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"Patients' Choice Award" by Vitals.com
Dr. Sam Naficy has been awarded the "Patients' Choice Award" by Vitals.com - a website dedicated to rating the quality of physicians across the country. Out of 720,000 physicians, only 5% received this honor.
Acne is a very common skin disorder of the pilosebaceous units (consisting of a hair follicle and its oil gland) that affects 85-100% of all people at some point in their lives. Although acne is most common during the adolescent years, many adults can be affected as well. According to a study published in the Journal of the American Academy of Dermatology over 50% of women and 42 % of men in their 20s reported experiencing acne. Acne is more common in women and persists into their 30s, 40s, and even 50s. According to the survey 35% of women over 30 reported experiencing acne while 26% of women over 40 reported experiencing acne.
There are varying degrees of acne ranging from mild to severe. Mild forms of acne consist of closed comedones (whiteheads) and open comedones (blackheads). Severe forms of acne consist of inflammatory papules (pimples) and cysts which then can increase the risk for scarring.
Typically the face and upper neck are most common affected, however the chest, back, and shoulders can be affected as well. Types of acne include:
- Acne vulgaris
- Non-inflammatory acne
- Inflammatory acne
- Cystic acne
Cause of Acne
Acne is typically caused by blockage of the pores of sebaceous (oil) glands. These pores can be clogged due to excessive sebum (oil) production and shedding of skin cells. Once plugged the sebum can be infected or inflamed by skin bacteria resulting in acne. Inflammation near the skin's surface produces a pustule (a pimple with pus) while deeper inflammation results in a papule (a pimple without pus) and if much deeper a cyst or nodule. Predisposing factors for acne include:
- Family history and genetic predisposition
- Hormonal activity
- Hyperactive sebaceous glands
- Certain medications
- Mechanical friction or pressure from helmets or backpacks
- Environmental factors such as humidity
Treatment of acne
Goals of acne treatment are to relieve symptoms and to minimize scarring. Treatment is based on a variety of factors including, the severity of acne, medical history, medication tolerance, and patient preference. Common treatment regimens include:
- Topical bactericidals products containing benzoyl peroxide
- Topical antibiotics such as erythromycin, clindamycin, and tetracycline
- Oral antibiotics such as erythromycin, doxycycline, tetracycline, and minocycline
- Hormonal treatments such as birth control pills and spironolactone
- Topical retinoids such as tretinoin, adapalene, tazarotene
- Oral retinoids such as isotretinoin (accutane)
- Phototherapy treatments such as photodynamic therapy, light/laser treatment
Successful management of acne often involves a combination of multiple different treatment modalities.
Treatment of acne scars
Acne scars are typically caused by damage to the collagen layer of skin as a result of the ongoing inflammation and at time from self-inflicted injury from picking. Acne scars can be improved by a number of different skin resurfacing procedures that can help stimulate collagen production and reduce the depth of the acne scars. Ideally the acne should be under good control before any attempt to improve the existing scars. Treatment options include:
- Radiofrequency treatment such as Thermage
- Fractional Laser resurfacing with CO2 laser (such as Active FX, Deep FX, Fraxel)
- Laser resurfacing with Erbium-Yag laser
- Dermabarsion (sanding of skin)
- Laser resurfacing with CO2 laser
- Subcision of acne scars
- Punch excision of acne scars
- Fat injection under acne scars
- Filler injection under acne scars