Rosacea, Acne&Cysts - a Memphis Dermatologist
by George Woodbury Jr. M.D. (11/28/2022)
Acne, Rosacea, and Cysts can have really negative effects upon a person’s mood and self-confidence. Fortunately, Dermatologists like myself now have a growing number of promising, new options for Roacea, Acne, and Cysts, and complexion issues. Let’s take a look, with my having practiced as a Memphis Dermatologist for the last 30 years: pimple popping should now be a thing of the past, making Acne scarring less and less of a problem.
First, let’s be clear about one important aspect of acne: Acne is not just a problem of pre-teens and teens. As many of my own patients have realized, it affects peoples in their twenties and thirties, and even beyond. And Rosacea is felt by many Dermatologists to be a related skin condition of both young and mature adults.
What causes Acne and Cysts? Dermatologists are increasingly realizing that both conditions are likely to be genetic: it runs in certain families. Clogging of pores results in a skin inflammation and a skin infection, explaining why antibiotics tend to help. Rosacea seems to be the result of hyper-reactive blood vessels, with trigger chemicals including certain spicy foods and certain ingredients in red wine.
In fact, traditional therapies for acne include 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, or topical dapsone. Sometimes we consider a five months’ course of an oral medicine called isotretinoin (Accutane), which dries up oil glands. Accutane is highly effective, but requires strict avoidance of pregnancy while on treatment, and monthly bloodwork. Sometimes Dermatologists also look at hormonal therapies, like spironolactone pills, or even birth control pills.
For Rosacea, we Dermatologists consider certain oral antibiotics as well as topical Metronidazole, and certain topical Vitamin A medications (Retinoids), to correct problems in the release of oil from sebaceous glands.
Severe cases of acne can result in cysts, so we often discuss with patients the options of medical management versus surgical management, sometimes involving injecting the cyst sac, under a shot of local anesthetic. Dermatologic surgeons like myself sometimes cut out or “excise” cysts, the goal being to cut down the risk of scarring. We encourage patients not to pop cysts, which can promote scarring.
In 2022, Dermatologists also have a new oral antibiotic which seems to have a quicker onset of action – Sarecycline – and a newer retinoid gel – Trifarotene®. There is also a variation of acne – called Pityrosporon folliculitis or fungal acne – which can be treated with prescription antifungal medicines.
After 25 years of practicing dermatology, in 2016 I decided to establish a skincare products company - Big River Silk Skincare™ Inc. – to manufacture and distribute organic skincare products for people going onto prescription therapies. For more on the gentle cleansers and moisturizers that my family of Woodbury Dermatologists has manufactured or compounded for many years for Tennessee and Arkansas Dermatology patients - AmberSoy™ Soap Gel and GlycoShea™ Facial&Neck Cream – see my post at www.Bigriversilkskincare.com – “cleansers and moisturizers for complexion issues.”
If you or a family member has complexion issues or acne, consider first getting a checkup with a Dermatologist. I am a Memphis Dermatologist, with my Dermatology practice since 1993 being at Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Cordova, TN, near both Germantown TN and Bartlett TN (www.Rheumderm.com or www.Bigriversilkskincare.com) (1-901-753-0168). Or you can find a Dermatologist in your own neighborhood by going to the American Academy of Dermatology web site, AAD.org. Just plug your zip code into the “Find a Dermatologist” tab.
George Woodbury Jr. M.D. (11/28/2022)