed. Enjoy!

 

How Do Lasers To Work To Treat Acne?

posted on: August 11, 2014

Tribeam Before and After TreatmentMy Patient after 4 treatments with the TriBeam TriPeel Laser Treatment

Acne treatments are not one size fits all. If topical treatments are not working for you or if you are looking to accelerate your results laser treatments may be an option to consider.

There are many different lasers that may be used to treat acne, but typically they work in one of three ways:

  • The laser will heat overactive sebaceous (oil) glands causing them to shrink so they produce less oil.
  • Some acne is caused by bacteria that are normally found on your skin. The laser can destroy bacteria by creating oxygen within the trapped pore which destroys the bacteria causing the inflammation.
  • Lastly, some lasers shrink and clear out pores by exfoliating the superficial outer layer of dead skin cells.

In addition to helping prevent new acne from forming, some laser treatments can also help diminish the appearance of acne scars and hyperpigmentation.  These laser treatments accelerate the healing process and stimulate collagen remodeling, an important step in the long-term treatment of acne.

These type of laser treatments typically have very little downtime. The Tribeam Laser that I use in my office will make the skin slightly pink for a few hours but things are back to normal the next day.

So what’s the downside to this treatment? The cost. Insurance companies usually will not cover this procedure. Expect to fork over anywhere between $200-$400 per treatment.

It typically takes a series of treatments to see the best results. Laser treatments are by no means the end all be all as far as acne treatments go. Acne can be a very difficult condition to treat and you have to find out what treatment is best for you. If you are considering laser treatments for acne make sure your provider goes over all of your acne treatment options to ensure you are making an informed decision.

Join me for my “All About Acne” Lecture

posted on: May 13, 2014

all about acne  flyer

Join me next week for my “All About Acne” Lecture. I will be discussing different causes of acne, various treatments, separating acne fact from fiction and everything else you’d want to know about this annoying condition that can pop up during any point in our lives. Gift bags and raffle prizes for all attendants!

Register for the lecture HERE

Beauty Seminars: April 30th and May 1st

posted on: April 18, 2014

So many patients will ask me, “When should I start worrying about my face?.  My answer: “It’s never too early to start.” But WHERE do you start? You would not believe some of the BS my patients are told by the sales girl at their local beauty store/cosmetic counter about skin care and procedures. I will be separating fact from fiction for you.

I’m doing two beauty seminars soon to teach you everything you need to know about various cosmeceutical products, sunscreens, chemical peels, Botox, Fillers, Micropen Treatments, Dermaplaning, leg vein treatments, pore size treatment, wrinkle treatments, laser treatments for brown spots, acne, blood vessels and much more!

I’ve broken up my beauty seminars into age groups (because someone in their 20’s is going to be focused on different treatments than someone in their 50’s.)

If you are in the Upland area come and see me!

Register Here:

Beauty Seminar: Wednesday, April 30th. Anti-aging in your 20’s, 30’s and 40’s

Beauty Seminar: Thursday, May 1st: Anti-aging in your 50’s and 60’s+

 

Beauty on a Budget: Don’t Break the Bank With Your Skin Care

posted on: April 10, 2014

Beauty skin care on a Budget Products

Walking down any beauty isle can be downright overwhelming (and the cost of a skin care regiment can add up quickly). Follow these tips on how not to break the bank on your skin care:

1. Don’t skimp on the sunscreen– Daily use of sunscreen will prevent sun damage, fine lines and wrinkles and brown spots. You’re sunscreen wears off a few hours so don’t forget to reapply!

2. More expensive skin care lines are not necessarily more effective– While there are some amazing quality products that are higher price points you can find great quality skin care products at the drug store too. Cetaphil Cleanser and Dove Soap are two cost effective products I really love.

3. Plain ol’ Vaseline– This is a very inexpensive project that has a multitude of uses. It can treat everything from dry/cracked feet, peeling nails and dry lips. You can use it to prevent chafing when running, apply it as diaper ointment and sooth kids scrapes and bumps.

4. Keep your routine simple– Do you really need 6 skin care products morning and night? What do all of those bottles even do? Recognize your concerns and make sure the products you are using are effective for those problems.

5. Two-for-One Products– Consider using products that have multiple functions such as a moisturizer plus a sunscreen.

6. More expensive products are not always more effective– While there are are many superb high price-point products there are many drug store products that work great as well.

7. Consistency is Key– Make sure you are doing something to your face morning and night. Even if it’s just cleansing and applying a sunscreen you must be consistent with your regiment to maintain your skin.

How to Survive Accutane

posted on: January 13, 2014

Accutane is a medication primarily used to treat severe, cystic acne. Accutane is not for everyone, but for those people in need, it can work wonders. If you and your provider decide that Accutane is the right treatment for you then here are some tips that will make the few months you are on Accutane a little easier

  1. Treat your skin gently. Your skin can be very sensitive during this time so make sure you are using a gentle cleanser to wash your face.
  2. MOISTURIZE! Accutane works on your acne by reducing the size of the skin’s oil glands causing your skin (and lots other things) to become very, very dry. Over 90% of patients experience dry skin so make sure you are moisturizing multiple times a day. My favorite treatment for very dry skin is Aquaphor Healing Ointment. If you find that is too greasy for daily use look for oil based creams like CeraVe Moisturizing Cream.
  3. Some patients on Accutane will experience nose bleeds because their nasal passages are dry and crack. Keep the inside of your nose lubricated with a Q-tip and a little dab Aquaphor or Vaseline.
  4. Care for your lips. Very chapped lips is the biggest complaint that I see from my patients. I love Aquaphor for lips too. You should probably pick up a few small tubes of Aquaphor because you will want a tube in your car, bathroom, purse, nightstand, pocket, etc…
  5. Soothe your eyes. Many patients experience dry eyes during the treatment. Pick up some lubricating drops for instant relief.
  6. You’re going to be dry. I know, you get it by now. Add a little moisture to your skin over night by sleeping with a humidifier in your room.
  7. Protect your skin from the sun. Accutane can make your skin more prone to sun burns so make sure you have sunscreen on whenever you’re in the sun.
  8. Remember it takes time, nothing works over night to cure acne. While over 95% of patients clear from acne it usually takes a few months to see those results. The average length of treatment is 6 months. Pick a milestone a few months out (like prom or 4th of July) and stay optimistic that your skin should be much improved by then!