Acne

Acne is the term for plugged pores (blackheads and whiteheads), pustules, pink bumps, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders, and even the upper arms. Acne affects most teenagers, some children, and many adults. While not a life-threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.

Types of Acne

Acne lesions range in severity from comedones (blackheads and whiteheads) to nodules and cysts. Here are brief definitions of acne lesions:

  • Comedo (plural comedones) – A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead; its appearance is that of a skin-colored or slightly inflamed “bump” in the skin. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci, and other skin bacteria.
  • Papule – A papule is defined as a small, solid lesion slightly elevated above the surface of the skin. A localized cellular reaction to the process of acne causes a papule.
  • Pustule – a yellow soft lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria.
  • Nodule – a solid, dome-shaped lesion. Many patients describe nodules as “blind pimples” which never seem to come to a “head”. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that would result in scarring. A nodule may be very painful.
  • Cyst – A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into deeper layers of the skin, may be very painful, and can result in scarring.

Our Plan:

We will assess the lesions on your face to determine the type of acne you have, and then choose a plan of care tailored to your specific needs. For example, retinoids are imperative when treating someone with numerous comedones, but not always as helpful when treating pustules.

Resolution Takes Time:

Treatments that promise fast results often capture the attention of acne sufferers hoping for quick resolution. However, the fact remains that acne does not clear overnight. The time a follicle becomes plugged to the time it becomes a visible lesion is 6 weeks—thus, any medication used today is treating/preventing acne 6 weeks from now. On average, 8 weeks are needed to see initial improvement. Once acne has significantly improved or cleared, continued treatment is necessary to prevent it from reappearing. If acne does not improve in 12 weeks, treatment may need to be adjusted as not every acne treatment clears every case of acne. Dermatologists recommend treating acne early to maximize effectiveness and help prevent scarring.

Before Your Visit

Please be sure to bring a list of all medications and allergies. If you are covered by an insurance plan that requires prior authorization, the authorization or referral form must be presented to our office before or at the time of your appointment. It is your responsibility to obtain necessary referrals. If you don’t have one, we will ask you to sign a waiver stating you are responsible for the bill. Payment will then be expected at the time of service. Please bring your insurance cards to each visit so the information can be checked and a copy placed in your chart.

Financial Information

Your insurance coverage is an agreement between you and your insurance company. Financial responsibility rests with the patient for deductibles, co-insurances, and non-covered services. Insurance coverage is a variable, and we cannot guarantee what services will be covered by your particular plan. We request that you sign an authorization form, which will enable us to receive insurance payments directly when applicable. Co-payments are due at the time of service. For your convenience, we accept personal checks, Visa, MasterCard, Discover, American Express, and cash.

A no-show fee of $50.00 will be charged to patients who fail to appear for their appointment and provide less than 24 hours' notice of cancellation.

Pathology, Labs, and X-rays

Surgical specimens are sent to a laboratory for analysis. The fee for this is a separate charge from the office visit and may be billed directly by the processing lab. Results are usually available 7-10 days after the test has been performed. Questions regarding payments for laboratory services should be directed to the laboratory.

Prescription Refills

Prescription refill requests will be taken only during regular office hours.