Dr. Sandra Lee’s Video Ep6

“If topical treatment alone does not improve acne, or if acne is severe or extensive, oral medications are the best option. If you’ve tried several topical medications without success, or if your condition is severe, oral acne medications are usually the next step in the treatment process. Treatment usually includes oral antibiotics and applying a prescription gel or topical cream to the skin. Depending on people with acne, treatment may include using prescription creams to prevent acne, taking antibiotics to kill bacteria that contribute to acne, or, if acne is severe, taking stronger medications such as like isotretinoin, or even minor surgery. Even if you have tried topical acne treatments such as creams or gels without any lasting results, laser therapy may be the right solution for you. While I would like you to try natural remedies first, if you are not seeing improvement and severe hormonal acne is making your quality of life worse, other treatments can make a real difference. While it may take a while, treating hormonal acne from the inside out until your hormones are in their natural, happy balance will allow your skin to truly heal.

While my approach isn’t an instant solution, and won’t replace everyone’s multi-drug regimen, hormonal acne can be very sensitive to a more holistic approach, which means less medication and more patches. While the studio treatments offered by Carolina Skin Care can be very effective in treating acne, patients should also commit to taking care of their skin at home. Multiple topical treatments, whether it’s steroids for eczema or topical antibiotics for acne, topical treatments may help in the short term, but in the long run, it can damage the skin, making you more likely to take it in the future. In addition to other treatments, you can take the most obvious step to soothe stress-related acne: reduce stress. If the creams and antibiotics you have been prescribed are not working, or if you cannot tolerate the side effects that medications may cause, you may want to consider acne treatments, which can be provided at your doctor’s office. Other treatments include birth control pills to control acne, hormonal drainage and extraction, and laser and phototherapy.”

1. Incorrect or Inconsistent Use of Treatment

Problem: Not using treatments correctly or consistently can hinder progress. For example, skipping doses or using products too infrequently may not be effective.
Solution: It’s important to follow the treatment regimen as prescribed. Consistency is key to seeing results. Be patient—most treatments take weeks to show improvement.

2. Inadequate or Inappropriate Treatment for Your Skin Type

Problem: Acne treatments are not one-size-fits-all. If the treatment doesn’t target the specific type or cause of your acne, it might not work. For instance, mild acne may only need over-the-counter treatments, while severe acne might need stronger medications like oral antibiotics or retinoids.
Solution: A dermatologist can assess your acne type and prescribe a treatment plan tailored to your specific needs, whether it’s hormonal, inflammatory, or bacterial acne.

3. Underlying Hormonal Imbalances

Problem: Hormonal changes, especially during puberty, menstruation, pregnancy, or conditions like PCOS, can cause acne that doesn’t respond well to topical treatments.
Solution: Hormonal imbalances may need to be addressed with specific treatments, such as oral contraceptives (birth control) for women or spironolactone to regulate androgen levels. In some cases, isotretinoin (Accutane) might be necessary for severe cases.

4. Dietary and Lifestyle Factors

Problem: Certain foods (like dairy, sugary or high-glycemic foods) and stress can exacerbate acne. If you don’t address these triggers, treatment alone may not yield noticeable results.
Solution: Consider adjusting your diet to reduce foods that may trigger acne. Managing stress through activities like exercise, yoga, or meditation can also help balance hormone levels and reduce flare-ups.

5. Genetic Factors

Problem: Acne can be hereditary, meaning that if your family members had persistent or severe acne, you may be more prone to it. Genetic factors can make it harder to treat acne with standard over-the-counter products.
Solution: If acne is genetic, it may take stronger treatments like oral medications (antibiotics or retinoids) or isotretinoin to see significant improvement. A dermatologist can help guide you toward the right treatment.

6. Environmental Factors

Problem: Pollution, humidity, or exposure to allergens can contribute to acne. Environmental factors, like touching your face frequently, can also introduce bacteria and dirt that exacerbate the condition.
Solution: Regularly cleanse your skin to remove dirt and oils, especially after exposure to pollutants. Avoid touching your face with unclean hands and consider using a barrier like a face mask or sunscreen to protect your skin.

7. Skin Care Routine Conflicts

Problem: Sometimes, certain skincare products can actually irritate the skin, making acne worse. For example, harsh exfoliants, strong astringents, or pore-clogging moisturizers can lead to breakouts.
Solution: Ensure that your skincare products are gentle and non-comedogenic (won’t clog pores). It’s also important not to over-exfoliate or use too many active ingredients at once, which can irritate the skin and worsen acne.

8. Medication Side Effects

Problem: Certain medications, such as steroids, anti-seizure medications, or lithium, can cause acne as a side effect. If you are taking any of these medications, it may be challenging to treat acne with regular skincare alone.
Solution: Speak with your healthcare provider about the side effects of your medications. They may be able to adjust your treatment or recommend additional acne treatments to counteract these effects.

9. Acne Scarring or Post-Inflammatory Hyperpigmentation

Problem: After the acne clears up, scarring or dark spots (hyperpigmentation) can remain. These scars may give the impression that acne is still present.
Solution: After the acne is controlled, treatments like chemical peels, microneedling, laser therapy, or topical treatments with retinoids or vitamin C can help fade scars and hyperpigmentation.

10. Treatment Resistance or Tolerance

Problem: Sometimes, the skin can build up a tolerance to treatments, meaning they may become less effective over time.
Solution: If your acne treatment isn’t working anymore, consult a dermatologist. They may suggest switching to a different medication or combining multiple treatments to address various factors contributing to acne.

11. Not Treating the Root Cause

Problem: Acne can be caused by multiple factors (hormonal, bacterial, clogged pores, etc.). Treating only one aspect (like bacteria or oil) may not be sufficient if other factors aren’t addressed.
Solution: A multi-faceted approach may be needed, combining topical treatments with systemic treatments (like oral medications or lifestyle changes) to target all aspects of acne.