For the past 15+ years, the team at PHDermatology has provided care to thousands of patients with acne, utilizing a variety of treatment approaches tailored to each individual’s needs. We understand that there are many methods to address acne, depending on the patient’s preferences and the specific nature of their condition.
In recent years, the surge of information on social media has often been conflicting. This inspired us to establish The Acne Clinic, addressing a critical gap in the market. Our clinic is rooted in science, recognizing that acne presents in different forms and can significantly affect one’s quality of life.
Acne can be a lifelong challenge for many, and we are here to support you every step of the way offering treatment options that fit your lifestyle. We understand that treatment adherence can be difficult - research shows that 27% of patients don’t fill all their prescriptions after seeing a dermatologist.
Acne is a chronic, inflammatory condition of the pilosebaceous unit and is extremely common, affecting around 85% of people at some point in their lives. While it often begins in adolescence, many continue to experience acne into adulthood. It manifests in various forms, including open and closed comedones, papules, pustules and in more severe cases, nodules on the face and or trunk.
The pathogenesis of acne is multifactorial, involving processes such as follicular hyperkeratinization, microbial colonization, increased sebum production, and a combination of genetic and environmental factors. This complexity makes acne a challenging but manageable condition with the right approach.
Early identification and intervention for acne are crucial because they can prevent the condition from worsening and reduce the risk of long-term skin damage. Addressing acne early helps prevent scarring, minimize pigmentation issues, reduce severity, boost confidence and improve treatment outcomes. By intervening early, you not only improve the immediate health of your skin but also reduce the potential for future complications.
Topical antibiotics treat acne by reducing the number of bacteria on the skin and by decreasing inflammation. Erythromycin, clindamycin, minocycline and dapsone are all available in topical formulations. Monotherapy is not recommended because of a concern for antibiotic resistance, so establishing a consistent plan in combination with other medications is important to achieve optimal results.
Topical Retinoids are vitamin A derivatives and are a very important part of an acne regimen because not only are they anti-inflammatory and comedolytic, but they can improve dyspigmentation and scarring. There are four types of topical retinoids FDA-approved for the treatment of acne. Each binds to a different set of retinoic acid receptors and is slightly different in terms of activity and side effects or tolerability. Tretinoin, adapalene, tazarotene and trifarotene application is best discussed with your medical provider because of potential photolability, oxidation and interactions with other medications.
Oral antibiotics treat acne by reducing the number of Cutibacterium acnes bacteria on the skin and decreasing inflammation. These bacteria can trigger immune responses that cause redness, swelling, and the formation of acne lesions. By lowering bacterial levels, oral antibiotics help calm the skin and prevent breakouts. Common oral antibiotics used for acne include tetracyclines (such as doxycycline and minocycline) and macrolides (like erythromycin). They are typically prescribed for moderate to severe inflammatory acne and are often used alongside topical treatments. While effective in the short term, they are generally recommended for limited use to avoid bacterial resistance and potential side effects like disruption of the microbiome. Newer alternatives such as sarecycline have lower risk of antibiotic resistance and are safer to use in younger patients, but we still try to limit the duration of oral therapy to several months.
Oral contraceptives help treat acne by regulating hormone levels, particularly androgens, which play a key role in acne development. Androgens, such as testosterone and dehydroepiandrosterone sulfate, can increase the production of sebum, or skin oil, which can clog pores and lead to breakouts. Birth control pills contain synthetic forms of estrogen and progestin, which work together to lower androgen levels in the body. This reduces sebum production, helping to prevent clogged pores, reduce inflammation, and minimize the occurrence of acne. Oral contraceptives are often recommended for women whose acne is linked to hormonal fluctuations, such as during menstruation or in cases of polycystic ovary syndrome (PCOS).
Oral spironolactone treats acne by blocking androgen hormones, particularly testosterone, which are responsible for stimulating excess oil (sebum) production in the skin. By reducing androgen activity, spironolactone helps decrease oil production, preventing clogged pores and reducing the formation of acne. It also has anti-inflammatory properties, which can further help improve acne lesions. Spironolactone is commonly prescribed for women with hormonal acne, especially those whose acne worsens during their menstrual cycle or due to conditions like polycystic ovary syndrome (PCOS). Because it specifically targets hormonal causes of acne, it is not typically used in men.
Oral isotretinoin, commonly known by its former brand name Accutane, is a powerful treatment for severe and resistant acne. It works by addressing the four main causes of acne: excess oil production, clogged pores, Cutibacterium acnes bacteria, and inflammation. Isotretinoin drastically reduces the size and activity of sebaceous (oil) glands, leading to significantly less oil production. This helps prevent clogged pores, reduces bacterial growth, and minimizes inflammation. It also promotes faster skin cell turnover, which helps keep pores clear. Isotretinoin is typically prescribed for cases of severe cystic or nodular acne that have not responded to other treatments. It has the potential to provide long-term or permanent acne clearance, but it must be used carefully due to possible side effects, including dryness, sun sensitivity, and, in rare cases, more serious risks like birth defects and liver damage. Regular monitoring by a dermatologist is essential during isotretinoin treatment.
Vitamin D is known for its anti-inflammatory properties and may help reduce acne-related inflammation.
Vitamin B5 is thought to reduce sebum production and may help patients with excessively oily skin.
Zinc gluconate may help regulate sebum, inhibit the growth of bacteria and reduce inflammation however the side effect of gastrointestinal upset can be limiting.
Niacinamide is known to be anti-inflammatory and is also helpful in strengthening the skin’s barrier function which can reduce irritation.
Chemical peels are a valuable addition to an acne treatment plan because they offer deep exfoliation, helping to unclog pores, reduce oil buildup, and promote skin cell turnover. By removing dead skin cells and impurities, chemical peels can treat active acne, prevent future breakouts, and improve the overall texture and tone of the skin. They can also help fade post-acne scars and hyperpigmentation, providing both immediate and long-term benefits. When administered by a dermatologist, chemical peels are tailored to each patient's skin type and acne severity, enhancing the effectiveness of other treatments.
LED Light Therapy is a gentle, non-invasive treatment that helps reduce acne by utilizing specific wavelengths of light to target acne-causing bacteria and inflammation. Blue light penetrates the skin to kill Cutibacterium acnes bacteria, which is responsible for breakouts, while red light reduces redness and inflammation, promoting healing. This painless, drug-free therapy is safe for all skin types and can be used as a standalone treatment or in combination with other acne treatments. With no downtime, LED Light Therapy offers a convenient and effective solution for those looking to improve the clarity and overall health of their skin.
TheraClear Acne Treatment is an advanced, FDA-cleared therapy designed to target and treat acne at its source. This non-invasive treatment combines suction and broadband light (BBL) technology to deeply cleanse pores, reduce inflammation, and kill acne-causing bacteria. By extracting impurities and delivering targeted light energy, TheraClear not only clears existing acne but also helps prevent future breakouts. It is suitable for all skin types and offers a fast, effective solution with minimal discomfort and downtime, making it an ideal option for patients seeking clear, healthier skin.
Research into acne treatment is advancing with innovative approaches focused on targeting the skin's microbiome, harnessing new technologies, and utilizing novel topical therapies. We have access to the most recent develops through our partnership with True Blue Clinical Research. Many new treatments are showing promise in clinical trials, providing hope for more effective, personalized acne care in the near future.
Click here to view the current study →
Hyperpigmentation
Atrophic ice pick scars
Subcision
Fractionated skin resurfacing
Microneedling with or without PRP