Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5FM this morning for Medical Matters.
June is Acne Awareness Month.
Sommer said, “Acne happens when your hair follicles get clogged with oil and dead skin cells, and this can lead to blackheads, whiteheads, pimples and more severe cases, cysts and nodules. Hormones and stress, diet, using the right skincare products or the wrong skincare products, I should say, and the the wonderful heat and sunshine of Florida can all play a role in aggravating or exacerbating acne.”
Is it true that you have dirty skin if you have acne?
Sommer confirmed, “No, that is a myth. Over washing and scrubbing can actually make it worse. So we have to treat acne like it’s an inflammatory condition. It’s not a hygiene issue. I think because people that tend to have acne have very oily skin, so it’s like an overproduction of oil in the skin. So they always have kind of like a shine. And teenagers or when you start going through puberty, and kids get really mean. They say, oh, you stink. Oh, you’re dirty. You don’t wash your face, like, what’s wrong with you? It has nothing to do with that. Not washing your skin can make it worse, but it’s not because you you’re dirty.”
There are different types of acne.
Sommer said, “Comedonal acne, it’s characterized by, those are the black heads and the white heads, the type of acne that’s caused by the clogged hair follicles. So those are the most common types like you’ll see especially people come in when they come in to see me for facials, whether it’s laser or when I do a regular facial, they’ll be like my pores are congested, and you can actually see, like they have lots of little white heads or black heads. That’s what’s considered comedonal acne.”
There’s also inflammatory acne.
Sommer said, “That’s when you’ll see people that have red and swollen pimples. Their face actually looks angry, and it’s caused by inflammation and even bacteria, and a lot of times that could be also from people that tend to pick or want to pop their pimples. We all have bacteria on our skin. Our skin protects you. It’s a barrier for everything else in your body. But when you have acne, and if it it looks like it’s palpable, then you’re actually introducing bacteria into the skin, so then your skin can become inflamed. That’s kind of what causes those red and swollen pimples.”
Then there’s nodular acne.
Sommer said that’s “painful bumps beneath the skin. It’s a severe form of acne, and that’s more inflammation. They will kind of look like those red bumps. They can be painful, and they don’t have like that white head that you can pop, but people will tend to try and manipulate them and pick them as well. So picking is not good.”
Then there is the cystic acne.
Sommer said, “It’s deep, it’s painful cysts and that’s usually caused by an infection of the hair follicle.”
How can you treat acne?
Sommer said, “So having a consistent skin care routine is really important, and it means cleansing, light exfoliation, like, again, excessive scrubbing can aggravate the acne. Moisturizing and applying sunscreen can help keep the acne away. You want to choose, like, they call it non comedogenic products, products that won’t clog your pores or exacerbate acne. So you don’t want, like, heavy, thick lotions after you cleanse your skin, you might use a serum, like a retinoid to help keep the acne away, and then you want to follow by a moisturizer that’s not going to clog your pores.”
Over washing your skin can actually do more damage, believe it or not.
Sommer said, “When you have oily skin and you you scrub it, you actually, you’re signaling your your body to produce more oil. So then you’re trying to overcompensate.”
What ingredients should people look for?
Sommer said, “Salicylic acid, benzoyl peroxide and retinoids can help prevent and treat acne. So when you’re looking, there are a lot of cleansers and serums that have salicylic acid and benzoyl peroxide. Certain people, even though you can have a combination skin which is oily and dry, or oily and normal. So you have to find a balance. Because I can tell you, this is just from experience, sometimes, if you use a salicylic acid twice a day, it then tends to dry out your skin too much. So sometimes just offsetting one of those with the gentle cleanser, and having one in it helps keep it at bay as well.
Keep hands and objects off of your face, but people do rest their phones on their face.
Sommer said, “That’s what leads to the acne that could be the nodular or the cystic acne, because you’re introducing bacteria into your skin. So if you’re going to touch your face, make sure you wash your hands. But again, really picking picking at it is not the best idea, because it also can cause scarring.”
Changing pillowcases regularly could also help.
Sommer said, “It’s not just your pillow cases. It’s your towels, hand towels, change them frequently if you use a washcloth or even a towel when you get out of the shower, change it often if you have acne, because even though you’re getting out of the shower and you’re using the towel on clean skin, over time, just the moisture, whatever attracts bacteria. So make sure you change those frequently.”
How does someone choose a treatment?
Sommer said, “there isn’t unfortunately, a one size fits all. Everybody’s skin is different, and the combination of treatments can be different. So there’s several different options. It starts as teenagers, when they go through hormonal changes, they’ll start with over the counter topical treatments, and then they may need to advance to the prescription topical treatments, like creams, gels and lotions. There’s so many different things to address mild to moderate acne. Again, we talked about the benzoyl peroxide, salicylic acid and retinoids, which is retinol. My daughter has acne, and she’ll say to me, Sephora has blew up with these young kids buying crazy skin care products, like really young kids, and they’re mixing serums and all these crazy things. And Retinol is, yes, it is used for aging skin, but it’s also used for skin with acne, and you don’t use it the same way. When it’s aging, you tend to use it every day because you have mature skin, and it helps fight, like, fine lines, wrinkles, pigmentation and all that, but it also helps to treat acne. So a lot of times you won’t use it every day because it can irritate your skin.”
Sometimes oral medications will be prescribed.
Sommer said, “They will prescribe isotretinoin or doxycycline, tetracycline and clindamycin gel are usually the prescription antibiotics that they will prescribe for really inflamed acne, if the bacterial infection is a problem and it’s hard to control.”
There are also in-office procedures that can help.
Sommer said, “Chemical peels, laser treatments, and even steroid injections can help in more severe cases of acne.”
Diet can also affect acne.
Sommer said, “There is a myth, chocolate causes acne, but not directly. It depends on the different types of chocolate. If you eat dark chocolate, the darker the chocolate, the less sugar there is in them. But anything that is high in sugar, high dairy diets, they can influence hormones and exacerbate acne.”
Regular physical activity can also help.
Sommer said, “Because stress can actually exacerbate acne as well, especially if you’re a picker, people tend to pick at their face more if they’re stressed, and then they get a worse break out of acne. So keeping your stress level with exercise and even with yoga or meditation, that can help keep your acne under control as well. People tend to once they start picking they can’t stop. And acne scarring occurs because you now injured the skin, like when you get a cut and it heals. But for whatever reason, sometimes the scarring occurs because the tissue doesn’t heal right way, instead of healing from the inside out, it kind of folds in on itself and you’ll get those, there’s a couple of different types of acne scars that will require more intense treatments like laser microneedling later on in life. Because you can scar from constant, chronic picking.”
A 2022 study in the Journal of American Academy of Dermatology did find that people with acne are 63% more likely to experience major depression in the first year after diagnosis.
Sommer said, “I talk to people about skin a lot, even even older women have, even though they’re in their 60s, and even almost in their 70s, they have had acne scarring, or some type of scarring, or they have really deep wrinkles, like aging, I don’t want to say, wasn’t kind to them, and it affects them tremendously. You don’t realize what a toll it takes because when you look at yourself in the mirror, you’re pulling every imperfection out every day. We all do it. It’s just our nature. And not everybody looks at you the way you look at yourself, but it is a confidence thing. So young kids, when they go through puberty and they get that really bad acne, it’s at that time when they’re in junior high and they’re trying to find themselves and it can definitely make an impact on their mental health.”
The lasers at Key West Surgical Group can help.
Sommer said, “They are two great lasers. I’ve seen some great results with both of them, so they can be used separately, in combination together and laser is not the only treatment. I do a lot of different things, and skincare is one of them, finding the right skincare and consistency with skin care is the biggest part of treating acne, besides doing the higher end procedures.”
For more information, click here: https://www.keywestsurgicalgroup.com/