Acne: When To See A Dermatologist

Acne is a common skin condition which affects more than 85% of adolescents, and up to 50% of adults. While prevalent, acne can be embarrassing and may contribute anxiety, depression and low-self-esteem. Treating acne can be very confusing as it comes in several different forms and can also vary in terms of severity.

While you can see a dermatologist for any acne issue, seeing a skin care professional may be the only way to address moderate to severe acne that does not respond to over-the-counter treatments. Here’s how to know when its time to see a dermatologist about your acne.

About Acne

Acne can occur anywhere on the skin where hair follicles and sebaceous glands are present. The cause of acne is multifactorial, often involving clogging of the hair follicle, increased oil production, and inflammation from bacteria. Acne may also be triggered by hormones or certain medications.

Acne can manifest in many different forms. For some people, acne clears up on its own over time or remains a minor, rare occurrence. For others, acne is persistent and may leave behind scars or discoloration even when skin lesions clear up.

A dermatologist can diagnose the root cause of your acne and offer treatment that goes beyond what over-the-counter remedies are capable of.

When is Acne Considered Severe?

Acne is considered moderate to severe if any of the following are true:

• Papules, pustules or cysts are numerous and extensive
• Your first blemishes occurred pre-puberty
• You have acne in unusual places, such as armpits, groin or thighs

When To See a Dermatologist for Acne

Severe acne is difficult to treat with over-the-counter remedies, and typically warrants a visit to a dermatologist. While there’s no reason to wait before calling your doctor, the following scenarios make it far more likely you’ll need dermatologic treatment.

Over the Counter Treatments Aren’t Working

Most people will use over-the-counter treatments before seeking professional assistance. Mild acne will generally go away in 4-6 weeks with OTC treatment such as cleansers, creams, serums, and spot treatments containing either benzoyl peroxide or salicylic acid.

Moderate to severe acne generally warrants medications and treatments that are stronger than what OTC products provide. A dermatologist can prescribe prescription-strength topicals or oral antibiotics to unclog pores, decrease oil production, and address skin bacteria.

Your Acne is Painful

Cystic acne is inflamed acne in the form of nodules that may or may not be pus-filled. Cysts can be soft or hard, and may be red or dark in color. Cystic acne extends deep under the skin, making it both painful and difficult to treat.

A dermatologist can address cystic acne in clinic by administering a corticosteroid injections directly into each lesion to help decrease inflammation. Following up with a prescription-strength skin care regimen reduces the severity of cystic acne and helps avoid future scarring.

You Notice Scarring or Discoloration Where Acne Has Cleared

Severe inflammatory acne damages can alter the skin structure. Damage to collagen can lead to several types of scarring. During the healing phase, skin may produce extra pigment leading to discoloration. These skin changes are long lasting and sometimes permanent.

A dermatologist will first help you get your acne under control to prevent future breakouts before addressing discoloration and scarring. Methods available to address acne scarring include dermal fillers, chemical peels, dermabrasion or laser resurfacing.

Your Acne Appeared (Or Got Worse) Within 6 Months of Starting a Prescription Medication

Prescription drugs such as hormones, steroids, antidepressants, and anti-anxiety medication may cause or worsen acne. Your doctor may be able to alter your prescription to reduce these unwanted side-effects.

If it’s not possible to stop taking your prescription medications, seeing a dermatologist can help get your drug-related acne under control.

Your Acne Affects Your Self-Esteem

No matter your age, acne can be an embarrassing condition that can make you self-conscious when out in public. Researchers have found the emotional, social and psychological effects of long-term acne are no different from the challenges presented by chronic illness.

If acne is preventing you from enjoying your life to the fullest, it’s time to see a dermatologist. With treatment, improvements in skin appearance help many people feel less self-conscious and more confident.

How a Dermatologist Can Help WITH Moderate to Severe Acne

Dermatologists can provide several professional strength acne medications or in-office treatments that are not available over-the-counter or for at-home use. Due to their strength (and subsequently the negative effects that can happen with improper usage), only a trained skin care professional can administer these types of treatments. Professional treatments for acne may include any combination of the following:

Prescription-Strength Topicals: Dermatologists can treat acne with stronger formulas of salicylic acid and benzoyl peroxide, as well as retinoid products such as tretinoin or Retin-A.

Antibiotics: Both topical and oral antibiotics are available to dermatologists for treating acne. Doxycycline and minocycline are commonly prescribed to reduce acne-causing bacteria.

Isotretinoin: Better known by its brand name, Accutane, isotretinoin is an oral medication that is used to treat severe cystic acne.

Chemical Peels: Chemical peels exfoliate skin, clearing pores of excess oil and other debris. Keeping pores cleared helps reduce the severity of acne. Chemical peels are also useful as a treatment for acne scarring.

Lasers and Light Therapy: Intense Pulsed Light (IPL), infrared light and other laser treatments improve acne in many patients. Which type of laser treatment is best for you depends on the type of acne you have.

A consultation with a dermatologist is the best way to determine which treatments options will be most effective to clear your skin.

Dr. Morgan Covington received her medical degree from the Pritzker School of Medicine at the University of Chicago. She completed her intern year training at Presence Resurrection Hospital and stayed in Chicago for her dermatology residency at the John H. Stroger Jr. Hospital. Dr. Covington is a member of the American Academy of Dermatology, Skin of Color Society, and Texas Medical Association.