The Dermatology Center of Long Island

Dr. Joel L. Lamm

Board Certified Dermatologist

516-933-1717

The Dermatology Center of Long Island

Dr. Joel L. Lamm

Board Certified Dermatologist

516-933-1717

400 S. Oyster Bay Road
Hicksville, NY 11801

OFFICE OPENING BEGINNING MAY 18, 2020
Dr. Lamm will be available on Monday, Wednesday and Thursday afternoons.
Please call the office to schedule your appointment.
The receptionist will go over our safety procedures.

Acne

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group. Adults in their 20s – even into their 40s – can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.

Here is a brief summary of definitions of words used to describe acne (from the American Academy of Dermatology):

Lesion

A lesion is a physical change in body tissue caused by disease or injury. A lesion may be external (e.g., acne, skin cancer, psoriatic plaque, knife cut), or internal (e.g., lung cancer, atherosclerosis in a blood vessel, cirrhosis of the liver).

Comedo (Plural Comedones)

A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead; its appearance is that of a skin-colored or slightly inflamed “bump” in the skin. The whitehead differs in color from the blackhead because the opening of the plugged sebaceous follicle to the skin’s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria.

Papule

A papule is defined as a small (5 millimeters or less), solid lesion slightly elevated above the surface of the skin. A group of very small papules and microcomedones may be almost invisible but have a “sandpaper” feel to the touch. A papule is caused by localized cellular reaction to the process of acne.

Pustule
A dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A pustule that forms Over A Sebaceous Follicle Usually Has A Hair In The Center. Acne Pustules That Heal Without Progressing To Cystic Form Usually Leave No Scars.

Macule
A macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border. A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the “inflamed face” appearance of acne.

Nodule

Like a papule, a nodule is a solid, dome-shaped or irregularly-shaped lesion. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin.

Cyst

A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into deeper layers of the skin, may be very painful, and can result in scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Some acne investigators believe that true cysts rarely occur in acne, and that (1) the lesions called cysts are usually severely inflamed nodules, and (2) the term nodulocystic should be abandoned. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing.

Who Gets Acne?
Nearly everybody between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple, regardless of race or ethnicity. Many of these young people are able to manage their acne with over-the-counter (nonprescription) treatments.

For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician.
In most cases, acne starts between the ages of ten and thirteen and usually lasts for five to ten years. It normally goes away on its own sometime in the early twenties. However, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults.

Acne affects young men and young women about equally, but there are differences. Young men are more likely than young women to have more severe, longer lasting forms of acne. Despite this fact, young men are less likely than young women to visit a dermatologist for their acne. In contrast, young women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics.

These kinds of acne may afflict young women well into adulthood.
Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, scalp, and upper arms and legs.

Acne Treatment

How Should Acne Be Treated?
The appropriate treatment for acne depends on the severity. Options may include

Mild Over-The-Counter Treatments

There are many types of OTC ingredients that treat at least one of the underlying factors that cause acne. Here are the most common OTC active ingredients and their benefits and limitations. Some of the more effective OTC products include Benzoyl Peroxide, Salicylic Acid (also known as Beta Hydroxy Acid), Sulfur, Alpha Hydroxy Acids (AHAs) and Retinol.

Accutane Treatment: Isotretinoin (trade name: Accutane) is a powerful drug used in the treatment of acne. Four to five months of Accutane treatment usually leads to clearing of acne. It is a potent medication that is very effective for nearly all types of breakouts. Accutane is needed for moderate to severe acne that has failed other treatments. It should be used for a severe, scarring acne. Is also used for acne present for many years that has not respond completely to antibiotic pills and creams. While it has many side effects, in some ways it is safer than long-term antibiotic usage. Most other acne-controlling medicines are antibacterial agents, which are effective only if used daily.

Laser/Light Therapy Treatments: Acne laser/light therapy, is a pain-free way to get rid of blemishes on acne-prone skin. It does not zap like a laser, but it kills acne bacteria and shrinks oil-producing glands to give skin a chance to recover on its own. In laser/light therapy, an intense but gentle beam of light is used to treat acne scarring without damaging surrounding tissue. Pain and recovery time is minimal, procedure is non-invasive and it works best in combination with other acne treatments.

Dr. Joel L. Lamm

Board Certified Dermatologist

516-933-1717

400 S. Oyster Bay Road
Hicksville, NY 11801

OFFICE OPENING BEGINNING MAY 18, 2020
Dr. Lamm will be available on Monday, Wednesday and Thursday afternoons.
Please call the office to schedule your appointment.
The receptionist will go over our safety procedures.

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info@lammdermatology.com

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