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Acne Through the Ages

By Steven H. Dayan, MD, FACS; Tracy L. Drumm; and Terri A. Wojak
Posted: April 27, 2012, from the May 2012 issue of Skin Inc. magazine.

Acne is the most common skin condition, affecting virtually everyone at some point in their lives. It can be triggered by many different factors, including hormone fluctuations, irritants, illnesses and certain medications. Acne ultimately results in an overproduction of sebum, a buildup of dead skin cells and an accumulation of bacteria. Some people experience mild noninflamed acne called acne simplex, while others have inflamed acne or acne vulgaris, which is severe and can be painful. Working with clients who have acne is often a collaborative effort between physicians and skin care professionals, and marketing the results to other potential clients is crucial for the bottom line.

Physician’s point of view: Steven H. Dayan, MD, FACS

Acne can occur at any age; according to the American Academy of Dermatology (AAD), to date, nearly 40–50 million Americans suffer from some form of acne. It is important that all skin care professionals are prepared to have several treatment options available for each age group. No matter what age it occurs, there is never a good age—or a good time—for an acne breakout.

Teen acne. One of the main culprits of acne is an increase in the hormone testosterone. This is a male hormone responsible for the development of the male reproductive system and secondary male sexual characteristics, such as voice depth and facial hair. A side effect of testosterone production is that it increases oil production and the frequency of acne breakouts. Testosterone is normally produced by the testes in large quantities in men, especially during puberty. This is the reason that most teenage boys experience acne. It also occurs in smaller quantities in teenage girls, but can be just as detrimental to the skin.

Many physicians prescribe topical or oral antibiotics for teens with acne; however, there has been much excitement about the use of light-based therapies for improving acne. Laser light in the red-to-blue spectrum may be effective at killing the bacteria that cause acne, as well as decreasing inflammation.

The laser works not by heat, but by activating a protein that is released by the Propionibacterium acnes bacteria to become a killer protein that destroys the bacteria and the surrounding inflamed acne cells. The effectiveness of light-based treatments can be increased by adding a photosensitizing solution to the face, called photodynamic therapy (PDT). Lasers alone or lasers used in combination with PDT have proven highly successful and soon may be the treatment of choice for the control of moderate-to-severe acne.