After doing an evaluation, the dermatologist can advise on what type of soap or drying lotion is best for your skin type and help you make informed decisions on appropriate water-based and oil-free makeup and concealer.
These days, a dermatologist's arsenal of effective acne treatments includes topical creams such as tretinoin, adapelene, azelic acid, and tazarotene to help unclog oil ducts. Antibacterial agents, including benzoyl peroxide, alone or in combination with antibiotics such as erythromycin or clindamycin, can be added to topical creams. For girls, certain low-dose birth control pills also may help clear up skin. For severe, disfiguring and cystic acne, there is a drug called Accutane (isotretinoin).
While extremely effective, this controversial drug is not without side effects. The FDA currently is considering placing this drug on a list of drugs that can only be obtained by registered doctors and patients.
Side effects of the drug include birth defects so women taking it must take precautions to prevent pregnancy. In addition, other possible side effects to Accutane may include depression and suicide, hair loss, muscle aches and pains, and vision loss. However, it does work, Mandy says. Within 20 weeks, Accutane completely clears up acne in 80% of people taking it, and in most cases, it is gone for good, he says.
Rep. Bart Stupak (D-Mich.) recently urged that Accutane's maker, Roche, should pay for independent studies of the medication's possible psychiatric side effects and called for additional FDA funds to study the drug. In May of this year, the congressman's son, B.J., committed suicide while on Accutane.
But "as dermatologists, we strongly believe that limiting access to Accutane is a disservice to patients," says Richard K. Scher, MD, president of the AAD and a professor of clinical dermatology at Columbia University and an attending dermatologist at Presbyterian Hospital in New York.
"Depression is a common problem in adolescents with or without acne. The links between suicide or depression and Accutane are unclear," Scher says. "To our knowledge, studies addressing the issue are yet to be completed and/or made available in medical literature."