Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to lack of confidence, anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.
A scar is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in some degree of scarring. An exception to this are animals with complete regeneration, which regrow tissue without scar formation.
Intense pulsed light (IPL) is a technology used by cosmetic and medical practitioners to perform various skin treatments for aesthetic and therapeutic purposes, including hair removal, photorejuvenation as well as to alleviate dermatologic diseases such as acne. IPL is increasingly used in optometry and ophthalmology as well, to treat evaporative dry eye disease due to meibomian gland dysfunction.
Tretinoin, also known as all-trans retinoic acid (ATRA), is a medication used for the treatment of acne and acute promyelocytic leukemia. For acne, it is applied to the skin as a cream, gel or ointment. For leukemia, it is taken by mouth for up to three months. Topical tretinoin is also the most extensively investigated retinoid therapy for photoaging.
Adapalene is a third-generation topical retinoid primarily used in the treatment of mild-moderate acne, and is also used off-label to treat keratosis pilaris as well as other skin conditions. Studies have found adapalene is as effective as other retinoids, while causing less irritation. It also has several advantages over other retinoids. The adapalene molecule is more stable compared to tretinoin and tazarotene, which leads to less concern for photodegradation. It is also chemically more stable compared to the other two retinoids, allowing it to be used in combination with benzoyl peroxide. Due to its effects on keratinocyte proliferation and differentiation, adapalene is superior to tretinoin for the treatment of comedonal acne and is often used as a first-line agent. The Swiss company Galderma sells adapalene under the brand-name product Differin.
Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.
Dermabrasion is a type of surgical skin planing, generally with the goal of removing acne, scarring and other skin or tissue irregularities, typically performed in a professional medical setting by a dermatologist or plastic surgeon trained specifically in this procedure. Dermabrasion has been practiced for many years and involves the controlled deeper abrasion of the upper to mid layers of the skin with any variety of strong abrasive devices including a wire brush, diamond wheel or fraise, sterilized sandpaper, salt crystals or other mechanical means.
An Er:YAG laser (erbium-doped yttrium aluminium garnet laser, erbium YAG laser) is a solid-state laser whose active laser medium is erbium-doped yttrium aluminium garnet (Er:Y3Al5O12). Er:YAG lasers typically emit light with a wavelength of 2940 nm, which is infrared light.
A comedo is a clogged hair follicle (pore) in the skin. Keratin combines with oil to block the follicle. A comedo can be open (blackhead) or closed by skin (whitehead) and occur with or without acne. The word "comedo" comes from the Latin comedere, meaning "to eat up", and was historically used to describe parasitic worms; in modern medical terminology, it is used to suggest the worm-like appearance of the expressed material.
In cosmetology, exfoliation is the removal of the surface skin cells and built-up dirt from the skin's surface. The term comes from the Latin word exfoliare. This is a regular practice within the cosmetic industry, both for its outcome of promoting skin regeneration as well as providing a deep cleanse of the skin barrier. Being used in facials, this process can be achieved by mechanical or chemical means, such as microdermabrasion or chemical peels. Exfoliants are advertised as treatments that enhance beauty and promote a youthful and healthy appearance.
Laser surgery is a type of surgery that uses a laser to cut tissue.
Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the skin. This prompts the skin to heal itself, by creating new cells. This process—to a certain extent—removes the signs of photoaging. The technique was invented by Thomas L Roberts, III using CO2 lasers in the 1990s. Observed complications have included scarring, hyperpigmentation, acne, and herpes.
A pimple or zit is a kind of comedo that results from excess sebum and dead skin cells getting trapped in the pores of the skin. In its aggravated state, it may evolve into a pustule or papule. Pimples can be treated by acne medications, antibiotics, and anti-inflammatories prescribed by a physician, or various over the counter remedies purchased at a pharmacy.
Photoaging or photoageing is a term used for the characteristic changes to skin induced by chronic UVA and UVB exposure. Tretinoin is the best studied retinoid in the treatment of photoaging.
Radio-frequency skin tightening is an aesthetic technique that uses radio frequency (RF) energy to heat skin with the purpose of stimulating cutaneous collagen, elastin and hyaluronic acid production in order to reduce the appearance of fine lines and loose skin. The technique induces tissue remodeling and production of new collagen and elastin. The process provides an alternative to facelift and other cosmetic surgeries.
Cameron K. Rokhsar is an associate clinical professor of dermatology at Mount Sinai Hospital and the founder and medical director of the New York Cosmetic, Skin, and Laser Surgery Center. He is a fellowship-trained cosmetic and mohs surgeon, a specialist in laser surgery including laser resurfacing and laser treatment of wrinkles and scars.
Yoram Harth is an Israeli dermatologist and inventor. He co-invented blue light acne vulgaris phototherapy, as well as a radio frequency device for home treatment for wrinkle reduction.
Venkataram Mysore is a dermatologist, dermatopathologist, and hair transplant surgeon from Bangalore, India. He has over 30 years experience as a dermatologist, 18 years as a teacher and is currently the director of the Venkat Center for Advanced Dermatology and Post-Graduate Training.
Laser-assisted drug delivery (LADD) is a drug delivery technique commonly used in the dermatology field that involves lasers. As skin acts as a protective barrier to the environment, the absorption of topical products through the epidermis is limited; thus, different drug delivery modalities have been employed to improve the efficacy of these treatments. The use of lasers in LADD has been shown to enhance the penetration of drugs transdermal, leading to a higher absorption rate, limited systemic effects, and reduced duration of treatment. Although this technique has evolved in the past decade due to its efficacy through scientific research and clinical practice, there remain some limitations regarding the safety aspect that needs to be taken into consideration.
Tina S. Alster, MD, FAAD, is an American dermatologist, educator, researcher, and author. Alster specializes in dermatologic laser surgery and cosmetic dermatology. She is the founding director of her skin care clinic, the Washington Institute of Dermatologic Laser Surgery, and is a Clinical Professor of Dermatology at Georgetown University Medical Center in Washington, D.C.
