Acne treatments At A Glance
- Best Results1-5 treatments
- Treatment Recovery0-2 days
- Procedure Time5 to 15 minutes
- Skin SpecialistNurse, therapist, medical dermatologist
- Duration of Results1 month to lifetime
- AnaestheticNot required
- Back to Work Immediately
- Cost$
Acne treatments
Using a combination of creams, tablets, vitamin A and chemical peels, our general dermatologists have success rates of over 98% in treating all forms of acne, including teenage acne, cystic acne, hormonal acne, bacne & blackheads. This page will discuss some methods we use to treat acne, however I will outline my programs I have developed over the years to reduce scarring in patients with active acne.
FactsImportant facts on acne treatments
- Treating acne early is important to prevent scarring
- Specialists have a variety of ways to effectively treat your acne, including creams, tablets, thru to chemical peels
- The cause of acne is often due to many factors including genes, diet, stress as well as the type of skin care & make up you are using
- Clinicians at Clinic Cutis employ peels, lasers, & LED technology to treat acne
- Dermatologists prescribe topicals as well as systemic agents to effectively control acne
- The biggest factor that determines scarring is the time taken to effectively control your acne
Why do I have acne?
We now understand that there is no one single cause of acne, but a multitude of different factors that contributes to this condition. The most important factors are genetic, followed by hormones, stress, diet, & skin care. All of these factors can cause bacteria to multiply, pores to block and oil to form. This results in acne.
Acne can be mild and non-scarring, such as blackheads & white heads, or extreme and scarring. Extreme acne includes cystic acne & extensive bacne. Regardless of the type of acne you have, general dermatologists at Cutis Dermatology can find a solution for you.
What is the very first step in treating acne?
The ABSOLUTE first step is to ensure that you are using the correct products on your skin- namely a suitable cleanser, moisturizer and active ingredients to help exfoliate blackheads and reduce oil production.
The majority of acne patients will not need to be on prescription tablets, and can be treated with over the counter acne skin care. Our expert dermatology clinicians can guide you thru a process of chemical peels, phototherapy & products for acne prone skin.
What types of treatments are there for acne?
We will guide you thru the multitude of treatments depending on your lifestyle, your previous responses, family history but most importantly the severity of your acne. We direct treatments at the factors that cause acne, in some cases it maybe due to oil production, in others it maybe hormonal.
This is an overview of how we approach acne treatments.
Acne Skin care – cleansers and moisturisers. Patients suffering from acne and oily skin will need to have the correct skin care as the basics of treatment.
Cleansers that are endorsed by Dermatologists include Obagi, Cetaphil, Neutrogena and QV Cleanser. Moisturisers that are do not clog pores include the Obagi and La Roche Posay range. The sunscreen of choice is La Roche Posay 50+ Face sunscreen.
Prescription creams, gels, and lotions- These products are prescription medications designed to reduce oil production, normalise bacterial counts and help with breakouts and blackheads. We use a combination of antibiotics and Vitamin A prescriptions to help treat mild to moderate acne. For extensive areas of acne, such as back acne (bacne), a special compounded solution can be used on a nightly basis. The most commonly prescribed creams include Eryacne, Clindatech, Duac, Stivel A, Differin & Epiduo.
Tablet antibiotics– Tablets should always be combined with a vitamin A cream to help reduce antibiotic resistance. A course of antibiotics ranges from 12 weeks to 12 months or longer. The most commonly prescribed antibiotics include Doxycycline, Tetracycline, Minocycline and Erythomycin. Antibiotics are most effective against papular and pustular acne (zits).
What types of chemical peels can help with acne?
Chemical peels–are aimed at exfoliation and decreasing inflammation. They are an excellent method of treatment for blackhead and white head acne, and to reduce oil & congestion.
We have a vast selection of peels. Our peels include the VITA peel- high strength vitamin A– probably the most favoured peel for blackhead acne and congested skin. We also have AHA or fruit acid peels, & BHAs or salicylic acid peels. In patients with very sensitive skin we use lactic acid. Specialist strength peels are affordable at only $98 per peel. Some patients require one peel; others will require a series of peels spaced 2 weeks apart.
Our clinicians will customise a peel based upon your acne type and your skin sensitivity. In most cases one peel can remove as much as 80% of blackheads.
View our Treatment Gallery
How does blue light therapy or Omnilux help with acne?
Omnilux treatments/ Blue and red light acne treatments– also known Low Level Emission or LED (light emitting diode treatment). This treatment is both anti-inflammatory and anti-bacterial – it works by destroying the bacteria that causes acne and at the same time decreases inflammation in the skin.
Blue light destroys the bacteria associated with acne, whilst red light stimulates collagen production. The very latest scientific evidence shows that a combination of red and blue light works best. Specialist will often combine LED treatments with either topical creams, or with AHA chemical peels. This treatment is especially useful in patients who are pregnant and cannot take tablets to control their acne.
Specialist prefer to deliver blue light via a device called IPL or intense pulse light- this is a much more powerful, but safe way of delivering higher energy levels to kill more acne forming bacteria.
What is the most advanced method to treat acne?
Acne specific lasers will be due in Australia in 2023. The laser is called AviClear. Using advanced laser light, it targets the oil gland, sparing normal skin. AviClear is safe & effective treatment for all types of acne- from mild to severe cystic acne.
Patients receive up to 85% clearance at 3 months, with even better results in the following months.
AviClear requires only 3 sessions, spaced 4 weeks apart. It will be the standout treatment for those who would like to avoid drugs such as Accutane.
Can anti hormone medications help my acne?
Anti hormone treatments-These are aimed at targeting hormones that can increase oil and sebum production. For females we recommend the oral contraceptive pill such as Diane, Yaz, Yasmin, Estelle or Juliette. Consult your doctor in regards to the use of the oral contraceptive pill. Specialists often use a drug called Spironolactone to control hormonal flares. In most cases it may take up to 2-3 months before anti-hormone treatments come in to effect.
What is Oratane/ Roaccutane and when do we use this tablet?
Roaccutane/ Oratane– This vitamin A tablet is reserved for severe cases of cystic acne or acne not responding to normal treatment. This is a ‘Specialist Use’ drug, is you will need to be carefully monitored during your treatment course. A course of Roaccutane/ Oratane ranges from 6 months to 14 months, depending on your dose levels.
If you acne does not respond to skin care and anti-acne treatments, our Dermatologists may elect to place you on this tablet.
Acne submarine comedones lie deep in the skin layers. They are often resistant to #accutane & require extractions
.
.
🔬Acne #cysts can be inflammatory (true cysts) or macrocomedones. The later can be persistent & often resistant to conventional management including topicals, #chemicalpeels & even oral isotretinoin / #accutane
.
.
👉Macrocomedones are best visualised by stretching the skin or providing counter pressure (tongue to cheek). These ‘cysts’ lie deep in the dermal layer. Picking will lead to #acnescars
.
.
💉Management includes ‘poke & extract’, more precise methods with less collateral damage include CO2 or erbium laser drill with a 1mm spot. Hyfrecation with a needle point, low watts can also be effective
.
.
📋Many ways to treat acne, be guided by your #dermatologist. Chemical peels include BHA or #salicylicacid peels (10-30%), retinoid peels (0.5-3%), topical #retinol - #retinoids, vitamin A analogues, abs, OCP, other hormonal control. Never underestimate the efficacy of the #acnediet
.
.
⏱Action: Give yourself a timeframe of 6 weeks for OTC management, if acne is not controlled, consider seeing a primary care physician, failing that, a medical dermatologist can assist
.
.
😎Davin Lim,
Dermatologist @drdavinlim
Brisbane
Australia🇦🇺
.
Disclaimer: I am a procedural dermatologist. If you do have medical conditions, including acne, please see my colleagues @cliniccutis .
#acnefree #acnetreatment #acnecysts#blackheads #blemishfree #acne#acnecysts
The algorithm of acne treatment changes with skin type
.
.
🔬Skin Science: Ethnic & darker skin types react differently to lighter skin. Firstly, PIH or post inflammatory hyperpigmentation is almost universal with inflammatory skin conditions for skin type 4 or higher. This can hang around for 5 years or longer. Secondly, fibroblastic response is exaggerated in darker skin, meaning higher incidence of #acnescars
.
.
👉👀Treatment Options: Comedonal acne, namely #blackheads & whitehead can be improved with #retinol, #retinoids, #microdermabrasion & chemical peels. Salicylic acid peels or BHA peels are more lipophilic compared to AHA peels.Sal acid peels have more anti-inflammatory properties cf AHA, ideal for #acne. Concentrations I use range from 8 to 30% BHA🍌🍌
.
.
👉👊Dermatologist use: Anti-inflammatory tabs, anti-hormone meds, topicals, #photodynamictherapy (not #kleresca), LLEDs & oral isotretinoin. PIH rx with usual topicals QSL & #picolasers
.
.
🏠Take home message: if you have uncontrolled acne with dark skin, probably best to see a dermatologist for early & effective control. The single most important factor contributing to acne scarring is the time taken to EFFECTIVE & in most cases ABSOLUTE control
.
.
Dr Davin Lim
Brisbane
.
Disclaimer: I do not treat acne. For medical conditions, please see my colleagues @cliniccutis they are 👍🏻💯
.
#chemicalpeels #accutane #skinscience #beautyscience #dermatologist #brisbanedermatologist #pih #skinlightening #cysticacne #blackheadacne #acnetreatments #acnecure #acnesupport #acnehelp #acneorg #acnehope #drdavinlim #davinlim
PIH also known as post inflammatory hyperpigmentation is most commonly associated with past - present acne lesions. PIH is also known as ‘acne marks’ or grade 1 #acnescars. This patient has active acne,& grade 1,2,3 scars
.
.
🔬PIH can refer to brown or red acne marks. I prefer to separate red acne marks in the category of macular erythema, or PIE - post inflammatory erythema. These can co-exist with other grades of acne scars
.
.
👉👌🏻How to treat? Prevention is the key. Treat acne early AND effectively. Predictive factors for #acnescars include a family history, manipulation of lesions (picking), degree of inflammation & time taken to EFFECTIVE control. Pigment can be decreased with sunscreen. Pigment faders such as #hydroquinone #kojicacid #meladerm #arbutin #licorice #AHAs & #ascorbicacid can be effective. Low strength peels such as AHAs or BHA salicylic acid - TCA can fade pigment. Lasers including nano-pico-fractional lasers can be useful as adjunctive treatment, as can vascular modulation. For resistant cases, see a dermatologist
.
.
👍🏻Davin’s Protip: Obtain CONTROL of acne prior to or concurrent with acne treatment, this reduces-prevents FUTURE scarring
.
.
😎Dr Davin Lim, Dermatologist
Brisbane🇦🇺
.
#dermatologistbrisbane #skinbrisbane #brisbaneskin #skincareexpert #dermatologybrisbane #skincaretips #healthyskin #darkacnescars
.
Disclaimer: I am a procedural dermatologist, namely I operate, laser, inject, & generally do scary stuff, I do not see cases of acne, however I do see cases of complex-severe acne scarring. For medical therapy to control acne, my colleagues @cliniccutis can assist
The MOST important predictor of acne scarring is the TIME taken to achieve EFFECTIVE control of acne. This post illustrates what can happen to scars when control is early + effective
.
.
🔬Skin Science: There are many factors that can contribute to acne scars including chronicity of the disease, extent, family history, & self manipulation (picking/acne excoriee). There are biochemical markers that can predict the chances of acne scars however clinical features are more practical / relevant. Scars are more common in CHRONIC ACNE, as well as adult jawline hormonal acne. The later is associated with deep, painful & blind ended pimples. Picking is frequently seen in this subtype of acne
.
.
👊Control of #acne is important. Dermatologist can prescribe topicals including vitamin A/ #retinoids, abs, oral #isotretinoin - #accutane, anti androgens, as well as physical modalities including #photodynamictherapy , #kleresca, LLEDs, & AHAs- BHA #salicylicacidpeels.
.
.
📋The ideal treatment depends on clinical factors, lifestyle factors, family & personal history. Be guided by your #dermatologist. Don’t forget the #acnediet
.
.
👉Acne, Acne Scars + Topicals: I am aware that recent papers show that topical retinoids, namely #adapelene - #differin can improve acne & scars. Most dermatologists agee that once acne is controlled, #collagen & scar remodelling can occur without exogenous factors. Regardless of these papers funded by #Galderma, topical retinoids remain as first line treatment in most patients
.
.
🔫💉Scar revision & acne: Scar revision can be initiated early, just as long as acne is under control. As per JAMA guidelines, all revision procedures apart from fully ablative lasers can be sensibly employed when patients are on oral isotret
.
.
😎Davin’s Tip: Take a photo & treat your acne. Review in 6-8 wks. If it is not under control / markedly better; see a dermatologist. Longer the inflammation, the higher the chance of acne scarring
.
.
Davin Lim @drdavinlim
🇦🇺
.
Disclaimer: I am a procedural dermatologist, I do not treat acne, my colleagues @cliniccutis
Can assist you for medical concerns
.
#pimples #acnetreatments #blemishfree #hormonalacne #zits
What other lasers help cure acne?
Laser treatment for acne-Laser can be extremely useful to treat some forms of microcystic acne. I use a special laser called an erbium laser to make a tiny opening in the skin’s surface to extract the cyst. Microcystic acne is also known as submarine comedomal acne. These cysts lie very deep in the skin, and only visible when you stretch the skin. To see if you have microcysts, push your tongue on your inner cheek and then above your chin.
If you see tiny 1-2 mm white dots that appear these represent microcysts. Most patients will need 1-2 sessions of laser to remove these cysts. Laser is NOT painful as we use a very strong numbing cream one hour before the procedure. Your ‘heal up’ time will be 2-3 days. Once cysts are extracted, they do not recur.
Another form of laser, called vascular laser, can also help reduce the redness associated with acne rosacea or reduce the redness associated with scars.
Can acne be influenced by diet?
Yes. It is now proven that acne can be worsened by diet. Diet itself is not the sole cause of acne, but may contribute to flares-up. High sugar foods, processed foods, as well as milk & dairy products have shown to flare acne up. Eating complex carbs, and protein can improve acne. Eating a well balanced diet high in zinc may also help. We encourage patients to eat a healthy well balanced diet, low in simple sugars.
Click here to download a Dermatologist Endorsed Acne Diet Guide.
Can acne and acne scars be treated at the same time?
Our group have published & lectured on groundbreaking evidence to show that concurrent treatment of acne and early acne scars is the best method. Why? Because early acne scars are much easier to treat compared to late scars.
Early acne scars respond better to treatment, additionally patients will have little or no downtime with non-laser treatments such as vascular lasers, Tixel, Fractional lasers & RF (eMatrix RadioFrequency).
What treatments are there for old acne scars?
I tailor all acne scar revision treatments depending on the acne scar type, downtime, and skin type or skin colour of the patient. Lets briefly discuss these 3 factors so you have an understanding of scar revision.
Identification of acne scars– this is the most important aspect of scar revision. Acne scars can be sub typed into box scars, ice-pick or deep scars, rolling scars, atrophic, hypertrophic or lumpy scars, pigmented scars, and anchored or tethered scars. Each type of scar will have an optimal treatment. Examples include-
- Ice pick scars- best treated with TCA CROSS & Punch Excision, and NOT Fraxel laser / laser resurfacing
- Rolling scars- best treated with Fraxel & Fractional laser resurfacing
- Box car scars- can be treated with TCA CROSS or fully ablative laser resurfacing
- Atrophic scars- can be treated with CO2 Fractional, followed by fillers, dermal or fat grafts
- Tethered scars- best treated surgically with subscion
Downtime of procedure– this refers to the time taken off by the patient due to recovery. Some acne scar revision procedures are associated with a long recovery time, some with no downtime. Examples include-
- Fillers for acne scars- no downtime
- eMatrix RF- 12- 36 hours downtime
- TCA CROSS- 5-6 days downtime
- Tixel 1-3 days minimal downtime
- Fractional & Fraxel laser- 3-6 days downtime
- Fully ablative laser resurfacing – 7- 10 days downtime
Skin colour of the patient- this is very important as darker skin patients such as ethnic skin, will need more conservative settings compared to fair patients. This is because darker skin patients can pigment or darken with laser treatments and TCA peels a lot easier than fair skin patients.
Most patients will have multiple scar types, and hence several treatment sessions are needed for the very best results. If you are fortunate enough to have scars such as shallow to medium depth box car scars with fair skin type, then you may only require one treatment. I never take a cook book approach to scar revision- everyone is treated on the merits of what scars they exhibit.
Why Cutis Dermatology for acne scar treatments?
My philosophy is to treat acne and acne scars at the same time. This changes mainstream management of just treating acne, as scars are just as important. Scar prevention and reduction using the latest technology can provide good reproducible outcomes.
How do I make a booking to see Dr Davin Lim?
If you have extremely severe and SCARRING acne, and if you have a referral from your GP, book in to see me. For minor scarring, my clinical team can assist. The majority of my work is based on surgical revision of scars.
If you have active acne, please see the clinical team of therapists & nurses. Recalcitrant acne is managed by my medical colleagues. I do not treat acne as my work is entirely procedural in nature.
Davin’s viewpoint on Acne Treatments
The future looks bright as new lasers have been developed to treat acne at its source- the oil gland or pilosebaceous unit. This new laser has been approved by the FDA & it arrives in Australia in 2023. It uses special laser light to penetrate into the deeper parts of skin. The technical name is non-ablative laser resurfacing. AviClear treatments are spaced one month apart for a total of three sessions. The clearance rate is over 85% at month three, with further improvements expected over the following months. AviClear can be used alone, or it can be combined with treatments such as topical retinoids & chemical peels for faster outcomes.
The very first step in managing acne scars is the PREVENTION of further scarring, hence treating active acne is the priority. Most patients don’t realise that the majority of acne can be treated using the correct over the counter skin products such as active Vitamin A creams, exfoliating washes, and gentle cleansers. See the section on acne skin care to have a better understanding of what to use.
For early scars on the background of active acne, I perform RF eMatrix or better still Tixel– this remodel collagen and scars with minimal downtime. Vascular lasers including V Beam Perfect or Prima can reduce red marks during the healing phase of acne scarring. For an assessment & treatment plan, book with my team at Cutis Dermatology.
Disclaimer: I do not treat acne. This is medical & not procedural. For acne control, please book an appointment with my colleagues at Cutis.
