Acne Overview

Acne is a condition resulting from the action of hormones on the skin’s oil glands making them “overactive”, which leads to plugging of skin cells within the pores. Microorganisms can get into the pores, the result can be swelling, redness, and pus. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Approximately 80% of all teens have acne nationwide with a noticeable jump in prepubescence. Although acne is not a serious health threat, severe acne can lead to low self-esteem, depression and permanent scarring.

At Abrams Dermatology, we understand how frustrating acne can be for teens and adults alike. We have a variety of treatment modalities available and will work with you to build a skin care regimen that treats your acne while helping to improve the overall health of your skin.

We realize that there is no single solution for all cases of acne and that each individual’s skin care needs change over time. We will evaluate your condition on a regular basis and adjust your treatment program as needed.

Acne Causes

There are four basic steps involved in the development of an acne lesion.

  • Hair follicles become blocked with an overabundance of normal skin cells. These cells combine with sebum (an oily substance that lubricates the hair and skin), creating a plug in the follicle.
  • The glands that produce sebum, known as sebaceous glands, enlarge during adolescence and sebum production increases. Numerous sebaceous glands are found on the face, neck, chest, upper back, and upper arms.
  • The increase in sebum production allows for the overgrowth of bacteria that normally lives on the skin.
  • Bacterial overgrowth causes local inflammation, which causes rupture of the follicle. This can lead to the formation of a red or tender pimple.

Hormonal changes during adolescence cause the sebaceous glands to become enlarged and sebum production increases. In most people with acne, hormone levels are normal, but the sebaceous glands are highly sensitive to the hormones.

Less often, women’s hormone levels are affected by an underlying medical problem known as polycystic ovary syndrome (PCOS).

Acne tends to resolve between ages 30 to 40, although it can persist into or develop for the first time during adulthood. Post-adolescent acne predominantly affects women, in contrast to adolescent acne, which predominantly affects men. Acne can flare before a woman’s menstrual period, especially in women older than 30 years.

Oil-based cosmetics may contribute to the development of acne. Oils and greases in hair products can also worsen skin lesions. Water-based or “non-comedogenic” products are less likely to worsen acne.

People with acne often use soaps and astringents. While these treatments remove sebum from the skin surface, they do not decrease sebum production; frequent or aggressive scrubbing with these agents can actually worsen acne.

The role of diet in acne is controversial. Some studies have found associations between cow’s milk and an increased risk of acne, perhaps because of hormones that occur naturally in milk. However, there is no strong evidence that high-fat foods or chocolate increase the risk of acne.

Psychological stress can probably worsen acne. In several studies of students, acne severity appeared to worsen during times of increased stress.

Acne Treatments

There is no single best treatment for acne, and combinations of treatments are sometimes recommended. Since acne lesions take at least eight weeks to mature, you should use a treatment for a minimum of two to three months before deciding if the treatment is effective.

Acne: Detoxing treatments penetrate pores to clear blemished skin

Teen/Acne Detox Treatment

An active blend of lactic, glycolic and salicylic acids penetrate pores to dissolve impaction and black-heads, kill bacteria, reduce inflammation and remove excess cell debris to leave skin hydrated, purified and clear. Custom deep pore cleansing with steam, extractions, clearing mask and acne control serum for teen or adults.

Obagi Blue Peel RADIANCE™

The Blue Peel Radiance offers a unique blend of acids to provide a gentle but effective peel resulting in tighter, smoother, brighter looking skin immediately after just one treatment. Used to improve a wide range a skin conditions including acne, scarring, photo-damage and melasma.

Ematrix Acne Treatment

The eMatrix treatments for acne involves minimal downtime and patients don’t need to limit their activities following a treatment. The ematrix acne treatment is a clinically proven, safe, effective acne treatment. It reduce sebaceous gland activity and destroy active acne. The e Matrix uses significantly less energy than conventional lasers and IPLs. This treatment focuses on the areas to be treated. We recommend 3 treatments for best results. This treatment is highly effective in reducing acne scar and improving skin texture. A full-face treatment takes about 20 minutes, during which you may feel some heat or a prickly sensation. Most patients need three treatments, each spaced about a month or six weeks apart. You should begin to see results after the first treatment, and your face will continue to show improvements for up to one year after your last treatment.

Skin care is an important aspect of acne treatment.

Wash your face no more than twice daily using a gentle non-soap facial skin cleanser (eg, Cetaphil®, Oil of Olay® bar or foaming face wash, or Dove® bar) and warm (not hot) water. Some providers recommend avoiding use of a washcloth or loofah, and instead using the hands to wash the face. Vigorous washing or scrubbing can worsen acne and damage the skin’s surface.

Use of a moisturizer minimizes dryness and skin peeling, which are common side effects of some acne treatments. Moisturizers that are labeled as “non-comedogenic” are less likely to block skin pores.

Some acne treatments increase the skin’s sensitivity to sunlight (eg, retinoids, doxycycline). To minimize skin damage from the sun, avoid excessive sun exposure and use a sunscreen with SPF 15 or higher before sun exposure.

Some acne treatments increase the skin’s sensitivity to sunlight (eg, retinoids, doxycycline). To minimize skin damage from the sun, avoid excessive sun exposure and use a sunscreen with SPF 15 or higher before sun exposure.

If you have mild acne, you can try to treat yourself with non-prescription products initially. Non-prescription acne treatments may include salicylic acid, benzoyl peroxide, sulfur, alpha hydroxy acids, or tea tree oil, all of which are available in non- prescription strengths. A combination of these treatments may be more effective than using one single product alone.

Noninflammatory acne causes whiteheads or blackheads without redness or skin swelling

Topical retinoid medications are often recommended for noninflammatory acne. Examples of these medications include tretinoin , adapalene, and tazarotene .

Retinoids are usually applied once per day, although people who develop skin irritation can reduce this to every other day or less, then increase as tolerated over time. Most people become more tolerant of retinoids over time.

Most retinoids are available in a gel or cream. People with oily skin may prefer gels because they have a drying effect, while people with dry skin may prefer a cream.

Retinoids can cause skin irritation. While using topical retinoids, you should apply a sunscreen with SPF 15 or greater before sun exposure.

People who cannot tolerate retinoids may try other topical medications, such as salicylic acid, glycolic acid, or azelaic acid. All of these treatments can be helpful in reducing noninflammatory acne, and azelaic acid may reduce acne-related darkening of skin.

Mild to moderate acne with some inflammation is usually treated with topical retinoids, topical antibiotics, or benzoyl peroxide.

A combination of two medications, usually benzoyl peroxide with a topical antibiotic or retinoid is more effective than treatment with one agent alone.

Benzoyl peroxide is usually applied twice per day. It may be combined with a topical retinoid, in which case the benzoyl peroxide is applied in the morning and the retinoid is applied at night. Benzoyl peroxide can irritate the skin, sometimes causing redness and skin flaking, and it can bleach clothing, towels, bedding, and hair.

Topical antibiotics (creams or liquids) control the growth of acne bacteria and reduce inflammation. Topical antibiotics include erythromycin, clindamycin, sodium sulfacetamide, and dapsone.

For people with moderate to severe inflammatory acne, oral antibiotics or an oral retinoid known as isotretinoin  may be recommended. Topical medication may be used in combination with oral treatments.

Oral antibiotics work to slow the growth of acne-producing bacteria. However, oral antibiotics can have bothersome side effects, including vaginal yeast infections in women and stomach upset.

Oral isotretinoin is a potent retinoid medication that is extremely effective in the treatment of severe acne. It cures acne in nearly 40 percent of people for life, with the remaining 60 percent of people needing further treatment with topical or oral medications. Oral isotretinoin is effective in treating the most disfiguring effects of acne.

Oral isotretinoin is usually taken in pill form twice daily with food for 20 weeks, then stopped. In some cases, acne can initially worsen before it improves. After treatment is stopped, improvement can continue for up to five months.

The hormone estrogen can help to offset the effect of androgens (hormones responsible for acne development). Estrogen treatment in the form of a birth control pill is sometimes recommended for women with moderate or severe acne.

Not all oral contraceptives should be used for the treatment of acne; some can actually worsen acne. Discuss the best options with your healthcare provider.

Other medications are available to reduce the effects of androgens in women, including spironolactone. Spironolactone can cause high blood levels of potassium, and monitoring of potassium levels and blood pressure is usually recommended.

The benefits of birth control pills and other hormonal medications may not be noticeable until three to six months after treatment is started.

Many acne treatments are not safe for use during pregnancy. Women who are pregnant or intending to become pregnant should consider stopping all acne treatments before becoming pregnant. If acne therapy becomes necessary, discuss the options with your healthcare provider.


(941) 926-2300
(866) 271-8796




Monday - Thursday

8:30 am – 4:30 pm


8:30 am – 1:30 pm


3328 Bee Ridge Road
Sarasota, FL 34239

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