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Acne: When to See a Doctor

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Updated: 11/01/2011 8:04 pm

Many of us turn to drugstore products to combat breakouts, which is a great first line of defense. However, no two pimples are alike, and a dermatologist is able to provide customized advice and treatment options for acne sufferers. Not sure if your bump in the skin care road warrants a doctor’s appointment? Answering yes to any of these three questions may be the best indicator that it’s time to see a dermatologist.

Have over-the-counter creams, gels, and cleansers stopped working?

Mild to moderate acne will often go away in four to six weeks with the use of drugstore creams, gels, and cleansers that contain benzoyl peroxide and/or salicylic acid, says Paradi Mirmirani, MD, a dermatologist in Vallejo, Calif. But stubborn, more severe cases of acne may require the expertise of a dermatologist.  

According to Amy Derick, MD, a dermatologist in Barrington, Ill., doctors can prescribe powerful topical retinoids to unclog blocked pores and to tame extra-oily skin. “Oral therapies like antibiotics, birth control, or isotretinoin can also be prescribed for deeper acne spots and hormonal breakouts (pimples that never come to a head),” says Derick.  

Another thing to consider when thinking of switching from over-the-counter to Rx: Sometimes people get breakouts from using the wrong drugstore products in the first place, says Ranella Hirsch, MD, a Cambridge, Mass., dermatologist.

As a general rule of thumb, if your skin is oily, wash your face twice a day with a salicylic acid cleanser. If it’s dry, use a gentle foaming cleanser. Bonus tip: Let the cleanser sit for a minute or two so that its active ingredients can penetrate your skin’s epidermis before rinsing off. Finally, try nixing pimples with a benzoyl peroxide treatment cream. If you don’t see improvements after six weeks, book an appointment with your dermatologist.

Is acne taking a toll on your self-esteem?

Acne affects at least 85% of teens; plus, 25% of all adult men and 50% of adult women get acne at some point in their grown-up lives.

For teens and adults alike, the recurring skin disorder can be difficult to cope with, leading to anxiety disorders and depression no matter how old you are. In fact, a study published in the British Journal of Dermatology found that acne sufferers experienced social, psychological, and emotional problems similar to those with chronic health problems, such as epilepsy, diabetes, and arthritis. 

The repercussions of acne left untreated are more than skin deep. If you find yourself skipping events and outings with friends, or if breakouts upset you, it’s time to see a dermatologist who can help clear up your acne quickly (in six to eight weeks, says Mirmirani), and offer techniques for dealing with pimples in a healthy way.

Are the pimples sore, or do they leave you with scars?

Cystic acne (inflamed acne caused when the follicle wall is damaged) and nodules, which are painful, under-the-skin masses, are some of the toughest types of acne to treat, especially without the help of a dermatologist.

“If you suffer with more serious forms of acne like cystic acne, over-the-counter treatments will never be enough, and waiting is just delaying the inevitable trip to the dermatologist,” says Derick.

Try to avoid the urge to pick or pop nodules or cystic acne, as this can lead to severe scarring and even permanent skin damage.  To reduce inflammation and boost the healing process, your dermatologist may administer a corticosteroid injection directly into the lesions. Then, the doctor will prescribe a regimen appropriate for your skin type, the severity of your acne, and the progression of your scarring.

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