Acne Vulgaris (Acne) & Acne Scarring
Due to a multitude of different reasons for getting acne, there are many forms of acne that one can experience. It is important to correctly identify which type of acne you have in order to come up with a helpful treatment and medication plan for you. By coming into the clinic, Dr. Kartono can adequately assess your situation and come up with a treatment plan for you!What is Acne Vulgaris?
Acne Vulgaris is a common skin condition that affects millions of people worldwide. It occurs when hair follicles get clogged with oil and dead skin cells, leading to the formation of pimples, blackheads, and whiteheads on the skin. Hormonal changes, particularly during adolescence, are often a major contributing factor to the development of Acne Vulgaris. Other factors that could cause acne are genetics, excessive sebum production, bacteria growth, poor skincare routines, and dietary habits.
What to Expect in the Clinic?
When you come into the clinic, we will ask you to describe how long you’ve had this condition and more details, such as if you’ve ever seen another dermatologist, gotten any treatments or medications in the past, where it is located, what has made it better or worse, any patterns you notice, and how frustrated you are. Please come prepared with a list of any over-the-counter treatments and prescriptions you have tried in the past or are currently using, including topicals and oral medications. We will take pictures to track your progress. What Can We Do?
We will go over every treatment you have tried in the past. Dr. Kartono will most likely prescribe medications, potentially both topically and orally. Dr. Kartono may also suggest a skin care routine that can be purchased over the counter, in combination with your prescriptions. If we have samples or coupons of her suggestions in the clinic, we will provide you with them. Routine use of your new skincare routine will be crucial in seeing improvement. Dr. Kartono may also suggest chemical peels, hydrafacials, blackhead extractions, or other treatments that are more typically regarded as cosmetic treatments, but can have medical benefits. 
Image sourced from DermNetTypes of Acne
Cystic Acne
Cystic acne is a severe form of acne characterized by deep, painful, and inflamed cysts. It is caused when bacteria, excess oil production, and dead skin cells clog pores, leading to the formation of large, tender nodules. While a quick solution may not be possible for cystic acne, seeking professional help is crucial. Dr. Kartono will help determine whether an oral medication, like Isotretinoin, or corticosteroid injections to reduce inflammation and prevent scarring are the best option for you.Fungal Acne
Fungal acne is caused by an overgrowth of yeast on the skin. This type of acne typically appears as small, uniform, itchy bumps. A quick solution for fungal acne includes using over-the-counter antifungal treatments, but prescription strength medication may be needed.Hormonal Acne
Hormonal acne occurs due to fluctuations in hormone levels, primarily androgens like testosterone, causing increases in oil production. This leads to clogged pores and the development of acne. Dr.Kartono may suggest hormonal therapies, oral contraceptives, or other oral medications to regulate hormone levels and reduce acne breakouts. Nodular Acne
Nodular acne presents as hard, painful bumps beneath the skin's surface. It usually occurs due to a combination of factors, including excess oil production, bacteria, and a buildup of dead skin cells. Dr.Kartono may suggest topical retinoids or prescribe antibiotics to kill bacteria and reduce inflammation. In severe cases, drainage or excision of the nodules is recommended.Blackheads
Blackheads small, dark bumps that appear on the skin, especially on the nose, chin, and forehead. They occur when hair follicles become clogged with excess oil and dead skin cells, creating a plug. When this plug is exposed to air, it oxidizes and turns dark, resulting in the characteristic black color. They can be caused by exposure to pollution, hormonal changes, and improper skincare routines can contribute to their formation.
Papules
Papules are small raised bumps on the skin that range from pink to red, or even brown. Papules can be due to acne outbreaks, insect bites, or allergic reactions, and are caused by inflammation of the skin, resulting in the build-up of excess oil, dead skin cells, or bacteria within the hair follicles.
Pustules
Pustules are small, inflamed bumps that contain pus, caused by bacterial or fungal infections. Pustules often occur when hair follicles become clogged with excess oil, dead skin cells, and bacteria, resulting in painful and inflamed eruptions on the skin's surface.
Whiteheads
Whiteheads are raised bumps that are usually white or flesh-colored. They occur when the pores become clogged with excess oil, dead skin cells, and bacteria. The buildup of these substances blocks the pore, preventing the oil from flowing freely and causing it to accumulate underneath the surface of the skin. Whiteheads can be caused by various factors including hormonal changes, genetic predisposition, improper skincare routine, and certain cosmetics.
Important Information about Treatments and Medications
Orals That Require Bloodwork
For cases of acne vulgaris that are more severe or unresponsive to other treatments/medications, Dr. Kartono may prescribe stronger medications, such as Spironolactone or Isotretinoin (Accutane). These oral medications require blood work throughout the course of treatment, to ensure that you are not experiencing side effects during the treatment period. Blood work will also be required before and after treatment, to ensure that you are a good candidate for the medication and to effectively finish treatment. Those on these medications cannot get pregnant, so we will also need to perform pregnancy tests in office. In special cases, pregnancy test results can be sent to us over email. For some of these stronger medications, the repercussions of becoming pregnant are severe, requiring two forms of birth control. Dr. Kartono and her staff will go over all side effects, risks, and specifics regarding these medications, as well the instructions to use iPledge, a system that monitors the correct use of Isotretinoin (Accutane). Hydrafacials
This treatment gently exfoliates, revealing a new layer of healthy skin. It removed debris from pores, hydrates, and nourishes skin, leaving a healthy glow.VI Peel
This form of chemical exfoliation suppressed pigmentation and minimizes stubborn post-acne scars, while promoting rapid cell turnover to reveal a more even and bright skin tone. It helps clear away dead skin cells and excess oil to speed breakout cleaning and purify pores. Microneedling
This treatment helps to stimulate the body to make more collagen and elastin, to promote healing of the skin. Over time, you will notice smoother, firmer, and more even skin.Good Skin Care Routines !!
prevention starts with a good skin care routine !
wash twice a day with a mild, gentle cleanser
make sure your facial products are labeled “noncomedogenic'“ or “oil-free”
use an over-the-counter acne cream or gel to help diminish blemishes and prevent future breakouts
don’t over exfoliate (it can cause more damage than good)
if your acne doesn’t improve after several weeks of consistent at-home treatment, seek the help of a dermatologist
it's crucial to avoid squeezing or picking at acne, as it can worsen inflammation and increase the risk of scarring.
Benzoyl Peroxide vs. Salicylic Acid
Prevention is key, but regular exfoliation combined with the use of skincare products containing salicylic acid or benzoyl peroxide can help. These ingredients help unclog pores and reduce the production of oil, promoting a clearer and smoother complexion.
Benzoyl Peroxide kills acne causing bacteriaa good product for people with inflammatory/hormonal acne, such as papules, pustules, and cystsmore likely to dry you out
Salicylic Acid clears out pores using BHA (Beta-Hydroxy Acid), and removes any dirt, oil, and dead skin cells that cause blackheads and white headsless likely to cause irritationbetter for sensitive & oily skin types
Let’s Talk About Acne Scarring
Scars that result from acne can be painful and emotionally hard to maintain on your face. What To Do
The first major step in treating acne scarring is scheduling a consultation with a healthcare professional who has experience with treating acne scarring. They will be able to make a recommendation depending on the severity of scarring. Whether it is starting with over-the counter products, prescribing medication, or opting for more invasive laser treatments or cosmetic procedures, Dr. Kartono can help you. Our office offers multiple services that can help exfoliate your skin, help with discoloration, and treat scarring. Everyone’s skin is different, so it is important to get a professional recommendation tailored to your skin type. You do not want to cause more damage to your already sensitive skin!Take a look at what Dr. Kartono had to say in The ‘Ville, Edition from April 2022, Northville’s News and Lifestyle Magazine