Dr. Kaminester and his staff in North Palm Beach welcomes patients who are seeking help for this physically and emotionally disturbing disease. Acne is not life-threatening, but it can cause disfigurement in the form of scarring. Dr. Kaminester has written articles on the subject and lectured in different parts of the world on acne. He studied with Dr. Albert Kligman, inventor of Retin-A (tretinoin) for acne, at the University of Pennsylvania School of Medicine in the Department of Dermatology and worked in his Acne Clinic. Dr. Kaminester educates his patients to understand the nature of acne, why they have it and what other measures they can take to get it under control.
Acne vulgaris is one of the most common, and often most distressing, of skin diseases. It affects about 50 million persons in the U.S., 85% of them between 12 and 24 years old. While acne affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it. Dr. Kaminester finds it quite gratifying to help these very appreciative patients with acne.
What is Acne?
Acne is characterized by “pimples” where sebaceous glands are most dense, usually on the face, but also on the back, chest and even other areas of the skin. Acne lesions are physical changes in the skin caused by a disease affecting the sebaceous gland and they range in severity from comedones to nodules and cysts. There are blackheads and whiteheads, which do not scar, and red papules and pustules that can cause permanent scarring, as well as painful and tender cysts and nodules.
Some of the different types of acne are:
- Papule: A small, inflamed, often pink lesion or bump, often tender to the touch. Groupings of small papules (“microcomedones”) may have a rough texture like sandpaper.
- Pustule: Papules topped by pus-filled, dome-shaped, red lesions, often with a hair at the center. Left alone, healed pustules usually do not form scars.
- Nodule: Similar in color and shape to pustules, nodules are large, painful, solid lesions lodged deep within the skin. They are often resistant to treatment and may form scars.
- Cyst: Larger than a pustule, cysts are deep, painful, liquid (pus) filled lesions. They may cause scarring.
The sebaceous glands are attached to hair follicles in the skin on the face, neck, back and chest. They produce an oily substance called sebum, which normally reaches the skin surface through the opening of the follicle (pore). When follicles become plugged, sebum cannot reach the surface of the skin. This blocked sebum promotes the growth of bacteria (Propionibacterium acnes, or P. acnes) beneath the skin, which in turn produce chemicals and enzymes that attract white blood cells, causing inflammation. Eventually the follicle wall breaks down and the sebum, skin cells and bacteria erupt to form lesions or pimples.
It is not known what causes acne, but suspected factors include an increase in androgens (male sex hormones) associated with puberty in both boys and girls, hormonal changes during pregnancy or when starting or stopping the use of birth control pills, heredity, certain drugs such as lithium and the use of greasy cosmetics.
Picking at pimples can make them worse. Pimples should never be opened except by a dermatologist because of the risk of infection. Other things that can cause acne to worsen are:
- Hard scrubbing of the skin;
- Friction caused by leaning on or rubbing the skin;
- Pressure from bike helmets, backpacks, or tight collars;
- Environmental irritants, such as pollution and high humidity.
Treating Acne
Dr. Kaminester often sees patients who have tried over-the-counter products without much or consistent benefit or have been to see other dermatologists.
Dr. Kaminester uses the latest topical and, if necessary, oral medications for treatment of acne. He likes to begin with topical medications, which are just applied to the surface of the skin (not taken orally). Many of the latest topicals contain two active ingredients. Thus, by using a morning and evening topical medication, along with a wash, the patient is already using five effective anti-acne medications in a single day.
Comedo extraction (acne surgery) is very beneficial for removing the blackheads and whiteheads and can results in a clinical improvement of the face or back in just a few days, especially for non-inflammatory acne. He has published articles on the subject of acne surgery in national medical journals. Intralesional injections can be given for larger cysts and nodules to calm them down, reducing their size and discomfort.
Articles Written by Dr. Kaminester
Click on a link below to read the article:
Contact us to schedule a consultation or to learn more about Acne treatments.
