Acne

Acne is a chronic and relapsing inflammatory condition of the oil glands. Dr. Eugene Mandrea has treated numerous patients with all types of acne and all grades of severities in Chicago and suburbs, for many years.

Latest news in acne research

A small OBJECTIVE study on the effect of diet in acne has been published in the August, 2008 issue of the Journal of the American Academy of Dermatology. A low glycemic load diet (i.e. whole cereal, low sugar, etc) caused a measurable reduction in the number of acne lesions. This is the first such study on the effects of diet on acne in over 30 years (download).

About Acne

Acne is caused by plugging of the opening of oil glands. As a result, the oil is trapped inside. Certain germs penetrate into the trapped oil and digest it into irritating chemicals. The skin tries to reject these chemicals through pustules (pimples), papules (bumps) and cysts.

Washing the affected areas more than once or twice daily will not prevent the germs from penetrating into the plugged oil glands. It will cause dryness, irritation and further plugging of the oil glands. Thus, excessive washing aggravates acne. Wash gently with Dove or Purpose soap, one or twice daily.

Acne scars may develop in the skin after the actual acne lesions disappear. Scarring is more common with the more severe types of acne, but may accompany any type, especially if the patient has picked at or squeezed the pimples. Typical acne scars appear as indentations in the skin of variable depth that do not improve substantially over time. This should be distinguished from skin discoloration in the areas of former pimples that does improve over weeks to months.

Recent studies have found that the bacterium that digests the trapped oil in and beneath the plugs in oil glands Propionibacterium Acnes is also involved at an earlier stage of pimple formation.

It has been found that this bacterium is capable of forming a biofilm that acts as a cement between the cells. As a result, these cells, which are supposed to die and passively get pushed out of the oil gland ducts, remain attached to each other and to the walls of the said ducts (Journal of the American Academy of Dermatology, 2007 Oct;57(4):722-4).

Thus, Propionibacterium Acne is involved in both the comedone formation (non-inflammatory acne) and in the pustule formation (inflammatory acne).

Recently, it has been noticed that Photodynamic Treatment with an intense pulsed light, especially the Isolaz, severe cases of acne can be cleared. In Photodynamic Therapy, a solution of aminolevulinic acid (Levulan) is painted on the patient's skin.

The patient waits between 30 and 60 minutes (Some authors have obtained good results even with a 10 minute wait). During this time, the aminolevulinic acid is metabolised into a toxic compound (Protoprophyrin). Following this, the Isolaz Intense Pulsed Light and vacuum are applied. This way, the pores are opened, the Propionebacterium biofilm (plug) is aspirated into the handpiece by the vacuum, the remaining propionebacterium is killed by the protoporphyrin and part of the oil gland is also damaged by the protoporphyrin. None of the other devices presently on the market have the vacuum power of the Isolaz.

The blue lights (Blu-U, etc) even though more specific in wave length than the Isolaz, don't penetrate as deeply, due to the shorter wavelength and do not have any vacuum. Nowadays, with the Isolaz and Levulan, severe cases of acne can be cleared in 3 visits, 2 to 4 weeks apart.

Topical Therapy for Acne in Chicago

Read more about Topical Therapy for Acne