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Facial Breakouts

George Woodbury MD 3/13/2023

Facial Breakouts – which can come from Acne, from Eczema (Atopic Dermatitis), from Rosacea, and from many other skin conditions – are some of the most common skin challenges faced by Memphis Dermatologists like myself. Sorting out the many possible diagnoses enables us to customize skin treatments to the needs of our individual patients. Let’s take a look at some of the common scenarios, to give you a feel what can help to alleviate these facial breakouts, from my perspective of treating Dermatology patients for over 30 years, with Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Cordova TN 38018 (1-901-753-0168).

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Acne is perhaps the most common facial skin condition worldwide, the old perception being that acne affected mostly people between the ages of 8 and 28, but the reality being that Acne affects many people into their senior years. Common in both men and women, the causes include excessive skin oiliness, clogging of pores, hormone changes, and stress. Acne has negative effects upon a person’s mood and self-confidence. Fortunately, Dermatologists like myself now have a growing number of promising, new Acne treatment options, so “pimple popping” and the scarring should become less and less common.

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Traditional Acne Treatment includes oral antibiotics like doxycycline and minocycline, with prescription topicals (meaning “on top of the skin”) for blackheads (comedones), papules, or cysts: Tretinoin Cream, differin gel (Adapalene), benzoyl peroxide, azelaic acid, and topical dapsone (Aczone® Gel). Sometimes we consider a five months’ course of an oral medicine called isotretinoin (Accutane), which helps by drying up the oil glands. Accutane is highly effective, but requiring strict avoidance of pregnancy while on treatment, and monthly bloodwork. Another oral pill we sometimes consider is spironolactone (Aldactone®).


Newer Acne treatment includes a topical antibiotic –  Amnesteen® (minocycline Foam) (Amnesteen) – a new oral antibiotic - Seysara® (Sarecycline) – a new anti-hormone cream -  Winlevi® (Clascoterone Cream) – and a new less-irritating retinoid cream - Aklief® (trifarotene cream).

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Eczema (Atopic Dermatitis) is a very common cause of facial breakouts – often starting in infancy, childhood, or young adulthood, and often running in families along with Asthma, Hay Fever, and Food Allergies. A special type of facial Eczema is Seborrheic Dermatitis, which many of us Dermatologists think may be due to the overgrowth of a natural skin yeast, because use of prescription topical antifungals can lead to relief. Another special type of facial Eczema is what’s called Perioral Dermatitis, an overlap of Acne and Eczema that can be triggered by hormone changes.


Flares of Facial Eczema can sometimes be caused by Contact Dermatitis, to reactions to fragrances, preservatives, or components of latex. Since 2004, as a member of the American Contact Dermatitis Society, I have offered Allergy Patch Testing, at Rheumatology and Dermatology Associates, in Cordova TN, to help detect triggers. Other causes of flares of facial Eczema can include genetics, or even a type of facial yeast infection (Seborrheic Dermatitis, common in Northern European-descended people).

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In 2023, Dermatologist have a growing number of new oral medications and injectable drugs to incorporate into an Eczema Treatment (Atopic Dermatitis Treatment), which had centered around prescription topical steroid creams and ointments, injectable methylprednisone, and oral prednisone: Eucrisa Ointment, Opzelura  (Ruxolitinib) Ointment, Dupixent®  (dupilumab) injections, Cibinqo® (Abrocitinib) tablets, and Rinvoq®  (Upadacitinib) tablets.

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Rosacea – formerly called Acne Rosacea – is a type of facial breakout that is more common in the Scottish and Irish – but which can be seen in any race. Traditional Rosacea Treatment has been based upon use of oral antibiotics – such as Doxycycline and Minocycline – with possible use of topical Metronidazole Cream or Gel (Metrogel) and possible use of topical retinoid creams (Retin A). Mirvaso Gel (Brimonidine) is a new topical Alpha-adrenergic medication that can help Rosacea patients with issues with flushing or skin redness.

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There are many less common causes of facial breakouts – including Discoid Lupus, Actinic Keratosis (Solar Keratosis), Sarcoidosis, and even a type of Lymphoma of the skin (Mycosis Fungoides). It sometimes requires input from both a Dermatologist and a Dermatologic Surgeon to help to sort out the correct diagnosis, and we sometimes do a fungal culture test, or even bloodwork, because the treatment needs to be customized to particular condition.

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After 25 years of practicing dermatology, in 2016 I decided to establish a skincare products company  - Big River Silk™ Skincare™ Inc. – to help patients with facial eruptions find Hypoallergenic Cleanser and Hypoallergenic Moisturizer, products with a minimum of chemical additives.  At Big River Silk Skincare, we manufacture and distribute organic skincare products for people going onto prescription therapies. I incorporated cleansers and moisturizers that my family of four Woodbury Dermatologists has used for many years for Tennessee and Arkansas Dermatology patients: AmberSoy™ Soap Gel, GlycoShea™ Facial&Neck Lotion and GlycoShea Facial&Neck Cream.

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AmberSoy Soap Gel is a great cleanser option for people with oily or combination skin. It can be used as a type of face mask, wherein it’s applied to the skin, then left on for 5-10 minutes.  Available in 1 oz ($12.95), 2 oz ($18.95), and 8 oz ($59.95), it comes in Mint, Lemon, and No Fragrance Added, with no dyes, formaldehyde, nor propylene glycol.

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GlycoShea Facial&Neck Lotion and GlycoShea Facial&Neck Cream make helpful fragrance-free moisturizer that acts as a face scrub, due to its Glycolic Acid, an AHA or Alpha-hydroxy Acid first discovered in pineapple and sugarcane. These products help to even out the appearance of fine lines in the skin, making them into Anti-Wrinkle Cream (Antiwrinkle Cream). 1 oz ($39.95), 2 oz ($59.95), and 8 oz ($179.95).


Big River Silk Skincare’s AmberSoy Soap Gel and GlycoShea Facial&Neck Cream are available for over-the-counter purchase at our headquarters, 8143 Walnut Grove Road, Cordova TN 38018, Monday-Friday, 7:30 AM to 4:30 PM. They can also be ordered at (shipping: $5.00 for US orders under $40.00; $10.00 handling and shipping for Canadian orders under $75.00). 1-901-753-0168.

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If you or a family member has complexion issues or a facial breakout, consider first getting a checkup with a Dermatologist. My own Dermatology practice since 1993 is with Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Cordova, TN, near both Germantown TN and Bartlett TN ( or (1-901-753-0168). Or you can find a Dermatologist in your own neighborhood by going to the American Academy of Dermatology web site,, then plugging your zip code into the “Find a Dermatologist” tab.

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