Source: American Academy of Dermatology (AAD)

Released: Thu 19-Oct-2000, 00:00 ET  Embargo expired: Wed 18-Oct-2000, 12:00 ET  Printer-friendly Version

Eliminating Physical and Emotional Scars of Acne

Contact:
Missy Gough, (847) 240-1734
mgough@aad.org

Karen Klickmann, (847) 240-1735
kklickmann@aad.org

Jennifer Gale, (847) 240-1730
jgale@aad.org

EMBARGOED UNTIL OCTOBER 18, 2000

TREATMENT THE KEY TO ELIMINATING THE PHYSICAL AND EMOTIONAL SCARS OF TEENAGE ACNE

NEW YORK (October 18, 2000) -- Teenage acne has generally been viewed as a normal rite of passage from adolescence to adulthood. Because of its visibility and its occurrence during a difficult time of social development, acne may often have a devastating effect on a teenager's self-confidence and self-esteem. When severe, untreated acne can result in disfiguring scars.

"Acne does not have to be an inevitable part of growing up," stated dermatologist Stephen Mandy, M.D., Clinical Professor of Dermatology, University of Miami, Miami, Florida, speaking today at the American Academy of Dermatology's Derm Update 2000. "Acne is a treatable medical condition, that if left untreated, can last well beyond the teenage years. The only way to prevent the physical and emotional scarring from acne is to treat the condition before it becomes advanced."

The Science of Acne

Acne is a chronic inflammatory skin condition which affects 85 percent of all teenagers, more than 20 million teens nationwide. In approximately 30 percent of these individuals, acne will persist into adulthood. Lesions are often found on the face, but may also be present on the back and chest.

Acne is the result of a sequence of genetic and hormonal events that begin with the onset of puberty. As hormone levels associated with the development of secondary sexual characteristics rise, oil production in the sebaceous glands of the face, back, and chest increase. In genetically susceptible individuals, this leads to a thickening of the lining of the wall of the duct of the oil gland, a process called follicular hyperkeratosis. This thickening ultimately leads to a blockage of the duct and subsequent accumulation of oil beneath the skin in lesions called comedones, which are commonly referred to as blackheads. Bacteria, known as corynebacterium acnes, proliferate within these comedones and produce free fatty acids which are very irritating to the skin. Allowed to proceed, this process can lead to pustular and cystic lesions which can rupture and leave scars.

Acne Treatments

"While there is no cure for acne, there are a variety of effective treatments which can control the sequence of events which cause acne," stated Dr. Mandy. "A patient's dermatologist can determine the appropriate therapy depending on the severity of the problem and the sensitivity of the skin."

Topical comedolytic agents, such as tretinoin, adapalene, azelic acid, and tazarotene, correct the follicular hyperkeratosis - or the plugged oil ducts. Antibacterial agents, including benzoylperoxide alone or in combination with antibiotics such as erythromycin or clindamycin, are added to comedolytic agents to address the corynebacterium.

In severe acne cases, where topical therapy may be inadequate, systemic therapy may be prescribed. "Oral tetracycline is most commonly used, but systemic therapy may also include other antibiotics, hormone therapy in women, and when necessary, isotretinion," explained Dr. Mandy.

Isotretinoin is an oral medication that decreases oil production by shrinking the oil glands. Studies have shown that when isotretinoin is taken over a 20-week period, 80 percent of patients will have a complete resolution of their acne, in most cases, permanently. "Yet this drug must be used with extreme care," warned Dr. Mandy. "Since isotretinoin causes birth defects, women of child-bearing age must take the utmost precautions to prevent pregnancy during this therapy. In addition, there are other potential side effects which require routine monitoring by the patient's dermatologist during the treatment period."

Acne Scarring

When acne treatment begins too late or is inadequate, scarring is often the outcome. Fortunately, dermatologic surgery provides more safe and effective treatments for acne scarring than ever before.

"Dermabrasion, the mechanical sanding of the upper layers of the skin, is quite effective in improving scars," stated Dr. Mandy. "With this procedure, a new layer of skin replaces the abraded skin during healing, resulting in a smoother appearance." Dermabrasion is usually performed once and most patients heal within one week.

The use of lasers has also had a significant impact in the treatment of acne scarring. The Erbium:YAG laser, which emits light through short bursts of energy that is absorbed by the water in the skin, allows for very precise sculpting of irregular scars. Patients usually recover from the procedure in three-to-five days and experience a short duration of post-surgery redness.

The CO2 laser works well for elevating depressed scars that give the skin a crater-like appearance. Since the CO2 laser produces more heat than the Erbium:YAG laser, it allows the energy emitted to penetrate deeper into the skin and tighten the skin's collagen fibers. By tightening the collagen fibers, the CO2 laser causes depressed scars to elevate and normalize in appearance. In most cases, only one treatment is required to produce permanent results with either the Erbium:YAG or CO2 laser.

"It is important for teenagers and their parents to realize that both acne and acne scarring are treatable medical conditions," stated Dr. Mandy. "Early and ongoing therapy may reduce, and even prevent, the physical and emotional toll of this common skin condition."

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of over 13,000 dermatologists worldwide, the Academy is committed to: advancing the science and art of medicine and surgery related to the skin; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care; and promoting a lifetime of healthier skin, hair and nails. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.

The American Society for Dermatologic Surgery (ASDS) was founded in 1970 to promote excellence in the field of dermatologic surgery and to foster the highest standards of patient care. For more information on cosmetic skin surgery and referrals to doctors in specific geographic areas, please contact the ASDS Consumer Hotline, 1-800-441-ASDS (2737), during weekday business hours or visit our Web site at www.asds-net.org.

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