Acne is the most frequent skin condition in the United States. It is characterized by pimples that appear on the face, back and chest. Every year, about 80% of adolescents have some form of acne and at least 5% of adults experience acne.

Acne is made up of three types of blemishes:

  • Whiteheads/Blackheads, also known as comedones, are non-inflammatory and appear more on the face and shoulders. As long as they remain uninfected, they are unlikely to lead to scarring.
  • Red Pustules or Papules are inflamed pores that fill with pus. These can lead to scarring.
  • Nodules and Cysts can lead to permanent scarring and may be painful.


In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. The sebum moves from the bottom to the top of each hair follicle and then spills out onto the surface of the skin, taking with it sloughed-off skin cells. With acne, the structure through which the sebum flows gets plugged up. This blockage traps sebum and sloughed-off cells below the skin, preventing them from being released onto the skin’s surface. If the pore’s opening is fully blocked, this produces a whitehead. If the pore’s opening is open, this produces blackheads. When either a whitehead or blackhead becomes inflammed, they can become red pustules or papules.

It is important for patients not to pick or scratch at individual lesions because it can make them inflamed and can lead to long-term scarring and problems with pigmentation.


Treating acne is a relatively slow process; there is no overnight remedy. TV commercials may show dramatic results in a short time.  Remeber, these commercials are meant to sell products and do not reflect reality.  We encourage you to try over the counter remedies for more mild and acne and seek our help if they do not provide relief.  Some treatments include:

  • Benzoyl Peroxide — Used in mild cases of acne, benzoyl peroxide reduces the blockages in the hair follicles.
  • Oral and Topical Antibiotics — Used to treat bacteria that cause inflammation in the pores.
  • Hormonal Treatments — Hormones play a huge role in acne, especially in women.  Low dose oral contraceptives and other hormonal treatments can help many women with acne.
  • Tretinoin — A derivative of Vitamin A, tretinoin helps unplug the blocked-up material in whiteheads/blackheads. It has become a mainstay in the treatment of acne.
  • Extraction — Removal of whiteheads and blackheads using a small metal instrument that is centered on the comedone and pushed down, extruding the blocked pore.
  • Isotretinoin  Originally approved in the 1980's, this powerful medication can actually induce a remission of acne.  It is used for patients with inflammatory scarring acne.  There are many side effects of this medication which will be thoroughly discussed with you prior to considering this treatment.