Understand Your Acne
ADVICE | TIPS | EXPERTISE[an-columns action="end column"] [an-columns action="end columns"]
Dr. Hadley King, Board-Certified Dermatologist
Dr. King, MD is Board-Certified Dermatologist specializing in general, medical, and surgical dermatology in New York. She is also a Clinical Instructor of Dermatology at the Weill Medical College of Cornell University 2-3 times a month where had she previously completed her residency. With a passion to serve patients with little access to dermatological services, Dr. King also volunteers her time to help the Maine community receive professional skincare guidance and treatment.
Tips from Dr. King on Teenage Acne
What percentage of your patients are teens and how many of them suffer from acne?
Overall I think about 20% of my practice is teenagers. Almost all of the teenagers I see have at least some acne.
What are the most common mistakes you see them making in regard to their acne?
I often see teenagers give up on acne treatments too quickly. They understandably want fast results, but some acne treatments take a few weeks to work. I also see picking. I understand the temptation but unfortunately, picking usually only makes things worse. Picking increases inflammation time for healing and it increases risk for infection, discoloration and scarring.
What is your recommended treatment course for them?
I usually start with a regimen that includes benzoyl peroxide and a retinoid. I urge them to be diligent and I explain the importance of not picking.
How does a retinoid help acne?
Topical retinoids have a comedolytic effect, meaning that they help to prevent and treat clogged pores. This is because they increase the turnover of skin cells and reduce the tendency of cells and keratin debris to clump together and clog up pores. They also decrease the discoloration that can be left after a pimple, and because they increase the turnover of skin cells, this reduces the healing time for acne.
What type of retinoids are on the market to treat acne, OTC and Rx?
OTC options include topical retinol and adapalene 0.1% gel. Prescription topicals include adapalene 0.3% gel, tretinoin and tazarotene. Prescription oral retinoids include isotretinoin.
Can you share any stand out stories of how clearing up skin can boost self-confidence?
I am often struck by the change in demeanor I notice in teens dealing with acne. When I first encounter them they are often reluctant to talk or make eye contact. They shrug when I ask questions and defer to their parent to do all of the talking. And the underlying frustration is often palpable. When I see them back for follow up after their treatment is working I love to see how much more confident and happy they are — they talk and look me in the eye and sometimes they have changed their hairstyles so that you can better see their faces.
Is there a correlation between self-esteem and acne in the patients you see?
Yes. Researchers have found in study after study that people with acne can also develop depression, anxiety, low self-esteem, poor self-image, decreased quality of life and a feeling of being all alone. I see this reflected in the patients I see.
Tips from Dr. King on Adult Acne
What percentage of your patients are suffering from adult acne?
It’s a myth that acne is only common in teenagers. When and how severely a person will get acne is very much genetically determined. There are many people who do only experience acne during their teenage years but there are also many many people who experience adult acne. This is more common in women than in men because of ongoing hormonal fluctuations, but some men experience adult acne as well. Approximately 54% of adult women experience acne, vs around 10% of adult men.
Why has adult acne become more common?
Perhaps because of stress and perhaps also because of endocrine disruptors we get exposed to.
What are the main causes of acne in the patients you see?
Acne is primarily caused by genetics and hormones. Stress and diet affect hormones and therefore also play a part. Foods with a high glycemic index may contribute to acne in some people, and dairy products may also be a factor for some people. If you are using skin care products that are comedogenic and are clogging your pores then this also may be a factor and you should look for non-comedogenic products.