Services: Teens

Acne

Leslie Capin, M.D.
Peggy Vernon, RN, MA, C-PNP
Aurora/Parker Skin Care Center
Aurora, Colorado

What is acne?
Acne is the most common skin disorder seen in the United States today. It is most commonly associated with whiteheads, blackheads, and pustules (small bumps under the skin containing pus); although, severe acne patients also experience tender red nodules and acne cysts.

What causes acne?
Prior to and during puberty, increased hormones cause an over-production of oil, which then plugs the oil glands, called sebaceous glands. These glands are most prominent on the face, chest, shoulders, and back-the most common areas of acne lesions. Poor diet or dirt does not cause acne. However, a well-balanced diet and proper washing make acne treatment more successful.

A number of other factors also contribute to acne. Stress and emotions can make acne worse. Conversely, acne can create stress. Oil-based soaps, lotions, cosmetics, and hair products cause increased plugging of the oil glands, and can make acne worse. Certain medications, such as epilepsy drugs, steroids, anti-tuberculosis medications, and some antidepressant medications, can cause acne or make it worse.

How is acne treated?
Acne treatment and management take weeks to months to see improvement. Patience and compliance are crucial.

Goals of treatment include decreasing oil production; opening the plugged oil glands; reducing the bacteria, Propionibacterium acnes; and eliminating or reducing scarring. Mild soaps and lotions are recommended. Gentle washing in the morning and at bedtime to remove cosmetics and debris is essential. Buff puffs and grainy soaps cause additional irritation and should be avoided. Moisturizers, make-up, and hair products should be water based.

Squeezing and picking acne lesions cause irritation and injure the underlying tissue, resulting in scarring, and should be avoided unless performed by a health care professional.

Topical agents, called keratolytics, relieve plugging of the oil glands. Over-the-counter preparations, such as Benzoyl peroxide and salicylic acid, are beneficial for mild comedonal acne. Applied twice daily after washing, results are usually seen within six to eight weeks. Consult your health care provider if results are not satisfactory. Prescription medications, such as Retin A, Differin, and Azelex, may be used once daily after washing. These medications are applied to the entire area, not just to the acne lesions.

Topical antibiotics also may be prescribed in combination with a keratolytic agent. These antibiotics reduce bacteria on the skin and control inflammation. They are beneficial for comedonal and inflammatory acne treatment, as well as for maintenance after control has been achieved with oral antibiotics. They are applied once daily to the entire area after washing. The most common topical antibiotics include Erythromycin, Clindamycin, and Sulfonamides. It is important to advise your health care provider if you have had an allergic reaction to any of these medications in the past.

Oral antibiotics reduce the bacteria, Propionibacterium acnes. They are used in combination with topical medications for more severe inflammatory acne. Common oral antibiotics are Erythromycin, Doxycycline, Tetracycline, and Minocycline. They must be taken for three to four weeks to begin to see improvement, and treatment often lasts several months.

For severe cystic acne, Accutane may be prescribed. This vitamin A derivative is taken orally for four to five months. The response rate is as high as 90%, with most patients experiencing prolonged remissions. Careful monthly follow-up by a dermatologist during treatment is required.

Oral contraceptives have proven helpful in some females with inflammatory acne, either alone or in combination with other acne treatment.

Anxiety

Depression

Eating Disorders

Mental Health

Ringworm

Leslie Capin, M.D.
Aurora/Parker Skin Care Center
Aurora, Colorado

Fungal Dermatosis: Tinea or Ringworm Infections
What is tinea (or a ringworm infection)?
Tinea, also referred to as ringworm, is a common fungal infection of the skin. Fungi are widespread in the environment. There are thousands of fungal species, but only approximately 200 species regularly infect humans, causing either superficial or deeper infections, and, occasionally, both.

The body area affected by the infection classifies tinea. “Tinea capitis” is a superficial fungal infection involving the scalp, while “tinea corporis” is a superficial fungal infection involving the trunk, limbs, and face. “Tinea manuum,” or ringworm, is an infection of the hands, whereas “tinea pedis” is a fungal infection the feet. “Tinea unguium,” or “onychomycosis,” affects the nails.

Smoking

Tattoos

Paul Gillum, M.D.
Aurora/Parker Skin Care Center
Aurora, Colorado

What is a tattoo?
A “tattoo” refers to any permanent mark made by placing colored material (“pigment”) under the skin surface. The pigment can be nearly any substance, including ink, dye, carbon, or metal. Most decorative tattoos are made by intentionally injecting pigment under the skin surface to create permanent artistic designs. Sometimes, tattoos are made when the pigment is accidentally pushed into the skin. For example, ear piercing, a gunpowder explosion, or a “road rash” could make an accidental tattoo.

What are the medical risks of a decorative tattoo?
Because needles and injections are used in tattooing, improperly sterilized equipment can spread viruses. Getting a tattoo significantly increases a person’s risk of contracting viral hepatitis. Although possible, there are no documented cases of HIV linked to tattoo needles. Since tattoos create a wound in the skin, there is a small risk of bacterial infection, scar formation, or a keloid.

Allergic reactions to the ink or pigment are possible, and the allergy may not stop unless the tattoo is removed. There are many reports of skin cancer occurring in a tattoo. Tattooing can spread warts and molluscum (a skin disease that is characterized by soft, round masses).

Tinea (ringworm infection)