Acne Treatment

What is Acne?

Acne occurs when the pores become plugged. Blackheads, whiteheads, pimples, and deeper lumps (cysts or nodules), occur on the face, neck, chest, back, shoulders, and even the upper arms. Acne is experienced by both teenagers and adults all the way through their 40’s. Untreated acne can leave scars, which can be treated by Dr. Pilest. Although acne can be upsetting and disfiguring, break outs can also lead to serious and lifelong scarring.


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How does acne form?

Hormones found in both males and females rise during adolescence (puberty) and stimulate and enlarge the oil (sebaceous) glands of the skin. These glands are found in the face, upper back, and chest. Rarely, acne can be due to a hormonal imbalance.

The oil glands are connected to a hair-containing canal called a follicle. The sebaceous glands make an oily substance called sebum, which reaches the skin surface by emptying through the skin surface opening of the follicle. The hair follicle opening is sometimes called the pore. The oil (sebum) causes the cells from the follicular lining to shed more rapidly and stick together, forming a plug at the hair follicle opening. Bacteria grow and stimulate inflammation, which causes the wall of the follicle to break. The bacteria spill into the skin causing redness, swelling, and pus.


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Top performer – a new dual-action acne laser

A more recent and effective acne treatment is Isolaz – a dual action treatment which uses suction to remove the clogged matter in the pores combined with a special medical light which kills the bacteria in the pore and on the skin surface. This treatment can be used alone or in conjunction with RX and topical therapy to enhance and speed skin clearing.

Acne Control Tips


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Clean skin

Keeping your skin clean is important. Don’t skip morning or night cleansing. But don’t “over clean”…acne skin is sensitive and if too dry on the surface, more oil is produced to compensate. A cleansing brush is an ideal companion and most can be used in the shower too.

Does diet matter?

Acne is not caused by the foods you eat. Dermatologists have differing opinions on the importance of your diet in the management of acne. One can conclude that a strict diet by itself will not clear your skin, but if certain foods seem to make your acne worse (Soda, chocolate, or fried foods), then try to avoid them. It is always important to obtain a well balanced diet. Drinking a good amount of water helps hydrate the skin. Dairy products are suspect and you should at least try not drinking milk or eating ice cream for a few weeks’ trial to see how your skin changes.

Does sunlight help or hurt?

A tan can temporarily mask your acne. Sunlight ages the skin and can cause skin cancer, therefore, you should not sunburn, “bake in the sun,” or use sunlamps. Choose a sunscreen that is oil-free, such as a gel or light lotion.

What types of cosmetics can I use?

We recommend Oxygenetix oxygenating makeup or pure mineral makeup. The Oxygentix line is available at Total Dermatology. Be sure to thoroughly remove your cosmetics every night with an oil-free cleanser and water. A flesh-tinted acne lotion containing Benzoyl Peroxide, Salicylic Acid, or Sulfur can safely hide blemishes. Also, shield your face when applying hairsprays, perfumes/colognes and gels. Recommended Acne Treatment Products


What types of treatments help acne?



is a very unique procedure which is based on REMOVAL of the food source of acne breakouts. Bacteria grows within the hair follicle (pore) and is fed by sebum and dead skin cells. Isolaz uses suction which vacuums the pore to remove the debris, thus removing the growth medium. Medical strength light is applied immediately following the suction to kill the exposed bacteria, thus helping to immediately begin the process of reducing acne. No downtime; treatments are tolderable and fast.

Combination Omnilux Light Therapy

The addition of alternate red light treatments increases the effectiveness of acne light treatments by acting as an immediate anti-inflammatory. At Total Dermatology your light therapy may be preceded by Salipeel to unclog pores. Acne patients are discovering faster, more visible response to their acne clearing. In investigative studies, PhotoTherapeutics noted a mean clearance rate of over 82% at 12 weeks after the final treatment. No downtime and treatments are pain-free.

LightStim Blue Light System

is a therapeutic light that treats moderate inflammatory acne quickly, easily, and painlessly. LightStim destroys the most common bacteria that cause acne within the skin. Results may be seen in 4 weeks. This drug-free treatment is one of the safest acne treatments available. With LightStim, there are no side effects. The treatment takes about 45 minutes and should be done twice a week for 4 weeks. During a primary consultation, Dr. Pilest will determine the best treatment plan for you.

LightStim has developed a home treatment unit that is helpful in controlling acne. Ask us about the Acne LightStim for home, available in our office for $169 and tax. It’s great for fast treatment of surprise pimples!

Photodynamic Acne Treatment

is a new procedure used to treat resistant acne as well as older acne scars leaving skin smoother. This process begins with an agent, Levulan, applied to the skin, then activated with specific wavelengths of light. The procedure takes 45 minutes. The Levulan agent targets all acne glands, acne rosacea (redness), and benign bumps on the skin. This treatment decreases skin oiliness, and the appearance of pores is minimized. The all over skin texture improves. Redness and skin peeling may occur during the first two days and you must avoid sun exposure the following day. 3-4 treatments are recommended at 2-3 week intervals to obtain optimal results. Because PDT is a topical procedure, there are no systemic side effects.


is a non-invasive laser treatment that targets acne with absolutely no downtime and a low risk of side effects. A treatment takes between 10 to 30 minutes allowing you to return back to work directly afterwards. The number of treatments and interval of treatments vary depending on the severity of the condition and the extent of the improvement desired. Dr. Pilest uses a small hand piece that touches your skin to deliver the laser light. You will feel a quick spray of coolant onto your skin during each laser pulse.

Results from SmoothBeam may vary depending on anatomical location and the extent of desired results. Several treatments may be required before these results can be seen. Precautions should be taken before and after treatment. One must avoid sun exposure for 4-6 weeks before treatment, and again after treatment. An appointment with Dr. Pilest should be made to discuss the best treatment plan for your skin.

Help for acne scars

Fraxel has become the most effective scar reduction treatment available. Fraxel laser treats the skin by way of thousands of microscopic-sized laser beams. Fractional technology makes this procedure a fast-healing skin resurfacing, planing down the ridges of scar tissue and encouraging new collagen formation to improve skin texture and integrity on a more global basis. Fraxel is not a panacea for everyone, and some skin types must be treated very carefully to prevent post-inflammatory pigmentation. Dr. Pilest and our dedicated Laser RN have vast experience in safely treating ethnic skins which tend to be prone to hyperpigmentation.

Fraxel Re:pair CO2 Laser is the latest procedure for acne scarring. For shortened treatment options for improving the appearance of your acne scars, Fraxel’s CO2 laser may be your best option. A skin evaluation with Dr. Pilest will determine which laser will give you the best response.

Vbeam has recently been used for treatment of acne and red acne scars. Vascular Beam Pulsed Dye Laser delivers an intense but gentle burst of laser light to the skin. The laser light is specifically absorbed by the blood vessels on the vascular lesion. These vessels are gently heated and coagulated. The laser has a unique ability to selectively target the blood vessels of a vascular lesion and lessons the redness of the skin. The skin is protected during laser treatment by a dynamic cooling device, which sprays a cool liquid onto the skin before each laser pulse, cooling the upper layers of the skin and providing patients with an increased comfort. It is safe, painless, and effective for lessening of redness from acne or acne scars.

Bellafill is an FDA approved filler used in lessening the appearance of acne scars.

Are there other options for acne control?


Control of acne is an ongoing process.

Acne treatments work by preventing new acne. Treatment takes time. If your acne has not improved after 6 to 8 weeks, you may need a change in your treatment. The treatment Dr. Pilest recommends will vary according to your type of acne. Occasionally, an acne-like rash can be caused by makeup, lotions, or from an oral medication. It is important to help Dr. Pilest by providing a history of what you are using on your skin or taking internally. Dr. Pilest can then choose the best way to cure your acne. The following are a list of options available at Total Dermatology to assist you in clearing up your acne.

  • Drug store products: Many non-prescription or over the counter acne lotions and creams help milder cases of acne. However, many these products may dry out your skin if used too often. When using these products, follow instructions carefully. Although not recommended for anything but mild acne, Proactiv and similar systems found in your local pharmacy are worth trying.
  • Prescription products: Dr. Pilest may prescribe topical creams, gels or lotions with Vitamin A acid or Benzoyl Peroxide to help unblock the pores and reduce bacteria. These products may cause some drying and peeling but are highly effective. Dr. Pilest will advise you on the correct use and how to handle side effects.
  • Topical antibiotics: Along with creams, antibiotics, such as Cleocin, can also be applied to the skin. These are used in less severe cases of acne.
  • Injections: In severe cases of large red bumps or cyst break-outs, Dr. Pilest may inject Cortisone directly into the bumps to help them go away.
  • Extractions: Dr. Pilest or his licensed Aesthetician may open pimples or remove blackheads and whiteheads. Don’t be tempted to pick, scratch, pop, or squeeze pimples yourself. When the pimples are picked at, more redness, swelling, inflammation, and scarring may occur.
  • Oral medications: Antibiotics, such as Tetracycline, Doxycycline, Minocycline, or Erythromycin, may be taken orally. Medication is often prescribed for moderate or severe cases, especially when acne is seen on the back or chest. Dr. Pilest will discourage long term use of antibiotics as often antibiotic resistance can occur as well as a wide variety or physical problems.Antibiotics work to reduce the bacteria in the follicle and my also decrease the skin’s redness directly. Women may develop vaginal yeast infections when taking antibiotics. If this occurs, discontinue medications and contact Dr. Pilest immediately for treatment of the yeast. Check with Dr. Pilest about taking antibiotics if you are pregnant or nursing, or if you are trying to get pregnant.
  • Birth Control pills have a significant improvement on acne. Oral antibiotics may decrease the effectiveness of birth control pills. Women who are taking birth control pills may notice a significant improvement in their acne.
  • Other drugs may be used to help with severe acne. These include female hormones or medications that decrease the effects of male hormones. Another oral medication, Isotretinoin (Accutane) is sometimes used when acne does not respond well to any other treatments. Patients must understand the side effect to Isotretinoin. Frequent follow-up visits are necessary to monitor side effects. These drugs can cause severe birth defects if taken during pregnancy. We no longer prescribe this type medication due to the severity of side effects.

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