by Dr. Kathryn Rawdan
Thought acne was just for teenagers? Ever wonder why you can’t get rid of your acne even with some professional help? It’s time to break the love-hate cycle with your skin. There are so many reasons why acne treatments fail but I have chosen three very common reasons I see most often in my practice of aesthetic medicine.
But first, what is acne and why is it important to treat it?
Acne vulgaris is the number once most prevalent dermatologic skin condition. Acne is an inflammatory condition of the skin caused by increased sebum (oil) production and abnormal keratinization leading to the characteristic lesions that we call black heads (open comedones), white heads (closed comedones), nodules and/or cysts. These lesions can cause severe scaring and lead to increased pigmentation.
The appearance of active skin lesion and residual scaring left behind can have a major impact on a person’s self-esteem, confidence, and overall well-being. Many report that they have avoided social events, have had difficulty maintaining eye contact in conversations and have felt too unattractive to date or engage in close relationships because of their acne.
There are 3 common reasons why your acne just isn’t getting better:
- Using the wrong products
- Improper duration of treatment
- Incorrect diagnosis
The correct acne treatment is based on acne severity which brings us back to the number one reason why your acne treatment is failing: using the wrong products. Topical therapy is the standard of care for mild to moderate acne. With so many options available over the counter in various stores it’s no wonder why the wrong products are often selected and therefore fail.
Acne is classified by the type of skin lesions, location and number of skin lesions, presence or absence of scaring. Acne is diagnosed clinically and treated most effectively by a skin care professional and severe acne should be treated by a physician who specializes in treating disorders of the skin and or a dermatologist. If you have been struggling with acne and are using over-the-counter products without success you are most likely using the wrong products or combination of products. Acne treatments target the different steps involved in the pathogenesis or how the condition develops. Combination therapy is most effective however the products need to be applied at separate times unless they are known to be compatible. You need to see a skin care expert and receive a proper diagnosis and individualized treatment plan.
Reason number two why acne is not getting better (or even gets worse!)
Unfortunately, even with the proper treatment plan, acne does not improve due to our own impatience and desire for rapid results. Let’s admit it; we are obsessed with instant gratification. When it comes to acne treatment, consistency and longevity of use with prescribed regimens is key! It is common that the appearance of the skin may appear to get worse before it gets better due to lesions coming to the surface quicker as part of the healing or purging process.
When patient’s do not see improvement within a week or two, or there may be some irritation and or redness they often abandon the treatment plan and become convinced that the regimen will not work for them. Feelings of frustration and hopelessness ensue as they begin to believe that nothing will work for them; just like so many times before…
It is important if not crucial to understand that the skin is an important and dynamic organ responding to both internal hormonal signals and external environmental factors. Most topical treatments require at least 8 weeks before improvement is seen and they may need to be continued for years as needed.
Moving on to the third reason acne may not be improving with treatment; the skin condition is not in fact acne at all! Different variants of acne do exist but there are numerous skin conditions often mistaken for acne. The most common condition mistaken for acne is rosacea but there are many other skin conditions including perioral and or perinasal dermatitis, keratosis pilaris, hydradenitis supprativa just to name a few.
Acne products when used for the wrong condition can exacerbate the problem and worsen the appearance of the skin. Depending on severity of acne patient’s may require prescription products both topical and or oral therapies.
If you have struggled and failed to get your acne under control book a skin consultation with Keowee Aesthetics today.
Gollnick H, Cunliffe W, Berson D, et al. Management of acne: a report from a global alliance to improve outcomes in acne. Journal of American Academy of Dermatology 2003;49 (Suppl 1):S1-37
Hull PR, D’Arcy C. Isotretinoin use and subsequent depression and suicide. American Journal of Clinical Dermatology 2003;4:493-505
“Is that stubborn acne really acne?”. American Academy of Dermatology 2022. www.AAD.org.
Magin P, Adams J, Heading G, et al. Psychological sequelae of acne vulgaris; results of a qualitative study. Can Fam Physician 2006;52:978-9
Magin P, Pond D, Smith W, et al. A systemic review of the evidence for ‘myths and misconceptions’ in acne management: diet, face-washing and sunlight. Fam Pract 2005:22;62-70
Ozolins M, Eady EA, Avery AJ, et al. Comparison of five antimicrobial regimens for the treatment of mild to moderate inflammatory facial acne vulgaris in the community: randomized controlled trial. Lancet 2004;364:2188-95
Wolverton SE. Comprehensive dermatologic drug therapy. 2nd Ed Philadelphia:WB Saunders;2007