Acne Treatments Questions and Answers Archive

Nov
2001

Q&A: Could my son's elevated bilirubin and alkaline be from the use of minocycline for acne?

Question:

My son is taking minocycline for his acne, he has had 2 liver panels done, his bilirubin and alkaline have come back elevated. Is this do to the minocycline? He has not had any symtoms. He wants to get on accutane, thats why he had the blood tests.He has to have another test tomorrow.

- Marcy

Answer:

 Amy Forman Taub, M.D. - LocateADoc.com

It is possible that it could be due to minocycline, although it is highly uncommon. The good news is that if so, it is reversible with discontinuation of the drug. However, they often do multiple other tests to determine what the cause of elevated liver enzymes are. You didn't tell me how elevated either- people occasionally get liver enzyme elevations that are mild for not always know reasons and they can resolve on their own. Accutane is a great drug for acne (although it does have potential side effects which he should thoroughly discuss with his doctor before taking it) and although liver problems are listed as a side effect, I have only seen about 2 people in my 12 years of practice get elevated liver enzymes and they both went back to normal after the drug was discontinued.

-- Amy Forman Taub, M.D.
Lincolnshire, Illinois



Nov
2001

Q&A: Would chemical peel be recommended to remove my patches of red acne scars?

Question:

I am 18 years old and have dealt with mild acne since i was 13. My skin has scarring and i would like to know if a chemical peel would be recommeded. I have little to no acne now, and would like to rid my face of the red scar patches. Is a peel worth it?

- Jennifer

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

You call them red scar patches. Does this mean they are mainly red, or red and indented. The redness makes me think you may be a candidate for a procedure called photorejuvenation, a new treatment for rosacea and sun damage. If there is red in the scar this procedure will help to remove it, plus stimulate the skin underneath to grow new collagen. Find a practitioner in your area or more about this at www.aslms.org or photorejuvenation.com or at esc-med.com. Microdermabrasion can help smooth out superficial scars (indents) but needs to be performed multiple times. Similarly, mild chemical peels would need to be done in a series. Neither peels nor microdermabrasion will help with redness.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Oct
2001

Q&A: What is the best way to get rid of acne scars and now hair on my face?

Question:

I have a couple of questions wrapped into one. When I was younger, I had pretty severe acne which left me with many scars on my face. Some of them are purplish, and others are what look like little "pits". Although they've faded quite a bit, I still find them hard to look at in the mirror each morning. What is my best bet to get rid of them? Also, I've noticed that I've been developing more facial hair (which I find disgusting) and it's to the point that I can't handle plucking and waxing anymore. I've heard of laser hair removal-what is this exactly? Is it painful? Is there any kind of miracle treatment that will cure me of my scars AND hair? If not, which should I try to clear up first? Approximately how expensive are the treatments? Any advice is greatly appreciated.

- Stephanie

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

3 of the best choices for the acne scars would be laser resurfacing with either a carbon dioxide or an erbium yag laser, surgically removing the scars and then having a more superficial laser such as photorejuvenation, mild peels or microdermabrasion, or having treatments with the Cool Touch Laser. You need to find a laser specialist and aesthetic dermatologist. I would go to the American Society for Laser Surgery and Medicine website www.aslms.com and they have listing of their members in all geographic locations. Your hair, if dark, would best be removed by a laser as well (unfortunately a different one than we use for scars). The most expensive option is laser resuracing which would probably run more than $2500 for a full face. Most of these solutions for scarring will probably run into the $1000 range. But it would be better to consult with an experienced aesthetic dermatologist and laser surgeon to determine what it best for you. Good luck!

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Nov
2001

Q&A: How can I get rid of two dark spots on my cheeks that came from the use of an acne medicine called Dernovat?

Question:

a dermatologist proscribed me a creme called Dernovat for my acne. after use of this creme I have 2 dark spots on my sheeks ever since(almost 10 years now) how can I get ride of them?

- shukri

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

I am not familiar with the cream you name. Assuming that you had a reaction to them and developed some type of hyperpigmentation, I would attempt to use a hydroquinone containing cream (preferably a 4% hydroquinone prescription cream such as Lustra) or an OTC version (such as Bleaching cream or gel on the skinfo.com website) as well as a retinol containing cream (again such as Afirm on the skinfo.com website) and even consider some mild chemical peels or microdermabrasion. Even though they have been there for a long time, interventions such as these may help. If these do not help, find an experienced laser surgeon who may be able to help you by going to www.aslms.org and searching for a practitioner in your area.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Nov
2001

Q&A: What should I do if I am detection a fluid pocket in my chin?

Question:

For the past 6 months or so I've had reoccurring fluid build up in my chin area. I thought it might be due to a clogged hair folicles at first, but it reoccurs so I'm thinking a cyst or boil? Stangely, I asked my General doctor about it recently and he felt nothing, which shocked me. it feels so fluid filled to me but not to anyone else who I'm constantly asking "don't you feel this?" Could I just be the version of a dermatologists hypo-condreact? What's worse is I constantly make it worse myself by attempting drainage. (I know I should just warm soak). Question: if I see a dermatologist will he/she be able to determine a cyst or something even if it's not "flared up" at the time? I'd really appreciate any imput you have to offer. Thank you.

- Leslie

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

Without seeing it it is tough for me to say.. I am going to assume it is there because you say it is. I would make an appointment with a dermatologist(you can alays cancel it), but you could always also try some over the counter stuff like benzoyl peroxide, to see if it would go down with some treatment. Try not to play with it as this does make it worse and can lead to infection or scarring. You could try some acne stuff at my website, www.skinfo.com where there is something called the complete anti-acne treatment and if you gave it a few weeks (the time it will take you to get in to see a dermatologist) you'd know if it were going to respond to something topical.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Oct
2001

Q&A: What should I do if I have red burning areas on my face after using Tazorak on and then off for acne, Aldera for bumps, and noe Tetinol liquid?

Question:

I obtained a prescription from my dermatologist to use Tazorak to treat my acne. At the same time, I used Aldera to help w/bumps (apparently caused by a virus). After several weeks, I noticed that the areas underneath both eyes and on the outer portions of my mouth, near my cheeks, became very swollen, and red. I wasn't sure if I used it improperly. I used the products right after I washed my face and noticed later that I was supposed to use it about 20 minutes after I wash my face. My dermatologist later took me off Tazorak and prescribed me w/a Retinol liquid. I used that for a couple weeks as well. The viral bumps disappeared, but now I have the "burns" on my face. It's gotten much better, but they are still visible. Will they ever go away? If not is there a way to get rid of them?

- Kimila

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

I assume by burns you mean red or brown marks. If you wait long enough they will go away by themselves, as they are the residual of the inflammation that you had. If you want to clear it up faster it might respond to 1% hydrocortisone cream, although using this could worsen or inflame either the acne or the virus. If there are scabs or crusts associated with these burn marks, you should contact your dermatologist as you may need more intervention.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Oct
2001

Q&A: Is it possible to find any relief from the severe pain caused by hidradenitis suppurativa (acne inversa)?

Question:

My father in law has been diagnosed with hidradenitis suppurativa and has had 20 surgeries to help out with his pain. It has reached a point where the pain has become unbearable for him. He has lost a lot of weight and the condition is spreading. Do you have a name of a doctor who can help him? Is there anything that we can do to get him to feel a liitle better? We are desperate...

- Sandy

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

I am so sorry to hear that your father-in-law is in such terrible discomfort. I did a literature search and found that there are really two main treatments for hidradenitis. One you might consider is oral isotretinoin, brand name Accutane, which is usually used for severe acne but has been shown to be successful in suppressing (not curing) the symptoms of some cases of hidradenitis. The most widely accepted treatment, however, appears to be radical surgery, that is wide excision of the entire skin surface in the affected area. With 20 surgeries behind him, it doesn't sound like this option is going to be one that gives him much hope. The authors that were associated with these papers about surgical procedures included Drs. Ratz and Finley at the Department of Dermatology at the Ochsner Clinic and Alton Ochsner Medical Foundation in New Orleans, LA and Drs. Brown, Rosen and Orengo, from the departments of dermatology at Baylor College of Medicine and Veterans Administration Medical Center in Houston Texas. Perhaps contacting one of these doctors for consultation on your father-in-law's case would prove fruitful. In addition, please have him checked carefully as squamous cell carcinoma, a type of skin cancer, can develop in long-standing open wounds. If he has hidradentis in the groin, he also may need to be evaluated by a gastroenterologist as this has been associated with rectal cancer. Good luck!

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Oct
2001

Q&A: What can I do to smooth out acne scars from bad acne when I was younger?

Question:

When I was younger I had pretty bad acne. Now I have deep and numerous pores. Is there anything I can do to smooth them out?

- Ken

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

There are a number of things you could do for enlarged appearing pores or acne scars. You could consider a microdermabrasion treatment, a very gentle "sanding" of the topmost layer of the skin. This helps the skin to smooth out over the course of a number of treatments. You could consider a few "Beta-Lift" peels, which place salicylic acid in the pores to exfoliate them and allow them to shrink. You could also start on a skin care regimen such as with a retinoid (like Retin-A or Differin- both are prescription) or you could try an overy-the counter version of retinol (such as Afirm 2X available at my website, www.skinfo.com) or a combination with an alpha hydroxy acid cleanser. Or let the skinwizard tell you what to do at www.skinfo.com- click on the skinwizard and answer 3 questions (your skin care goal would be "toning") and it will guide your selection of a skin care regimen for your individual needs.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Sep
2001

Q&A: Should I consider laser skin resurfacing to remove pitted scars from plucking ingrown hairs on my chin?

Question:

I have pitted scars from plucking ingrown hairs on my chin area, not knowing that plucking was making them worse. I have been having laser treatments for the ingrown hairs which has made a big difference and has helped me alot. Although I am still left with these small (not red) scars that are not deep, but bothersome to me and have heard alot of bad things about chemical peels which I do not think I want to have done. I have looked into laser treatment for resurfacing and was wondering if that is the way I should go, although these scars only on the chin area are not deep nor are they red, so I am stuck as far as where to turn, where to go, as the laser place has suggested the peels giving me all the side affects. I am ivory skin colored with dark hair, facial hair all over, which most is blode and not bothersome, aside from the dark ones that started appearing on the chin area, had hormones tested and that was not the case, was told that this was and is hereditary. Can you please give me some guideline as to where to start, if laser resurfacing would be the best route to go, so forth?

- Nadine

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

Laser resurfacing is a really intensive treatment which I would use only as a last resort. Chemical peels vary by the strength and the chemicals that are used. Mild chemical peels- salicycilic acid 20-30% (Beta-LIft Peel) or glycolic peels 30-40% virtually have no risks and in a series may help you. Another option would be microdermabrasion, which I favor as a treatment for this type of problem, but you will also need multiple treatments, at least 5-6. Finally, you could try to find someone who has a Cool Touch II Laser. These are known to improve acne scars without much risk. Go to the web site www.aslms.org to find a laser practitioner in your area.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Aug
2001

Q&A: What is the procedure for skin peeling and the health affects?

Question:

A few weeks ago a girlfreind who is african-american had a proceedure done which is called skin peeling. Her skin looked radiant,glowed as well as seemed a little lighter.I am interested in the proceedure as well, at this time I would like to know the health effects if any, and exactly what is this proceedure. Thankyou, L.Saint-Claire

- lee

Answer:

Amy Forman Taub, M.D. - LocateADoc.com

There are many types of skin peeling, but the two most superficial are with glycolic acid and salicylic acid in a 20-30% concentration. These superficial peels (sometimes called "lunchtime peels", since you could have them on your lunch break and nobody would know you had it done when you went back to work. These smooth the skin, clean and tone pores, reduce pigmentation abnormalities such as sun freckles or melasma and help reduce acne. If done multiple times, they may help reduce fine lines.

--Amy Forman Taub, M.D.
Lincolnshire, Illinois



Aug
2001

Q&A: After bad acne reaction to makeup, what do you recommend for scar removal?

Question:

A couple of months ago I had a real bad reaction to some makeup. I broke out with really bad acne. The acne has cleared, but some scars were left. What would you recommend to have these scars removed?

- marie

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

Dear Marie, I wish it was easy to remove scars. It depends upon their character and depth. If they are very deep, they may need to be surgically removed. If more superficial, a type of deep resurfacing will improve them markedly and, if very superficial, a light treatment such as microdermabrasion performed a few times will make them much better. I would suggest that you visit with a dermatologist or plastic surgeon who offers all of the options in order to determine what is best for you.

--Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii