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Acne Action Month: New Dermatology Breakthroughs Mean Answers For You.

40-50 Million Americans suffer from acne. That makes acne the most common skin disorder in this country today! Summer weather welcomed by many uncovers the suffering that many keep hidden all Winter.

Acne can leave emotional as well as physical scars in adults as well as teens. Depression, withdrawal, and even suicide can result as the ultimate impact of this too common misunderstood problem, Dr. Timothy Rosio notes that this doesn't have to happen to you or your family. Your Dermatologist has new information and solutions for you.

That's why Dr. Tim Rosio is educating the public all summer beginning with June as "Acne Action Month." He also developed the "Acne Treatment Center" as part of AnewSKIN Dermatology. With over twenty years of experience helping others with acne, and having suffered from acne personally in his teen and adult life, Dr. Rosio has assembled new knowledge, leading edge skin care and high technology such as lasers and light devices to diagnose and treat the more than ten different types of acne in a wide variety of skin types faster and more effectively. Information is available to the public in the form of adult and teen literature, website and online BLOG from AnewSKIN.info and AnewSKIN.net, office seminars, and Dr. Rosio's complementary "Healthy Skin" pilot program for health classes in schools.

As part of Acne Action Month, Dr. Rosio is asking people to reach out and share their stories about acne, acne scarring, and their feelings about the condition. Selected stories will be made available anonymously to help others realize they are not alone, and to encourage support and early intervention from home, school, and society. Awards of skin care treatment for acne and acne scarring will be complementary and will include pulse light treatments, laser treatments for scarring, and dermatologic grade acne products donated from Dr. Rosio.
Email your life experiences with acne to cassistant@anewskin.info.

The Most Frequent Problem May Continue—and Be Passed On. Did you have problem with acne as a teen? Having a new or continuing form of acne as an adult such as Rosacea or hormonal acne? You're not alone. 40-50 million Americans are with you. Also, genetics shows there's a good chance your teen does too, or will. Acne and its scarring can destroy self esteem, or prevent it from developing normally. If you know how having acne feels, you can offer guidance and support. If you didn't have acne yourself, and your teen or loved one does, it's important to learn what acne is and how it can be treated—and especially important to stay aware of how he or she feels about it. See "The Human Toll of Acne: In Their Own Words."

Many Myths, A True Medical Condition. Unfortunately, there's still many myths and false ideas out there about acne.  So, even well-meaning parents and other adults can give incorrect information and advice. They may blame acne on certain foods, for example, or believe that more frequent face-washing is the answer (it isn't). Many parents, the general public and general doctors are not aware that acne is a true medical condition, and not a phase that everyone goes through or grows out of.

New Answers, New Optimism. However there are many new reasons for optimism if you have acne or parent a teen with acne. Yes, our optimism is based on the fact that a lot has changed since you were a teen. Today, Dermatologists understand much more about acne and have new methods to treat it to prevent or erase scarring successfully, faster and more successfully than ever before. Even a person with mild acne can benefit from a Dermatologist's treatment. Dr. Tim Rosio, fellow of the American Academy of Dermatology advises his patients and educates the public on the latest treatments for acne and Rosacea available now, and how ongoing research into the causes of these conditions holds promise for future therapies.

Dermatologic Diagnosis is Key. The causes of acne are many include excess oil production, skin inflammation, skin cells in the hair follicles that shed too quickly and an increased number of the acne-causing bacteria Propionbacterium acnes. However, hormones also influence both oil production and the shedding of skin cells, thereby contributing to the formation of acne lesions. For example, when androgens (the male hormones present in both men and women) over-stimulate the oil glands and hair follicles in the skin, hormonal acne flares can occur. Medications internally, and mismatched skin care products such as cleansers, moisturizers, make-up, hair care, and sunscreens can all trigger acne or keep it from improving. So your dermatologist and a detailed history of your skin and all products used is very important.

New Twists on Old Treatments.    In the past, most cases of acne were treated solely with antibiotics. While these treatments can be very successful, a growing concern about long-term antibiotic use is that bacteria are evolving to become resistant to these medications. As a result, the development of other effective therapies and combination therapies has evolved.

For example, Dr. Rosio notes that some of the newer therapies for acne are anti-inflammatories, which can be used in some cases to lessen the severity of acne and stop or decrease scarring. Controlled-release of lower dose doxycycline is a newer anti-inflammatory oral medication that some dermatologists use to reduce the redness and swelling of acne. Combination therapies, which may include an anti-inflammatory and antimicrobial effects that can decrease resistance and are more convenient to use for patients, has made combination therapeutics increasingly common treatments used to manage acne. In addition to oral treatments, Dr. Rosio uses a number of topical medications from other areas of medicine to treat acne disorders, including an antip-parasite drug, metronidazole, a life-saving anti-inflammatory medicine called dapsone and a natural extract of grains known as azeleic acid. These are three newer topicals that are tolerated well and effective in reducing the symptoms of varying forms of acne and Rosacea.

Lasers: Improving Skin at 286.000 miles per Second!

Dr. Rosio uses his twenty years of leading expertise with lasers and light-based technologies as a basis for a newer approach to treating acne as a complementary treatment to traditional medical therapies. Dr. Rosio notes that these technologies include the pulsed-dye yellow laser, mixtures of red, green, and blue light, invisible infrared wavelengths, and photodynamic therapy, which target the sebaceous (or oil) glands and can reduce acne flares. While Dr. Rosio does not recommend lasers and light-based technologies as single therapy for acne, he has demonstrated it is the most rapid of all methods for inflammatory (red, painful, swollen lesions). "I see improvement in as little as five minutes after a four minute Pulsed light treatment, and often within the hour my patients say ‘my skin feels smoother already'. By the next morning, most see twenty-five percent less swelling and redness."

"Patients are becoming increasingly concerned about the long-term use of oral medications to fight acne, so lasers and light sources appeal to them," said Dr. Rosio "It's very likely that with the advancement in dermatologic research, we will see sebaceous gland targeting lasers in the future that will be effective for the treatment of acne."

Treating Outer and Inner Scars & Improving Self Esteem

Dr. Rosio added that many patients are concerned about scarring that can result from acne, and many acne scars can be very aggressive and difficult to treat. For mild scarring, retinoids, chemical peels, microdermabrasion, and lasers can give mild improvement. In addition, fillers can be used successfully to fill in depressed areas and improve the appearance of scars.

A new laser therapy that I use for acne scarring is fractional laser resurfacing. My laser technique is to target damaged skin in columns of microscopic treatment zones, which include the outermost and underlying layers of skin known as the epidermis and the dermis. Fractional laser resurfacing stimulates the tiny columns of scarred skin to remodel over time while the surrounding healthy skin is left intact. You can return to work and social activities by the next day in most cases without it being evident.

"One of the main benefits of fractional resurfacing is wound healing and increased collagen production that reduces acne scars," said Dr. Rosio. "However, most patients will notice a modest improvement in acne scarring and multiple treatments are required. For more severe scarring, such as deep „ice pick‟ scars, I use several acne surgical procedures– including punch grafting or punch excision – to remove, raise, fill or separate the scar tissue from the underlying skin. I use these surgical procedures in combination with other therapies, including lasers and fillers, and I can improve severe acne scarring."

Rosacea Triggers and Treatments

Rosacea, is a chronic skin condition, affects an estimated 14 million people in the United States and is characterized by redness, flushing and prominent blood vessels on the face. Dr. Rosio explained that rosacea commonly occurs in younger as well as mature people, and there are many known triggers for this bothersome condition – including sunlight, alcohol, spicy foods, caffeine, heat, citric acid, and stress. While the exact cause of rosacea is not fully understood, Dr. Rosio noted that a recent study suggests that the presence of an abnormal peptide (a small protein) in the skin of rosacea patients may contribute to the disease. "There is some evidence to suggest that the peptide cathelicidin within the skin is processed differently in rosacea patients than in individuals not affected by rosacea and induces inflammation that may contribute to rosacea," explained Dr. Rosio. "These findings are encouraging, as we can identify better treatments for the disease if we have a better understanding of how the altered peptide induces the problems."

Getting the Red Out

Over the years, lasers have been shown to be effective in treating the symptoms of rosacea. For example, Dr. Rosio mentioned that he uses various settings with pulsed-dye lasers and he gets good results for rosacea patients with lots of broken blood vessels, and his use of both pulsed-dye laser and intense-pulsed light treatments are effective at treating redness on the face and flushing associated with rosacea. "Patients undergoing laser therapy for rosacea will likely need multiple treatments. However, I have found with proper selection, my treatment techniques with lasers and light treatments are very effective and produce long-lasting results," said Dr. Rosio.

In addition to oral treatments, I use a number of topical medications to treat rosacea, and Dr. Rosio explained that metronidazole, dapsone and azeleic acid are three topicals that are tolerated well and effective in reducing the symptoms of varying forms of acne and rosacea.

Get in Touch: Communication Tools Help This Painful Condition. Unfortunately, many people never get the help they need until severe damage is done physically and emotionally. Dr. Rosio's Acne Treatment Center wants you to know that if your teen doesn't seem to want to talk, you may be comfortable starting the conversation with some acne facts, which can help you be sure you are giving your teen correct and up-to-date information. Also be sure to let him or her know that much more can be done to treat acne today than when you were a teen.  AnewSKIN's Acne Treatment Center BLOG, Website, Teen Skin Magazine, and help guides can assist you.

Tips:

• Reassure your teen that having acne is more "normal" than not having it, since he or she has plenty of company—some 40 to 50 million Americans. Up to 85 % of teens and young adults up to 24 years of age suffer it.
• Concentrate on the fact that now there has been so many new dermatology advances in treating acne!
• Pick up Dr. Tim Rosio's complementary guide to Teen Skin.
• Sign up for a free special guide online that informs you of new options for treating acne.
• Check out Talking Acne with Your Teen Guide, a helpful resource for parents who want to have meaningful talks about acne with their teens.

Suggest making a dermatologist appointment to start your teen on the path to clearer skin. The sooner you can help your teen get control over acne, the greater the chance for success. Chances are you'll both feel more confident and in control once you know what acne treatment the doctor thinks is right for your teen.

When should you see a Dermatologist?
In many cases, insurance helps pay for the office visit as well as medicine. Whether you are just beginning to fight acne or seeking a new solution to an old acne problem, even mild acne is a medical condition that can benefit from medical treatment by a dermatologist. If your acne is getting worse even with over-the-counter or general doctors' treatment, it may be a good indication that you need a dermatologist to examine you and recommend a skincare regimen, including a carefully chosen acne treatment based on your skin type.

The way your acne makes you feel may also be a reason to see a dermatologist. Do any of the following statements describe how you've been feeling lately?

• Your acne embarrasses you in front of others, and/or
• Your acne makes you shy away from others, and/or
• Your acne makes you feel depressed about your future, and/or
• You are not satisfied with your current acne treatment.

Though you may sometimes feel as if you're the only person who has acne, actually some 40 to 50 million Americans do. That makes acne the most common skin disorder in the United States.

As you know, teen acne is very common. In fact, by their mid-teens, more than 40% of people have acne, or acne scars, that need dermatologic treatment. However, acne doesn't necessarily go away with adolescence — adults with acne may suffer into their 20s, 30s and beyond.

What is Acne?

Acne is a disorder resulting from the action of hormones and other substances on the skin's oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples, or zits. Acne lesions usually occur on the face, neck, back, chest and shoulders. Although acne is usually not a serious health threat, it can be a source of significant emotional distress. Acne can also lead to permanent scarring.

What Causes Acne?

The exact cause of acne is unknown, but doctors believe it results from several related factors:

• One important factor is an increase in hormones called androgens. These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum.
• The lining of the wall of the hair follicle sheds skin cells, which then stick together with the sebum produced by the sebaceous glands. This causes a plug to form below the surface of the skin. This plug cannot be washed away. This process can take days to weeks for a visible lesion to form. Whiteheads and blackheads are the result of this clogging of the pores. The sebum and cell debris together contribute to the growth of bacteria that naturally live in your pores.
• Your body's own immune system will naturally attempt to clear the clogged pores by sending in certain specialized cells that invade the follicle to help clean it up. However, in the process, the wall of the follicle may weaken and rupture, emptying the contents of the follicle into the surrounding tissue. When this occurs, swelling or redness can develop around the affected follicle, resulting in the larger bumps or pimples characteristic of acne. These are known as papules and pustules and can sometimes cause scarring.
• Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.
• Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder.
• Certain drugs, including androgens and lithium, are known to cause acne.
• Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug.

Factors That Can Make Acne Worse

How many of the following factors that can cause an acne flare are familiar to you?

• Oil from skin and hair products (moisturizers, cosmetics or hairspray) or grease encountered in the work environment (for example, a kitchen with fry vats)
• Changing hormone levels in adolescent girls and adult women 2 to 7 days before their menstrual period starts
• Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
• Environmental irritants, such as pollution and high humidity
• Squeezing or picking at blemishes
• Hard scrubbing of the skin
• Stress

Do you see some of the misstatements you've heard about acne in the list below?

1. Myth: You can buy something that can clear your acne overnight.
   Truth: Treating acne takes time. It is important to be realistic. Don't be tempted by overnight promises; you want to find the best treatment for YOU.
2. Myth: Acne is just a cosmetic disease.
   Truth: Acne is a medical condition that can benefit from professional treatment. Even mild acne can have an emotional, as well as a physical, impact.
3. Myth: I can only see my general doctor or I have to get referred to see a dermatologist about my acne.
   Truth: dermatologists are the only board certified experts in skincare and you should be able to see a dermatologist at any time, without a referral, to help you on a path to clearer skin and help customize a skincare regimen for you. Some HMO's may bar you from seeing a dermatologist, but you can prevail if your skin doesn't respond to basic ‘trial and error' attempts.
4. Myth: All acne medications are the same.
   Truth: All acne medications are not created equal. It is important to know different medications contain different ingredients. Even similar ingredients and concentrations may have radically different formulations, bioavailability, and effects on skin irritation and improvement. If you haven't found a treatment that works for you or you are just not satisfied with your current treatment regimen, talk with your doctor, who can help you decide on the skincare regimen that is right for you.
5. Myth: You will grow out of your acne.
   Truth: Some people continue to experience breakouts into their 20s, 30s and beyond. But, there is no reason for someone to endure acne. Acne can be cleared up with proper treatment. If the acne products you've tried haven't worked, you should see a doctor.
6. Myth: Acne is caused by poor hygiene.
   Truth: Acne is not caused by dirt or surface skin oils. Far from preventing acne, frequent washing may actually irritate pores and worsen acne.
7. Myth: Acne cannot be cured.
   Truth: While there is no "cure" for acne, acne can be managed, and for many people, it eventually recedes with the right treatment. There is a wide range of acne medications currently available. Doctors can evaluate your skin and help you determine the right treatment for your particular skin type and the kind of acne you may have.
8. Myth: Getting a suntan can help clear acne.
   Truth: The sun may appear to clear existing acne while reddening your skin. However, a sunburn is actually skin damage. Sun exposure causes irritation which can make acne worse.
9. Myth: Foods, such as chocolate, cause acne.
   Truth: There is no scientific evidence that proves a connection between diet or food and acne. Chocolate, French fries, pizza? Enjoy! But if you truly feel a certain food makes your acne worse, it makes sense to avoid it.
10. Myth: Popping a pimple will make a zit heal faster.
    Truth: Popping a pimple may make a zit temporarily stand out less noticeably on your face. However, pimple-popping may make it take longer to clear up. Why? When you pinch the pimple, you can also squeeze dead skin cells, oil and even bacteria further into your skin. As a result, a red or brown mark or scar can form and take weeks or months to clear. If a skin dent or pit forms instead, it will never go away.

Don't let myths about acne keep you from getting the most effective therapy for your acne. Make an appointment to see Dr. Rosio today.

1. The social impact of acne. AcneNet. http://www.skincarephysicians.com/acnenet/socimpct.html.
2. Mallon E, Newton JN, Klassen A, et al. The quality of life in acne: a comparison with general medical conditions using generic questionnaires. Br J Dermatol. 1999;140(4):672-676.
3. Hanna S, Sharma J, Klotz J. Acne vulgaris: more than skin deep. DOJ. 2003;9(3):8.
4. Thomas DR. Psychosocial effects of acne. J Cutan Med Surg. 2005;8(suppl 4):3-5.
5. Teen Perception Survey. American Acne & Rosacea Society/Dr. Eva Ritvo. Conducted by Kelton Research. 2009.
6. What is acne? AcneNet. http://www.skincarephysicians.com/acnenet/acne.html.
7. Raised acne scars: treatment can ease pain, diminish scars. AcneNet. http://www.skincarephysicians.com/acnenet/raised_acne_scars.html.
8. Skin color changes: spots may fade with right treatment. AcneNet. http://www.skincarephysicians.com/acnenet/skin_color_changes.html.
9. Lolis MS, Bowe WP, Shalita AR. Acne and systemic disease. Med Clin North Am. 2009;93(6):1161-1181.
10. Hu H, Real E, Takamiya K, et al. Emotion enhances learning via norepinephrine regulation of AMPA-receptor trafficking. Cell. 2007;131:160-173.
11. Data on file. Galderma S.A.
12. Acne myths. AcneNet. http://www.skincarephysicians.com/acnenet/myths.html.
13. Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998;139(5):846-850.