Today’s acne affects women and men in all stages of life. At Steele Dermatology, we see boys, girls, men and women with acne (breakouts, zits, pimples) from teenage years well into adulthood. There are no 2 patients with the same acne. Every patient has different triggers (diet, stress, hormones, bacteria, yeast, etc.), skin types (oily, sensitive, dry, etc.), and lifestyles that affect not only the condition, but also the appropriate treatments. While acne certainly isn’t life threatening, it can have a huge impact on your life and the way that you feel about your appearance—we know that acne can be frustrating and embarrassing. Dr. Steele Johnson will take your acne seriously and create a comprehensive and effective plan to finally clear your acne breakouts such that you no longer have to hide behind make-up or clothing.
Acne is often complicated by scars, blemishes, dark spots, etc. These long-lasting scars, spots and textural changes can be equally or even more distressing than the acne bumps themselves. Dr. Steele Johnson considers a treatment plan to be incomplete without treating the blemishes, dark spots and scarring. We have many options for minimizing the scars, discoloration and blemishes that can be left over by acne. Some options include chemical peels (which will help even skin tone and remove excess pigment deposited as an acne bump heals), lasers (which help remove pigment and even skin texture with resurfacing), and creams (which can help keep skin tone even). It is of the utmost importance to us at Steele Dermatology that our treatments are both safe and effective for your skin type and color. You can be confident that we will only offer treatments that are safe for you.
The mission of the Acne Treatment Center at Steele Dermatology is to treat every aspect of a patient’s acne and leave patients with clear, even and smooth skin. Dr. Steele Johnson recognizes that the effects of acne go far beyond the physical and can make one feel self-conscious, embarrassed and uncomfortable about their appearance.
Treating acne isn’t just making a single bump go away, it’s about preventing breakouts and creating long-term solutions, correcting dark spots and red spots, and smoothing out scars left by acne. The Acne Treatment Center is designed to create a system for addressing all of the issues effectively and creating happy, satisfied patients.
All patients are evaluated by Dr. Steele Johnson who will examine your acne, and also determine what the triggers and causes may be of your breakouts. Depending on your case, Dr. Steele Johnson may order blood work to investigate potential hormonal or dietary causes. Other tests that may be helpful include bacterial culture.
Otherwise, you may be asked to take a food log to help identify the triggers of your acne. The ultimate goal is to prevent acne breakouts (as well as treat current breakouts), so the first step is to identify any specific causative factors. For some genetics plays a role, and we can quickly move on to treatment since that factor cannot be changed.
Once the type of acne that you have is narrowed down and any triggers/causes are identified, Dr. Steele Johnson will put together a treatment regimen for you. Acne treatment often includes appropriate cleansers, moisturizers, and other skin care products, as well as topical creams that help minimize bacteria and keep pores clean and clear of acne.
Beyond that, there may be some oral supplements and/or medications that will address your acne. Whether they be vitamins/supplements or prescription medications, most oral treatments will be targeting inflammation in the skin and/or bacterial/yeast colonization. Other oral medications that address hormonal drivers of acne may be warranted in some.
In some patients, isotretinoin, which is a systemic medicine that targets the oil glands is recommended for persistent or severe acne. Dr. Steele Johnson doesn’t like for her patients to take anything more than they have to in order to keep their skin clear (i.e. a minimal amount of medicine), but also wants to make sure patients are adequately treated to ensure that they remain clear.
While products and medications that are applied or taken in pill form are usually requisite to some degree or another in acne treatment, adding certain in-office procedures can often make all the difference in one’s skin. Regular acne treatments, extractions, chemical peels and/or red or blue light treatments can take treat acne in a way that other modalities cannot.
These procedures are perfect for those who want to minimize medications, but also they can be used in conjunction with a medication program for even better results. These med-esthetic treatments result in skin improvements that can’t be achieved by medications alone. You may get these treatments anywhere from once a week to once every 4-6 weeks depending on your regimen.
Extractions are used to treat white heads, black heads and milium. These are lesions that are not inflammatory, but simply represent a pore that is clogged with sebum (oil) and skin cells (keratinoctyes). Sometimes they do not respond well to topical creams or pills and require manual extraction. Creams can be used to prevent new lesions from forming.
Chemical Peels come in many different varieties, and there are some that contain ingredients that help with active acne and future acne. They penetrate the superficial layers of skin and pores with ingredients such as glycolic or salicylic acid to treat acne bumps. They go deeper and are more effective than topical applications of the same ingredients.
Blue and Red Light treatments are a more recent treatment for acne. Such devices emit light in the blue and red light spectrums and have been found to minimize inflammation and kill bacteria. It is a great addition to most acne treatment regimens.
Creams/Topical Solutions may be called “bleaching creams”, but it is more accurate to call them skin evening creams since the goal and the effect of these creams with Dr. Steele Johnson’s instructions is to even out the skin tone rather than “bleach” any one area. These creams are very effective in the prescription strengths that Dr. Steele Johnson will provide. They gradually even out the skin color over their time of use.
Injections include steroids and/or Botox for thickened scars. Acne scars can sometimes be thick, raised scars, especially on the chest, shoulders and back, and sometimes on the face or neck. For any thick scar, there are thick bundles of collagen in the scar that need to be thinned out. Steroids have historically been used, but Botox is a new, innovative treatment that Dr. Steele Johnson uses to improve scars more than could otherwise be done with steroids alone. It may take more than one treatment, but the end result will be permanently smooth skin at the site of your scar. This advanced treatment also prevents the scars from puffing up and coming back, like they can tend do do with steroid shots alone.
Fillers are usually used for cosmetic alteration, i.e. filling wrinkles or folds, but they may also be used to treat sunken in scars. A more common type of scar from acne is the “pitted” scar which is an area where the collagen in the under layers of the skin has been destroyed, so the skin sinks in a localized area creating a pit. For some of these scars, a filler substance (like a hyaluronic acid) can create scaffolding for the superficial layers of skin and elevate the scarred area to be smooth. While fillers are usually not permanent in the case of correcting aging skin, they tend to give more permanent results when correcting a scar (since the scar doesn’t continue to get worse, but aging dose continue to happen after the procedure).
Lasers may be used in conjunction with fillers or on their own. They are especially useful for acne scars that are sunken in and wider than they are deep. In that case, a laser resurfacing procedure will work to smooth out the texture of the skin. The laser will create small areas of damage to the skin that will stimulate the skin to make more collagen that will fill the areas that are sunken due to collagen destroyed from the inflammation of an acne bump. It takes several treatments to get the response that most people desire, but in the end, it is a safe, effective and elegant way to address acne scars.
Dr. Steele Johnson knows that you want to not only make sure that you stop breaking out, but you want clear skin, i.e. get rid of discoloration (red or brown), smooth out any textural unevenness, and fix scars. This is an important part of the treatment process, however oftentimes Dr. Steele will address the acne first to clear active lesions such that you don’t get frustrated by treating scars and discoloration only to get new acne and new scars and dark spots. Also, clearing the acne alone will lead to great improvement in discoloration and scarring as well.
Ultimately, our goals for your skin are the same as yours. There are many steps to achieving clear, even, beautiful skin and Dr. Steele Johnson has created our Acne Treatment Center to make sure that we take you through those steps and get to the skin that you ultimately want.
The full name of rosacea is acne rosacea. It is an adult form of acne that usually doesn’t start to affect people until their 20s, or more commonly, in their 30s, 40s and 50s. Those who have rosacea may or may not have ever had the more typical type of acne (acne vulgaris). Although we often think of rosacea in very fair skinned people, it can affect people of all skin types. Rosacea consists of different signs and symptoms that may affect patients to varying degrees. Since Rosacea is always front and center on the face and can be quite dramatic in appearance, we know how much it can bother you and can make you self-conscious about your appearance. Dr. Steele Johnson will help identify your individual symptoms of rosacea and create a treatment plan that is most appropriate.
There are different components to rosacea: redness is probably the most common sign/symptom. It usually affects the mid-face predominantly (the cheeks and chin usually). It may be worse at different times of day and can be worsened by environmental factors like sun, wind and extremes in temperature. Patients can even experience burning with rosacea. Broken blood vessels is another common feature that doesn’t have any symptoms but does tend to get worse over time. The only way to adequately treat them is with a laser. As one would imagine from the term acne rosacea, one can also experience pimples with rosacea. This is probably the easiest of all the rosacea symptoms to treat. Dr. Steele Johnson often uses medicines used to treat common acne, but considers that rosacea-prone skin can tend to be more sensitive and not tolerate some of the stronger acne meds. The rarest symptom of rosacea is oil gland overgrowth that can affect the nose and result in a large bulbous nose. This is uncommon and most people with rosacea will not be affected by this condition, even after many years.
Rosacea can really vary from mild to severe based on the your specific symptoms.
Treatments for rosacea are patient-specific given and may include topical creams, oral medications/pills, laser treatment and camouflaging makeup. It is often a combination of treatments that works best, while a prescription cream may be good for minimizing pimples, you may require a laser to treat redness and broken blood vessels. At Steele Dermatology, you can be confident that we will find the combination of therapies that works best for you.
Rosacea is very common, but symptoms can vary widely. It can range from just a little redness and slight flushing or blushing to severe pimples, broken blood vessels and even stinging or burning. At Steele Dermatology we will develop a treatment plan to address your specific symptoms.
Patients with rosacea may have more sensitive skin and require a regimen that includes products that is strong enough to treat your symptoms, like redness and pimples, but gentle enough that it doesn’t cause irritation. Sometimes creams like retinoids, which are otherwise key treatments in acne regimens, can be too irritating for those with rosacea.
Topical creams, serums, cleansers and sunscreen can be important components of your treatment. In addition, sometimes oral medications are required. Laser treatment is often a significant way of permanently improving the condition, especially for redness and/or broken blood vessels. Lasers specifically target the dilated blood vessels and redness without affecting the healthy skin leading to immediate and lasting improvement.