New Teen Acne Guidelines Published In Pediatrics.

Just released by the American Academy of  Pediatrics is a consensus opinion on how teens can be best managed with their acne. These principals are endorsed by your providers at Hada Cosmetic Medicine. First you will get a consultation, by either your physician or Physician's Assistant, to make sure you are given a diagnosis. You may select to have some treatments by aestheticians, but it is important to periodically check in with your physician or advanced practice provider as they mange your acne. Available treatments include over-the-counter products; topical benzoyl peroxide (BP), retinoids, and antibiotics; and oral antibiotics, hormonal therapy, and isotretinoin. Other important considerations are how this affects you psychologically, how well you are able to comply with our treatments, and the role of diet, sleep and exercise in your acne. Sometimes it is important to also seek consultation with a dermatologist or endocrinologist.

• It has been shown that Benxoyl Peroxide (BP) is safe and effective, and an excellent first line therapy. It can be continued with other medications regardless of what type of acne or how severe your acne is.
• The next step may be antibiotics and they can be given as a topical treatment or as oral antibiotics,. It may be important to continue the BP, at this point to minimize development of antibiotic-resistant Propionibacterium acnes (the germ that actually causes most acne).
• For all types and severity of acne, and for youths and adolescents, topical retinoids may be used alone or in combination products and regimens.
• Because topical antibiotics are slower to work and fairly prone to antibiotic resistance, they recommend that topical BP should be added if topical antibiotics are needed for more than a few weeks.
• If oral antibiotics are given, we will select one that is effective, and we will discuss how often, most will need to be taken with food, and we will go into any special instructions, such as sun sensitivity to think about if you are outdoors a lot.
• Isotretinoin is recommended for severe, scarring, and/or refractory acne in adolescents and may be used in younger patients, but you must avoid pregnancy with this medication
• Hormonal therapy with combined oral contraceptives may be useful  as the next step for young women, but they usually will not be started until you have your period for a full year.

Hot! Hot! Hot!

Do you need more heat to your skin?! We used to think tanning improved acne because we believed the skin temperature elevation at the time of tanning could kill bacteria. Tanning is not enough Hot!. Actually clearing the skin of bacteria is a cure for acne, without any of the Hot Hot!. When you get phototherapy in the visible light range with a laser or IPL treatment you generate enough heat to conquer the Staph aureus and the E. coli that that live in the skin and cause most  break outs, that's treating with what some of us like to call Hot Hot Hot!.There are some other strategies to killing off acne, don't just stop with heat though. A major weapon that white blood cells use to kill bacteria is to poison them after they are surrounded off. In fact the WBC actually engulfs the bacteria and then produces a poison pill that is sort of like scrubbing the kitchen sink! A chemical form of the Hot! The white blood cell can produce lethal to bacteria oxidants similar to peroxide and bleach.And don't think the bacteria cannot fight back. The bacteria can turn around and produce a pigment that is similar to the same compounds that give both color and anti-oxidant healthy products to  vegetables such as tomatoes and carrots. "Just as colorful vegetables with antioxidants are touted for their ability to protect us against aging or cancer, we discovered that the GBS bacteria is pulling the same trick to protect itself against our immune system," said the study’s senior author, Victor Nizet, M.D., associate professor, UCSD Division of Infectious Diseases, and an attending physician at Children’s Hospital San Diego. So what is really best is to turn to those lasers, back to the Hot Hot Hot (locally, in a safe and comfortable way with your cosmetic medicine consultant) to kill off those tricky bacteria, so they are eliminated from your skin and your acne can begin to heal.

Smoke, Secondary Smoke, Firesides and Candles: Causes of Acne

Adult skin is sensitive to smoke. Smoke of all kinds. Most adult women have acne with large comedones (are you still being unscientific and calling these black heads and white heads?!). Smoke, especially cigarettes are a common cause of these types of acne lesions. So experiencing an increase in skin issues. Think about total smoke exposure and how much protection your skin needs for those winter fireside family get-togethers.And come to Hada to get a consultation on getting clearer skin Other factors to watch for in your skin issues: stress, milk intake, high glycemic index foods (those that release sugar).