I chose to talk about acne because it is the most common skin condition in the United States. According to the American Academy of Dermatology, 40 to 50 million Americans are affected by acne at any one time. Although so many people get acne, when it happens to you, it feels lonely and embarrassing. It can be emotionally and socially traumatizing. Acne can be so emotionally traumatizing that on the American Academy of Dermatology website at the end of the acne section is the suicide hotline. At Northern Arizona Dermatology Center we understand that, and treating acne can be one of the most satisfying parts of our practice. Although acne is common, finding accurate information can be challenging. Some information regarding acne can be very misleading. I recommend visiting AAD.org (the American Academy of Dermatology website), uptodate.com, and SDPA.org (the Society of Dermatology Physician Assistants website).
Patients often ask me at what point should someone see a dermatologist for treatment of acne. Acne can occur at any age and if acne is bothering you emotionally, whether it is mild or severe, I recommend seeking treatment. There are many treatments that are very effective and also easy to use. I strongly encourage people who have tender, cystic acne to seek treatment. This type of acne can be painful both physically and emotionally and I feel that it is important to treat this to prevent scarring.
One thing that I enjoy about treating acne is that acne is very much a condition where the “art of medicine” applies. Every patient is different and every patient can respond differently to treatment. There is no one “magic wand” for treatment of acne; we have to find the right regimen for each patient. Unfortunately, every acne medication, even Accutane, can take two to three months to really do its best job, so having patience with acne is essential to good outcomes.
When you see a dermatologist, we often look at the type of acne that you have. Comedonal acne is mostly black-heads and white-heads, where inflammatory acne has red, tender bumps and pustules, or “pimples.” There is another type of acne, called nodulocystic acne, which includes deep tender cystic lesions and nodules. These different types of acne are often treated in different ways. It is important to take into consideration an individual’s skin type as well as their lifestyle when thinking about the treatment of acne.
In the treatment of acne, we often use topical medications. There are several topical medications that you can find over-the-counter that have benzoyl peroxide and salicylic acid as the main ingredients. When starting these medications, I recommend applying a small test area on the outer part of your cheek. That way, if you have a reaction to the medication, it will not affect the front part of your face that people are looking at.
As far as prescription medications go, there are several topical medications. We use benzoyl peroxide, salicylic acids, as well as topical sulfa medications, topical antibiotics, and topical dapsone, and retinoid medications. If used consistently, these can be safe and effective. When acne is more inflammatory and tender, we often add internal medications to help. These can include birth controls pills for women, oral antibiotics, spironolactone and isotretinoin, which is the generic form of Accutane. All of these medications can be safe and effective if used appropriately and taken as directed. If you are given internal medications for treatment of acne, please discuss possible side effects with your provider. Other treatments for acne include photo-dynamic therapy, chemical peels and laser treatments.
At Northern Arizona Dermatology Center, it is our goal to help patients improve their acne by 60 to 80 percent. We do not have a “magic wand” but we want to help you improve your overall appearance and your confidence so that you can enjoy doing the things that you enjoy rather than worrying about your acne. FBN
Kelly Czarnecki, PA-C graduated from Truman State University in Kirksville, Missouri with a B.S. and a B.A. in Biology. Czarnecki then attended the Arizona School of Health Sciences, graduating with a Master’s degree in Physician Assistant studies.
After receiving her Physician Assistant certification, Czarnecki worked in the field of Rheumatology for two years, then completed a postgraduate fellowship in dermatology. She has worked in dermatology for seven years. Czarnecki enjoys the field of dermatology because of the variety of patients, and surgical procedures.