Acne Treatment in Walnut Creek

How I Treat Acne

The order below is the usual one. It is adjusted to you — to the type of acne, to how long you have had it, and to what you have already tried.

1. Medical-grade topicals: salicylic acid and benzoyl peroxide.
2. Prescription topicals: antibiotics and retinoids.
3. Oral treatment where it is needed: antibiotics and, in selected cases, isotretinoin.

For scarring, once the active acne has settled, I use microneedling to even out the texture and prompt the skin to rebuild beneath.

Erbium laser resurfacing is also an option for acne and acne scars in selected cases.

Any over the counter products must be discontinued as these often contain ingredients that actually aggravate your acne.

Who I Treat, and Who I Refer

I treat adults and teenagers. There is no age at which I say no in advance; whether treatment is right, and which treatment, is decided at the consultation once I have seen your skin. Acne that resists treatment, including fulminant acne, is referred to a specialist. I would rather refer you early than keep you on a plan that is not working.

What Acne Is

Acne is a skin condition that is brought on by many different causes mainly the overproduction of a natural moisturizing oil called sebum. Sebum is secreted through your hair follicles, and these narrow pathways can easily become clogged, creating bumps on the surface of the skin. These bumps produce a desirable environment for overproduction of bacteria that can secret irritating material. Both bacterial overproduction and the material they secret can be highly irritating to the surrounding skin resulting in significant inflammation and scarring. Effective acne treatments focus on addressing these underlying issues to reduce inflammation, prevent scarring, and restore healthy skin.

The Types of Acne

Whiteheads

Medically labeled as Closed comedones, these are small, whitish or flesh-colored bumps and spots. Typically, closed comedones have a white, circular center surrounded by a reddish halo. Whiteheads usually don’t cause scarring.

Blackheads

Blackheads are also referred to as open comedones. These are small, black or dark-colored spots that typically appear as slightly raised bumps. The center of the blackhead is darker than the surrounding area.
Blackheads sometimes have the appearance of exposed dirt, but in reality, these are open whiteheads. When the interior of these open comedones is exposed to the air, they darken or turn black.

Inflammatory acne

Inflammatory acne blemishes include:

Pustules

These are large and have a well-defined center. This center is filled with white or yellow pus from an overabundance of bacteria or bacterial infection.

Papules

Smaller than pustules, these have no discernable center and appear as solid bumps under the skin’s surface. They are tender to the touch and usually appear with the surrounding skin swollen and red.

Nodules

Look Like larger papules, they are inflamed deep under the skin and painful to the touch. Nodules are a signal that the deeper layers of skin are clogged. These are known to cause a darkening of the skin or scarring.

Cysts

Like nodules, cysts exist deep within the skin layers; they grow very large and are soft and painful to the touch. Cysts require treatment with antibiotics.
Inflammatory acne is a more severe form of acne, likely to cause complications, such as scarring or pitting.

When You Will See a Response

How Long Will it Take to See Results After Acne Treatment?

It depends on the severity, type of acne, adherence to instructions and presence of other factors including but not limited to other associated medical conditions. If this is your first time getting treated for acne and your acne is not severe, typically you will see a response within weeks of starting treatment.
Occasionally several different factors are involved in acne and will need to be addressed one at a time. In such cases, although you would see a response in a month or so, you would probably need further follow up to make sure all aspects of what is making your acne worse are evaluated and treated.
Treating acne is a process rather than a one time remedy. The intensity of treatment for acne does not need to stay the same and frequently needs to be increased or decreased depending on the circumstances. Most of the time a maintenance treatment regimen can be instituted that will maintain your skin’s health for the long term. Unfortunately, due to the nature of acne, breakouts can happen, but with appropriate and timely action that is nothing to be concerned about.

How Long Will Results After Acne Treatment Last?

You will likely experience significant improvement within 1 to 3 months of starting treatment with appropriate follow up and change in the intensity of treatment. At this point, one would be on a maintenance protocol. Depending on the type of acne your condition may resolve within a couple of years spontaneously at which time you will gradually come off of treatment. Under other circumstances, one would need to stay on long term maintenance treatment to prevent breakouts. Such circumstances are rare and usually associated with other types of medical illness.

Fees

The consultation is $150, waived if you proceed with treatment. Prescriptions are filled at your pharmacy. In-office treatments such as microneedling are priced per session. We go over the cost of your plan before anything starts.

Acne Treatment Questions