Located in Miami, Florida, the Advanced Acne Institute is a recognized leader in acne treatment. Dr. Arthur Colsky founded the Institute solely to focus on acne treatment, and that's been our only goal; to help our patients achieve clear skin. Our board certified physicians and clinical experts use state-of-the-art treatments and innovative therapies to heal even the most severe forms of acne breakouts. Before coming to the institute, many patients have tried a variety of over-the-counter or even doctor-recommended treatments, without improvement.
At the Institute, we use innovative, highly-effective prescription and non-prescription acne therapies tailored to each patient's individual circumstances. This allows us to control even the most severe and resistant forms of acne.
In addition to advanced medical therapy, the institute provides state-of-the-art skincare treatments targeted for acne-prone complexions. Our clinical skin care experts perform medically supervised acne facials and pore cleansing treatments.
Make-up artists are also on staff to provide expert instruction in acne-safe make-up techniques.
The Institute is proud to be the exclusive provider of the Clearstyle line of make-up and cosmetics designed specifically for use on acne-prone skin.
Rotational Therapy was developed at the Institute and it has helped us achieve optimal results for all forms of acne. It is the first and only acne treatment system that uses rotating active ingredients which help target acne on multiple therapeutic levels. The system is centered on a unique and very innovative formula called Hydrating Base™ that supports and calms the very fragile skin barrier. This is very important when attempting to heal acne.
The Institute receives patients and treatment inquiries from all over the United States, and schedules international patients who come to the Institute for treatment consultations.
The Advanced Acne Institute; providing innovation and leadership in acne treatment.
Rotational Therapy is a novel therapeutic home-care system that we developed at the Advanced Acne Institute. It offers a new direction in home care for people with acne-prone skin. Unlike other acne care systems, it targets acne with a dual regimen to selectively address each component of acne breakouts in a rotating sequence. The rotating treatment targets the components of acne one at a time for maximum effect.
Unlike the numerous acne treatment systems that exist, Rotational Therapy is a dermatologist-designed acne treatment program that is specifically formulated for results in both mild acne and for patients under treatment for moderate to severe breakouts receiving prescription therapies. Revolving around a hydrating base, it conditions and supports the skin barrier. Rotational Therapy incorporates a rotating regimen of an anti-bacterial blemish cleanser and an exfoliating wash. The rotating treatments work in concert to open and clear pores, remove dead skin cell buildup, and kill bacteria while the hydrating base promotes healing and calms dryness associated with inflamed skin.
The system evolved over many years of treating patients with acne and identifying the reasons why conventional regimens were ineffective. We noticed that patients using standard therapies would often stop using them consistently due to the development of excessive dryness and irritation. In addition, patients would often come to the Institute using treatments that were not targeting the different causes of acne breakouts. In Rotational Therapy, we designed a system that takes into account the reasons for acne treatment failure and structured a system to eliminate side effects.
Q: Hi, I'm Dr. Arthur Colsky, and today I'm here with Kristi, who is a patient at the Advanced Acne Institute. She's agreed to share her experiences with acne and how she has successfully treated it.
Let's start from the beginning. How old were you first started experiencing breakouts?
A: I was about twelve years old, a freshman in high school. I was a young freshman. Acne was with me throughout high school.
Q: Did you have blackheads and whiteheads, or did you start with having pimples? What was the first thing that you noticed?
A: Well, the first thing that I noticed was I had a lot of pimples across my forehead, then a lot of whiteheads started coming out. Blackheads didn't come out until about a year or two later. But then it started spreading to not just my forehead but my nose, my cheeks -- I started getting some on my arms, my shoulders.
Q: And so, how did that make you feel?
A: Not good. I didn't want to wear tank tops or bathing suits, because, "Who has acne on their shoulders?" Right? I knew everybody else, the teenagers, would get pimples, but then when I take pictures of my friends and I'd look at those pictures, it was really embarrasing to see all the red marks all over my face.
Q: Did you have friends who had the same problem, or did you feel you were alone in that?
A: Most of my friends would have, like, one bad pimple once a month, not a consistent amount of pimples all the time, which is what I experienced.
Q: Anybody in your family -- did your mother or father have acne in the past?
A: I think my mom may have had some acne in high school, but they never really spoke much about it. They had really clear skin, so...
Q: So what did you do? Did you try to use make-up to cover it up? Did you wear your hair long? What tricks did you use to try and camouflage your breakouts?
A: I tried the make-up, but that doesn't work as well when you still have the bumps there. It just looks like there are bumps that are skin-colored instead of being red. I would wear my hair down for nice occasions so it would be hidden.
Q: So what's the first thing you did to try to treat it? Did you use any products from the pharmacy? What did you do?
A: Well, first I just started with regular face wash. I thought, "I'm not washing my face enough." Then I bought these wipies where it tries to dry out the oil on your face and that didn't do much, so then I went to a dermatologist. I went to several dermatologists, actually. I tried everything, every antibiotic to every cream, even some of the stuff that is advertised on TV, and nothing really worked. The acne just stuck around anyway.
Q: How long did you do that for?
A: About four and a half years.
Q: Four and a half years! So your acne never really got better during that time?
A: Not really. I mean, there would be certain days that wouldn't be as bad, but that's just the natural cycle of having acne, I guess.
Q: Did you get frustrated during that time?
A: Well, yeah! I would hate having a really nice event and having one nasty mark on my face, and I had a hard time not picking at my skin, which my mom would always complain about.
Q: Well, today your skin looks perfectly clear. What did you do? What is your success?
A: I finally went to the right dermatologist! I went on Accutane, which is a strong medication, and usually only for severe acne cases, but since my acne was spread out to so many different locations it was hard to treat with creams or anything else. It worked really well!
Q: Did you haver any side effects when you were taking that medicine?
A: The only side effect that I experienced was dryness. I put a lot of chapstick on, and my hair would get dry more easily, but it wasn't anything I wasn't willing to put up with.
Q: A lot of people are probably going through the same things that you did and they are probably frustrated as well, they are probably using a lot of products that are marketed and they are probably seeing various types of doctors including dermatologists. What's your advice to somebody that is struggling with the same issue that you had?
A: Well, my sister is actually going through the same thing now because she is five years younger than me, and what I tell her every day is just keep washing your face, keep putting on whatever cream the doctor tells you to put on. I know it's frustrating but at some point is is going to go away. Some day you are going to find the right cream and the right face wash and it is going to help you, and you'll feel better.
Q: Thank you for joining us, Kristi, and sharing your thoughts.
Q: Welcome to Focus on Health. Today our topic is Understanding Acne and How To Treat It. Our guest is Dr. Arthur Colsky. He's the founder and medical director of the Advanced Acne Institute. Dr. Colsky, thank you for joining us.
A: Thank you for having me.
Q: First of all, what is acne?
A: Acne is a condition in which the pores of the skin don't work normally. A pore consists of a hair folicle and an oil gland, and they come together to form an opening onto the surface of the skin. Under normal conditions, the oil gland produces an oily substance called "sebum" that comes through the opening and lubricates the surface of the skin. In acne, hormones stimulate the oil glands to such a degree that the oil gland produces too much sebum, so much so that it becomes swollen, enlarged and blocked. This forms a bump on the skin, and if that pore becomes filled with bacteria, it can become inflamed, and this produces a pimple.
Q: Who is susceptible to acne?
A: Almost everybody is at risk of developing acne. Acne is typically found in teenagers; everybody knows that the teenaged population is one of the primary groups that has to struggle with acne. But in reality, acne can affect a wide range of age groups. It is very common to have people in their 20's and 30's, in their 40's and beyond, suffering from acne.
Q: What would cause an acne breakout to occur?
A: Some people are more susceptible to the effects of hormones on their oil glands. We don't know always why that is. Sometimes it can be a genetic predisposition. But for some reason, the hormonal stimulation of the oil glands is so robust and so excessive that the oil gland cannot handle the excess production and that's what gives rise to the subsequent events that cause a pimple to occur.
Q: Does diet play a role?
A: This is a very controversial question. At the Advanced Acne Institute, diet is a common theme that we discuss with our patients because quite often one of the questions from a patient will be: "Doctor, I'm eating such and such, and I think that it's causing my breakouts to get worse. Is that a fact?" My answer to them is, "We don't know."
There's no scientific evidence that directly links a particular food with an acne breakout, but there are some studies that seem to suggest that certain foods, such as milk products or foods with a high glycemic ratio may have a causative role. But we're still not sure. So what we tell our patients is that, if you find a food that causes your breakout, that you think is associated with more breakouts, we ask that you avoid that food.
Q: So they can't blame the chocolate?
A: You can't blame chocolate or pizza or soda, no.
Q: What about stress? Is that more of a factor with acne?
A: Stress is an important factor in acne. It is common when students are studying for final exams that they are having a breakout, and studies show that. Their breakouts are much more significant right before the exam, then once the exams are over, that they retreat back to baseline status. So stress is a very common inducer of a flare in acne.
Q: Is there any truth to reports that birth control pills will either increase or actually help with acne?
A: I think that's an important question because birth control pills really have offered a significant option we have used for many of our female patients. At the Advanced Acne Institute, we often talk to our patients about the option of birth control pills, especially when someone notices that they are having breakouts that are preceding their menstrual period, or if we are going to use other medications, birth control pills play a central role. In fact, there are some birth control pills that are FDA approved for the treatment of acne. What we discuss with our patients is to either talk to your gynecologist, your family physician, or your dermatologist about which birth control pill might be right for you. There are some that might actually make acne worse, because of the type of hormones contained in those pills. So you have to be sure that you are on the right type.
Q: So if you are susceptible to acne, those are real questions you need to ask, when it comes to taking birth control pills.
A: Yes, that is a very important thing, and sometimes birth control pills alone are sufficient to give the improvement that we're looking for, and if not, we add other medicines together with it. But birth control pills are often a very helpful option that we have.
Q: So how do you treat acne?
A: That forms the basis of what we do at the Advanced Acne Institute. The main message to take home with how to treat acne is that it's not a one-size-fits-all process. Now, many people fall prey to some of the highly advertised products that claim to cure anywhere from mild acne to very severe acne and that's simply not the case. Every person has a type of acne that is individual to that person, and we have to treat it as an individual treatment. If one has very mild acne, often times we can treat that person only with some topical medications, and even some of the products that you can get without a presciptions are sufficient in that type of case. If, however, someone has more moderate acne with more breakouts, often we need to add prescription medications to help to improve the breakouts and lead to a lessening of the acne susceptibility.
Now there are some patients who have severe breakouts, and in those patients we often have to use very potent medications by prescription, and they can be very helpful and reduce the incidence of scarring that can occur as a permanent condition later on.
Q: So with people who have more than just mild acne, you need to treat the acne from the inside out?
A: That's right. Topical medications alone are rarely successful in addressing people who have moderate to severe acne. So it is important to talk to your acne specialist and get on the right type of treatment as quickly as possible to prevent some of the permanent consequences such as scarring.
Q: What about lasers? How do they work in treating acne?
A: Lasers are a relatively new option that we have now. Some years ago, lasers were beginning to be developed that had some degree of success with acne, and some of the early reports suggested that up to 80% or 85% of people might actually respond very beneficially. But in reality, those early reports have not proven to be completely accurate. Some of the early lasers are really not used that much any more because they haven't been very successful at acne treatment. Now, some of the newer lasers combine light sources together with a vacuum-assisted technology that tends to improve patients and lead to successful intervention. A lot of dermatologists are using those lasers now and as technology continues to progress we will likely have even more success with laser therapy for acne.
Q: What about chemical peels?
A: Using chemical peels we can address acne by decreasing inflamation by killing bacteria and by clearing the pores. They chemically reduce the material that is clogging the pores and releasing the dead skin cell buildup. Now there are various chemical peels that are useful, and depending on your particular circumstance, your skin type, you may be a candidate for one or the other. But some of the peels can be very helpful as an adjunctive therapy.
Q: How do you advise your patients to take care of their acne at home?
A: Home care is also an important aspect of acne management. One thing that we like to avoid -- it's a myth when people feel that acne is a condition of hygiene. It's not. So people who try to scrub clean, it is not going to be effective, and it actually may hinder their improvement because it is going to cause more irritation. So we put together a system at the Advanced Acne Institute where we use a combination of rotating therapies that patients use to kill bacteria and help open pores, and to reduce the dead skin cell buildup and help to open the clog--the material that is clogging the pores. We use it in such a manner as to avoid the irritation, because irritation is a very common problem associated with home care for acne. Patients tend to get very dry and irritated skin because the products that are used tend to have that effect on their skin. With the process that we recommend, we mitigate that irritation as a risk factor by using a hydrating base in a certain way with a rotating regimen of the products that I mentioned.
Q: Well, women, in particular, when they are hit with acne in their adult age, want to put make-up on their blemishes. Is that safe? Would you recommend that?
A: I think there is no reason that somebody should sacrifice their personal style just because they have acne, and I think that as long as the make-up is safe for acne-prone skin, there's no reason not to use it. Now, there are a lot of different types of makeups out on the market, and one of the types that we often recommend is mineral makeup. Mineral-based makeup tends to be more safe for acne-prone skin, but there are other makeups as well. We like to avoid thick foundations and those types of products that could clog the skin and lead to an exacerbation of acne. At the Advanced Acne Institute, one of the things that we do is discuss how to use concealers and these types of recommendations so that our patients feel that they can be social again and they don't have to worry about how their blemishes are affecting their life.
Q: That's very important. So how do you advise someone who comes into your office with acne?
A: Well, the first thing we do is an individualized assessment. We take a medical history, we find out what medications the person is on, we see if there's a family relationship with people who have had acne in the past, and some other factors. We make sure that there is no other condition that they may have that may be associated with acne. For example, polycystic ovarian syndrome in some of our female patients is an inducer of acne that is a bit more resistant to treatment. So the first thing is to get to know the patient, get to know what is predisposing to their breakouts, and tailor a treatment that is going to fit their lifestyle and their expectations. Not everybody wants to have completely clear skin and they don't want to use the more aggressive therapies, whereas other people do because they want to solve the problem because acne becomes a problem for them socially. For example, when somebody treats acne, the thing you have to understand is that people are not coming to you because they are having a condition that may threaten their lifespan. They are not coming to you because they are in severe pain. They are coming to you because they have a pain of a different sort. The pain is psychological and social. Acne is creating an environment in which they can't feel comfortable and confident. It's important to realize that when you discuss with your patient what type of treatment is best and indicated for their particular circumstance, and that you address that concern. It's not uncommon for a patient to come in to my office and say, "You know, Doctor, acne is affecting my style!" And so, we've addressed that. We've put together a web portal called "Clearstyle.com", and in this portal we address these very questions. We talk about how to dress, what type of wardrobe to wear to downplay the effects of complexion. What colors to wear. What types of accessories to use. We interview stylists and doctors and psychologists. We address it from the standpoint of the patient's concerns. I think that's an important aspect to consider.
Q: Well, that sounds like a wonderful resource that a lot of people certainly should check out. Dr. Colsky, thank you so much for joining us today about this very important topic that, you're right, is not life threatening, but affects so many people on so many other levels.
A: Thank you very much.