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Prescription Acne Medication
Microdermabrasion has become an increasingly popular prescription acne medication provided in beauty salons and spas, and dermatologists also perform the procedure. Sometimes referred to as "dermapeeling," it has long been popular in Europe, gaining a foothold in the United States and other countries over the last few years.
With microdermabrasion, the thinnest, outermost layer of skin is stripped off with a machine that sprays sand-like crystals of aluminum oxide on the face and then vacuums them up. The process creates an extremely superficial wound-approximately 1/10,000th of a millimeter in depth (thinner than a sheet of paper).
"One of the main benefits of microdermabrasion is the ability to create controlled, superficial removal of skin, allowing each patient to receive a custom treatment that is deeper in areas of more severe damage," says Dr. Mark Rubin, an associate clinical professor of dermatology at the University of California, San Diego.
The procedure is virtually painless, so no anesthesia is required. You'll experience mild redness for a few hours afterward. Usually, patients require four to eight treatments, scheduled every 1 to 3 weeks, Dr. Rubin explains.
"This is truly a lunchtime peel, in that it can be done in 15 to 20 minutes, with minimal preparation time," he says. "What we're accomplishing with microdermabrasion is not only removing some of the damaged skin, but stimulating new cell growth, as well. Research has shown that repetitive, superficial abrasions can create significant new cell growth. Microdermabrasion takes advantage of this response by allowing patients to gradually resurface their skin without the downtime and risk of more aggressive prescription acne medications"
Before undergoing any procedure, make sure the provider is qualified. Ask about credentials and how many procedures he or she has performed. Ask to see "before" and "after" pictures. Also ask about recovery time, and if the provider is vague, be suspicious. Lastly, ask what happens if the procedure does not meet your expectations.
Don't confuse dermabrasion with microdermabrasion. While it has been around for more than 100 years, dermabrasion is much more intense and must be performed by a dermatologist.
Dermabrasion is a skin-resurfacing technique designed to eliminate deep acne scars ("ice-pick" scars or craters), heavy wrinkles and disfiguring rosacea. As with microdermabrasion, the skin is mechanically sanded, but the physician goes much deeper, penetrating more layers of skin. Once layers are removed, newer, healthier layers replace them, creating a smoother appearance.
Dermabrasion requires local anesthesia for pain control, and patients experience a mild burning feeling for several days afterward. Dermatologists will generally use semi-permeable dressings over the abraded area, which allow moisture and air to reach the skin. At first, the skin appears pink, but its normal color is ultimately restored. Total healing occurs within two weeks, and patients must wear sunscreen with an SPF of 15 (or higher) to protect their skin.
"While newer laser resurfacing treatments and microdermabrasion can be used for superficial facial lesions and defects, dermabrasion is still the best treatment available for deeper scarring," says Dr. Christopher B. Harmon, a clinical instructor of dermatology at the University of Alabama, Birmingham. "Dermabrasion is an excellent alternative for patients whose skin may not respond well to laser resurfacing. Utilizing dermabrasion instead of laser resurfacing can avoid unwanted scarring, loss of normal skin pigmentation, skin redness and dryness, which may be the result of excessive thermal injury.
"While acne may have long ago faded, the disfiguring scars can last a lifetime if untreated," he adds. "The wire brush used to sand the skin in dermabrasion can sculpt away the sharp edges of these scars."
Dermabrasion is also used to treat rhinophyma, the bulbous nose some rosacea patients develop. Dermatologists use dermabrasion to restore the nose to its normal shape and size.
"It's important that patients understand the advantages and disadvantages of all resurfacing procedures in order to achieve optimal results," Dr. Harmon emphasizes. "The dermatologist and dermatologic surgeon are the most qualified to answer questions and perform any type of resurfacing procedures. If you're concerned about the experience of the individual performing your resurfacing, be sure to ask about their qualifications."
Prescription Acne Medication: Peels
Glycolic acid peels are effective in treating acne. Glycolic acid is an alpha hydroxy acid (AHA) that helps reduce the amount of sebum trapped in the follicles. Glycolic acid peels exfoliate dead layers of skin and, typically, require no downtime. These peels are performed every two to four weeks in a series of four to eight sessions.
Betahydroxy acid (BHA) peels-including salicylic acid peels-are more powerful when it comes to unclogging pores and smoothing the complexion. You may experience a slight sensation of tingling or burning after a peel, as well as some redness. If the feeling worsens, be sure to alert your dermatologist. Skin may require additional prescription acne medication if peeling is excessive or skin is overly inflamed. In the future, your doctor or esthetician may want to try a different type of peel, with a lower concentration of acid.
Laser therapy is one of the newest cutting-edge approaches in prescription acne medication. What happens during a typical appointment?
"Clients come in for a consultation with our clinic manager to review their concerns and the benefits of our treatments," says Dr. Kathleen Gilmore, medical director for American Laser Centers. "Afterwards, they schedule their first treatment. If they have been on Retin-A, they need to stop using it for two weeks before starting laser therapy, and if they have been on Accutane, they must discontinue its use three months before starting laser therapy, as it causes thinning of the skin."
Be sure to show up for your appointment without makeup, creams or lotions on your face (or whichever area will be treated). Before treatment begins, the staff will take photographs of the area in question, and you'll be placed on the treatment table.
"The client is given protective eyewear, an inert gel is placed in the area to be treated, the laser probe is applied to the skin, and a pulse is delivered," Dr. Gilmore explains. "Even though you're wearing eye protection, you will perceive a sense of light with each pulse. You may feel a slight touch or snapping sensation with the pulse. Most patients don't feel anything at all during the treatment.
"Once one segment of the face is treated, a cooling pack is applied for a few minutes to that area to draw out the heat. After the entire face has been treated and cooled, then a hydrating, noncomedogenic, post-laser lotion is applied to the face by the technician. Important post-treatment and pre-treatment instructions are reviewed with the client. Most importantly, the client is instructed to use a high-strength sun block and to avoid tanning before and after each treatment. Skin care is reviewed, and clients may then make an appointment for their microdermabrasion treatment for two weeks following their laser treatment."
Skin rejuvenation is performed every four weeks, according to Dr. Gilmore. Microdermabrasion is performed two weeks after each skin rejuvenation treatment.
"Many clients notice improvement after the first treatment," she says. "However, the best results are on completion of six treatments."
Laser skin rejuvenation can help eliminate mild acne scarring and surface irregularities caused by a history of acne, Dr. Gilmore notes.
"We presently don't provide laser skin rejuvenation treatment for persons with brown and black skin," she adds. "The higher amount of pigment in the skin places them at too high a risk for burns or thermal injuries. We provide microdermabrasion to help even minor imperfections as a result of acne."
See Appendix II, located at the end of this book, for a Product Resource Guide from American Laser Centers.
Prescription Acne Medication: Light Treatment
The ClearLight is a device that uses high-intensity, ultraviolet-safe blue light to safely penetrate the skin and eradicate propioni bacteria.
This noninvasive treatment is nonirritating, and patients experience no downtime. Results are generally seen after 12 weeks of treatment (two treatments per week).