Acne and Acne Rosacea
Acne vulgaris (the common acne) is among the most common skin problems for which people seek dermatological consultation. It is no longer just a teenager’s problem. Although the average course of therapy is 9 to 18 months, some patients with inflammatory acne can be under therapy for 18 to 36 months. We really do not cure acne. We control it for the period of time the patient has it. Current therapies are extremely effective, but results are directly related to patient compliance.
There are four grades of acne.
Type I acne presents with primarily comedones (blackheads). There is little or no redness or inflammation. Scarring does not occur.
Type II consists of the presence of both comedones and small pustular lesions (zits). This can leave some marking, but not scarring.
Type III, presents with comedones, superficial pustules and red tender inflammatory lesions. Scarring can occur with this type of acne and early aggressive therapy is often required if significant scarring is to be prevented. A dermatologist can be of considerable usefulness in managing this type of acne.
Type IV acne is called acne conglobata. This is every teenager’s worst nightmare. It consists of all of the types of lesions described above, but the level of inflammation is severe with large painful cystic lesions and invariable and extensive scarring. The management of this type of acne is not for amateurs. The highest level of professional care should be sought to deal with this problem. Aggressive medical management is a prerequisite if significant destructive scarring is to be prevented.
Therapy for all types of acne are readily available and quite effective. If you have a complexion problem and don’t seem to be improving as expected, it may be in your best interest to see a dermatologist.
Acne rosacea is a chronic skin condition usually seen in adults. Patients with mild cases of rosacea report symptoms such as redness (ruddiness or flushing) or pimples (whiteheads or pustules) on the central portion of the face. Severe cases of rosacea can lead to conditions such as an enlarged nose or numerous enlarged blood vessels on the face. The Lloyd Dermatology and Laser Center is well equipped to handle all forms of this condition.
Rhinophyma – Severe Acne Rosacea
Severe acne rosacea leading to an enlarged nose occurs most commonly in men and is referred to as rhinophyma. This condition can be surgically treated using several lasers currently available at our facility. This entire procedure can be performed in our office in approximately 45-90 minutes and involves only minimal pain. The skin is normally resurfaced in 10-14 days from the surgery and a complete recovery is expected in 4 to 6 weeks.
The above photos demonstrate the treatment of a patient with severe rhinophyma. The Merrimack carbon dioxide laser was initially used in the cutting mode (as a scalpel) to remove the tumor from the nose. This technique allows large amounts of tissue to be removed quickly in a relatively bloodless field.
By superimposing photographs of the patient taken before the onset of rhinophyma, the physician can visualize the original image and resculpt the nose close to its original contours with the Sharplan SilkTouch laser. This enables the physician to reshape and smooth the skin without leaving sharp lines of demarcation.
Rhinophyma before and immediately after treatment
(Note the striking increase in the size of the air passages in the bottom photo as compared to the photo taken before the surgery).