Acne and Rosacea

Acne is a very common skin disorder caused by overproduction of oil/sebum, which favors the colonization, and proliferation of bacteria (e.g. propionibacterium acnes).

Acne affects both genders and typically presents between ages 9 and 40 years old.

There are different types of acne lesions including: closed comedones, open comedones (black heads), inflammatory papules, pustules (white heads), nodules and cysts.

At Houston Dermatology and Plastic Surgery, we will determine the triggers of your acne and tailor the type of treatment based on the severity and lesion morphology as well as your skin tone. We have vast experience using topical and systemic retinoids, antibiotics, oral contraceptives, spironolactone as well as chemical peels, light-based and laser therapies to aggressively and successfully treat acne.

These are some basic recommendations to achieve acne-free skin:

• Wash your skin using a gentle cleanser, gently massaging the skin and using your hands only. Avoid aggressive scrubbing with loofas, rags or washcloths.
• Avoid washing the skin more than twice a day.
• Moisturize the skin with non-comedogenic lotion or cream.
• Protect your skin from the sun with daily applications of broad spectrum SPF 30 or higher.
• Avoid squeezing or picking at your acne lesions as this practice can favor the development of permanent scars and spread bacteria.
• Use non-comedogenic makeup only.

Acne Scars

Scars are a permanent sequela of acne, which can happen inherently in certain types of ethnicities or by improper manipulation of the lesions.

There are several types of acne scars (icepick, rolling, boxcar, hypertrophic and keloidal).

At Houston Dermatology and Plastic Surgery, we will determine the best approach to improve the cosmetic appearance of your scars. We have ample experience in the use of pulse-dye laser, micro needling, and subcision, chemical peels, fractional lasers, and dermal fillers in multiple skin types and ethnicities to help improve the appearance of acne scars.

** Keep in mind that some of these treatments cannot be done if you were treated with isotretinoin (Accutane) within the past 8-12 months, as the miniaturization of the sebaceous glands dampens the natural healing process required by these treatments.

** These treatments are unlikely to be covered by your medical insurance

Rosacea

Rosacea is a condition typically found in fair-skinned women and men of Celtic or Scandinavian origin between ages 30 and 50 years old.

In Rosacea, there is an abnormally brisk response of the blood vessels in the central face which make the patient prone to flushing or having acne-like breakouts.

Rosacea is typically classified as:

• Erythematotelangiectatic: Red forehead, nose, cheeks and chin accompanied by dilated capillaries and venules.
• Papulopustular: Inflammatory acne form bumps accompanied by oily skin.
• Phymatous (glandular): Thickening of the skin of the nose, chin and forehead with oily texture and enlarged pores.
• Ocular: Watery, itchy, dry eyes that become easily irritated.

At Houston Dermatology and Plastic Surgery, we will help you determine the type of rosacea, identify and educate you about the avoidance of common triggers (heat, hot beverages, stress, and alcohol) and effectively treat your symptoms.

We have extensive experience in the use of topical and systemic antibiotics including topical dapsone and ivermectin, topical vasoconstrictors (brimonide), azelaic acid, chemical peels, as well as pulse-dye laser and surgical alternatives for correction of phymatous skin.

The following are useful recommendations for our patients with Rosacea:

• Use mild facial cleansers and avoid rubbing or scrubbing the skin
• The daily use of non-comedogenic broad-spectrum SPF 30 or higher is imperative. Re-apply every 90 min if performing outdoor activities.
• Strict avoidance of triggers (vary with each person).
• Use of green-tinted based concealer or makeup can help cover the redness.
• Visit an ophthalmologist if your eyes are constantly red, watery, dry or irritated.