Acne is the most common skin care problems seen by doctors. According to the American Academy of Dermatology, over 50 million Americans are affected annually. It is a dreaded issue that can cause physical and psychological problems such as poor self-image and anxiety. CMDL spoke to Dr Sheetal Sapra of ICLS in Oakville, Ontario about the different treatments available for acne sufferers.
CMDL : We understand acne (pimples, blackheads, whiteheads, cysts) occurs when pores become clogged. Can acne be caused by diet, stress or genetics and are there different types of acne?
Dr. Sapra: Acne essentially is a hormonal genetic disease. Often a genetic tendency, acne will reoccur when hormones come into play usually at puberty. They can also occur at various times of menstrual cycle, and associated with stress. The role of diet is very controversial. Studies have shown no single agent that will cause acne. There is a suggestion that a diet high in dairy may worsen acne.
CDML: If you have oily skin, are you more prone to acne?
Dr. Sapra: Not necessarily, one can have oily skin and not be prone to acne. To the contrary, dry skin types can suffer from acne; therefore, the level of sebum production does not necessarily determine if one will develop acne.
CMDL: Are there skin care procedures you would suggest for acne prevention?
Dr. Sapra: There are various skin care products available over the counter (OTC) to treat acne. When it comes to skincare products, the use of a Clarsonic brush I feel essentially prevents acne. This helps in removing the open and closed comedones that may be precursors to an acne-like lesion. Using OTC agents that contain benzyl peroxide are useful as well.
CDML: There have been many dermatologists suggesting taking oral supplements for clear skin. Is there any truth to that?
Dr. Sapra: There are oral supplements available to assist in the regulation of sebum production which may decrease the number of breakouts someone suffering from acne is experiencing. Many nutri-cosmetics improve the overall health of the skin, therefore, usually improving and controlling breakouts.
CMDL: For more severe cases, would you suggest laser treatments? If so, what kind and how does it work?
Dr. Sapra: Laser can be used for the treatment of acne. A combination of Vbeam IPL and Genesis laser, as well as Blu-u light, are useful in improving acne. In the past, Blu-u and Levulan was felt to be as effective as Accutane, but it can have significant side effects and is rarely used.
CMDL: Are there any prescription medications (birth control, etc.) you would suggest to treat acne?
Dr. Sapra: When it comes to prescription medications of acne, most common products are topicals that contain combinations of benzyl peroxide, vitamin A and antibiotics. These are useful in helping very mild acne. Many dermatologists will use oral antibiotics for acne and these are considered to be first line by many dermatologists. My concern with them is that they can have significant side effects. It can result in antibiotic resistance and also becoming allergic to an antibiotic. I often do not use antibiotics long term in treating acne. The most definitive method to treat acne is hormonal control with the BCP (birth control pill). This is often useful in woman, and we can use a combination of diane35 and Yasmin.
CDML: What do you find is the most successful course of treatment for acne?
Dr. Sapra: The most definitive treatment for acne is Accutane. For 80% of patients, one course of Accutane is very effective. Accutane has been somewhat controversial as it was felt to be a dangerous drug in the past. While it does have side effects of dry lips, dry eyes, dry skin, fatigue, occasional aches and pains, its most significant side effect is teratogenicity; i.e. it can cause harm to an unborn baby. It is normally safe to become pregnant 6 months after a course of Accutane. It has also been associated with mood changes, but its direct role in this is also controversial.
CMDL: Will acne ever stop or is it a lifelong battle?
Dr. Sapra: In many patients acne will stop after one or two courses of Accutane. In others, it may become a lifelong battle. This is hard to determine and many factors would come into play, such as causes for acne breakouts, and courses of treatment, etc.
About Dr. Sheetal Sapra
Dr. Sheetal Sapra is not only a leader in the field of Dermatology, but he is also a pioneer of new technologies aimed at improving the lives and looks of his patients. As one of the founders of ICLS, Dr. Sapra’s philosophy of providing amazing patient care with state-of-the-art technology has helped turned ICLS into a premiere dermatology and plastic surgery practice.
Dr. Sapra has an unmatched dedication to finding the best ways to restore a vibrant, youthful appearance. This has made him a part of the vanguard of modern dermatology techniques, including the latest laser technologies.
A respected authority in his field, Dr. Sapra is an advisor and educator for different types of laser systems. “I am constantly seeking out newer, safer ways of helping my patients, which means keeping up with the latest technologies and listening to patient needs.”
By becoming an expert in some of the most state-of-the-art dermatology treatments, Dr. Sapra hopes to provide only the safest, most effective, and comfortable treatments for his patients.
Dr. Sapra’s practice consists of both general OHIP and cosmetic dermatology, and he also upholds an active role as a primary investigator for various clinical research trials. Dr. Sapra has always prided his wide involvement in the field of dermatology, whether it’s personally treating his patients with great care or contributing to the advancement of dermatology through research.