Skip to content
My WebMD Sign In, Sign Up

Acne Health Center

Font Size

Expert Q and A: Avoiding the Angst of Acne at Any Age

An interview with Jenny J. Kim, MD, PhD.

What's new in acne treatment? continued...

We’re also combining devices with medical treatment. So we can use a topical medication that will penetrate into the [gland] where the acne is occurring and that makes that oil gland light up, and then you come in with either laser or light-based technologies. These include the pulsed-dye laser, red and blue light, and photodynamic therapy, which target the sebaceous (or oil) glands and can reduce acne flares.

But I don't think they should the first line of therapy. The problem is that there are limited large, prospective, well-controlled studies that demonstrate their effectiveness, so that will be an area we need to explore in the future.

What about scarring?

We can’t really predict which acne will lead to scarring. It’s not always the severe acne.

Acne scars can be very aggressive and difficult to treat. For mild scarring, retinoids, chemical peels, microdermabrasion (which uses tiny rough grains to buff away the surface layer of skin), and lasers can give mild improvement.

Another therapy that is approved by the FDA for acne scarring is fractional laser resurfacing. It thermally damages the tiny columns of scarred skin, while the surrounding healthy skin is left intact.

The fractional photothermolysis is nice in that it’s safe in all skin types. But it's not like magic; you can’t get rid of that scar immediately. You need multiple treatments. And they are usually not covered by insurance, so can be very expensive.

For deep scars we use fillers to fill in depressed areas. The collagen and hyaluronic acid filler appear to be very good.

For more severe scarring, such as deep "ice-pick" scars, several surgical procedures -- including punch grafting or punch excision -- can help to remove, raise, fill, or separate the scar tissue from the underlying skin. They’re usually used in combination with other therapies, including lasers and fillers.

What about skin care?

Use a mild cleanser and sun protection that is non-irritating to the skin.

Don't traumatize your skin with scrubs, astringents, or alcohol-based products. Wait five or 10 minutes before putting on medication after washing. If you’re going to buy cosmetics, use products that don't clog the pores -- they'll be labeled "oil-free" or "nonacnegenic" or "noncomedogenic."

I find that products containing salicylic acid are useful. Separating treatments, such as using salicylic acid or benzoyl peroxide in the morning and a retinol-based product at night, might be helpful if you have sensitive skin.

Newer hydroxy acids (aka glycolic acids) appear to be better tolerated and the nice thing is that they have been shown to inhibit enzymes called metalloproteinases in our skin. This breaks apart collagen so that could help prevent acne scars.

Cosmeceuticals that contain natural products and have anti-inflammatory properties, such as licorice, oatmeal, soy, and feverfew, could be useful. But natural doesn’t always mean good. A lot of natural things cause allergic reactions. So it’s very important to consult your dermatologist and discuss what you’re using.


Kim has consulted for several companies that make skin care products, including Allergan, Medicis, and Stiefel.

Reviewed on March 11, 2010

Today on WebMD

Girl with acne
See if you know how to control your acne.
happy woman with clear skin
Triggers and treatments for blackheads, whiteheads, and cystic acne.
Bride with acne
Dos and don’ts for hiding breakouts.
close-up of a young man soaping his face
Why adults get acne and how to treat it.
Boy cleaning acne face
HPV Vaccine Future
beauty cream
Bride with acne
Woman applying mineral makeup
Arrows pointing on teen girl blemish

WebMD Special Sections