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D e rm at olo g y
Newer Techniques Provide More Options for
Prolonged antibiotic use increases the risk of
developing antibiotic resistance and may cause
upset stomach, dizziness, discoloration or
increased sun sensitivity.
Newer, device-based therapies can safely and
effectively address acne and improve the
appearance of discolorations and scars caused
by acne, without the use of pills and with
fewer side effects, according to Dr. Kim.
Photodynamic therapy (PDT), for example,
uses a photosensitizing drug and light source
to shrink oil glands, kill bacteria and reduce
inf lammation in the skin. This reduces
acne breakouts, improves the skin’s overall
texture and helps to resolve acne-induced
skin discoloration. Creams, chemical peels
and laser resurfacing techniques can be used
to effectively address perceived discoloration
and redness associated with acne. A more
advanced technique, fractionated laser, is
required to address actual changes in skin
texture caused by acne.
While most cases of acne are mild enough to
be treated with over-the-counter medications,
some 20 percent of patients require a more
aggressive approach to prevent or address
permanent scarring that can result from
“We’re not sure why some patients have mild
acne and others have severe forms of the
disease,” explains Christina Kim, MD, a
dermatologist in the Clinic for Acne, Rosacea
and Aesthetics (CARA) at UCLA. Acne
occurs when clogged skin pores become
inflamed or infected with bacteria. Family
history, hormone changes (such as menstrual
cycles and puberty), inflammation, stress
and exposure to certain drugs are common
primary causes of acne, but some evidence
suggests that diet and environment may
also play a role, Dr. Kim says.
Common strategies to fight acne include
prescription topical treatments, as well as
prescription antibiotic pills and creams, often
used in combination, which help to reduce
UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631)
bacteria and fight inflammation. Some oral
contraceptives also improve acne in women.
In severe cases, when first-line treatments
are unsuccessful, a form of vitamin A,
isotretinoin, may be recommended. Though
very effective, isotretinoin is associated with
dryness, itching, nosebleeds, muscle ache
and sun sensitivity, as well as increased blood
triglycerides and cholesterol, increased liver
enzyme levels and other problems. It is also
associated with severe birth defects if taken
during pregnancy. Patients should have a
thorough discussion of risks and benefits
before starting treatment.
“Previously, our best option was to cut out the
scars, create another scar and then reshape the
surface,” says UCLA dermatologist Jenny Kim,
MD, PhD, who specializes in the new laser
aesthetic techniques. “Fractionated lasers are
new lasers that can be used to remodel the
dermis so that the scar tissue is less noticeable.
In addition, fillers can be used to improve
acne scars and remodel skin.”
PDT, fractionated laser and other aesthetic
therapies usually require several office visits
and are not typically covered by insurance.
The newer techniques, however, provide more
options for fighting acne than the traditional
systemic and topical therapies.
“We have a range of very effective treatments
available to address acne, but not everyone
can tolerate the side effects,” says Dr. Kim.
“At CARA, we treat all patients with acne,
including high-risk patients who need higher
levels of care, such as people with a history of
depression, patients with severe liver or bowel
disease, or those who can’t take antibiotics or
isotretinoin for other reasons.”
To view a video about
new techniques for
fighting acne, go to: