Question: I occasionally get pimples.

Answer by Dr.Lin: I’d classify you as having moderate acne.  
Let’s use appearance to classify the different types of acne lesions:

• Comedone (open ) dark or black also called a black head
• Comedone (closed) underground bump. The keratinous material clogs the pore, then it oxidizes and the oxygen turns it back, 

• Pustule: Is an inflamed lesion(s) that has a lot of white blood cells that attack bacteria 

• Acne Cyst (boil, painful bump) These painful bump(s) or cysts can fill with puss and blood. It is best to see a dermatologist. You may need antibiotics. It is important to know a cyst can last from 6 months to a year. Do not attempt to pop them yourself, as you could scar your skin. 

Question: Is there a evolution to the pimples? If I wait too long to treat them, will they get worse? 

Answer by Dr.Lin: In children and teens we do see evolution of pimples. Children and teen get white heads and black heads. Whereas adults tend to get papules, pustules and zits from hormonal acne. It is common to see this in teens until the age of 60. It is common to see deep cysts around the mouth. 
 

Question: Will I ever grow out of acne?

Answer by Dr.Lin: Menopause is usually the age when you grow out of it. For home care and treatment of adult acne I suggest drying the pimples by using the ACT Acne Spot Treatment. The  ACT Acne Skin Care Kit
& Medi-Bac Kit by Dermalogica also work well. 
 

Question: Should I consider holistic medicine for my acne? 

Answer by Dr.Lin: Several years ago I had acupuncture for my acne. I have not been formally trained, however I have first hand experience with alternative medicine. I was treated with suction cups also known as moxibustion. I had to eat herbs and roots and had frequent acupuncture sessions. I personally did not find it helpful for my acne. However, I think it is great for pain management. 
 

Question: How should I treat my acne? 

Answer by Dr.Lin: I have come up with an acne protocol. I have found it is beneficial for  Comedonal, papular and cystic acne. The treatment is aggressive to try to prevent and avoid scarring. 

• I usually recommend topical prescriptions that different types of acne can benefit from. 
• The ACT Acne Skin Care Kit is given to use daily from home. ACT treats acne and is infused with botanical extracts that help calm and smooth the skin. ACT is non-irritating and is well tolerated 
• In some cases I suggest an *oral antibiotic
• In office treatment chem peels with extractions 

*Use caution when taking birth control pills, oral antibiotics can cause BC to become less effective. 

Question: Can I do my own acne extractions?

Answer by Dr.Lin: Don’t pick your own skin. With professional extractions the contents of the pore are expressed. Oftentimes while self-extracting you could forcing it down. This can be dangerous because you could deliver bacteria into the deep venous sinuses and cause infection or even death. Another less dangerous but still problematic issue would be that you could scar your skin. 

Question: Are there other treatments for acne. I just don’t have that much time. 

Answer by Dr.Lin: You could have PDT or blue light treatment. I have found that it does not last as long. Sometimes it lasts for about a year. I have found that it improves the appearance but does not clear acne. 
There is also accutane. It is a safe treatment for the right person. There are certain side effects that must be monitored. Upset stomach, depression, mood swings and headache require careful monitoring. I have never had to stop medication. It is a serious and safe medication for the correct patient. 

Question: What can I do about my acne scars? 

Answer by Dr.Lin: Acne scars can be classified into two categories:

1. Temporary Acne Scar
2. Permanent Acne Scar

Temporary Acne Scars:

Temporary scars look like either red and/or brown spots. Temporary scars can last up to a year. They will fade eventually. The ACT kit can help improve the appearance of the red or brown spots. In some cases I suggest bleaching cream to speed the process. The Linage LinQ  Skin care line can also be beneficial for lightening those spots. IPL or laser treatments may be necessary for treatment. 

Permanent Acne Scars:

Permanent Scars include: 

• Rolling Scars: Uneven and undulating 
• Box Car Scars: The skin has sharp corners like the corner of a box. Usually 2-6mm 
• Ice Pick Scars: Deep, pinpoint scar that goes deep into the skin

Treatment for the scars: I treat the deepest part first. 

• I use TCA spot treatments. I drop the acid to the bottom of the scar and cause the scar to scar itself and close up. It helps to diminish the scar and makes the scar less uneven. 
• For deeper scars I use punch excision. This is where I use a sharp instrument to cut out the scar and then suture it
• Punch elevation: I punch out the scar and gently lift it up so that it is even with the skin. Then, I use a special tape to hold it in place and allow it to heal using secondary intention. 
• Punch Grafting: I first punch out the acne scar and take skin that I have removed from behind the ear. I put the graph in the hole in the scar and tape scar. 
• Subcision & Filler: To elevate depressed areas and break-up those fibrous bands that cause the scar to appear bound down. Filler is injected to elevate or fill the scar. 
• Profractional Laser: Is used to resurface the skin.