Acne Treatment St. Louis 

Our board-certified dermatologists, Dr. Feigenbaum and Dr. Gibstine, provide comprehensive acne care using the latest treatments to address all stages of acne, from mild breakouts to severe cystic acne and scarring. Located at Missouri Baptist Medical Center, we serve patients throughout the greater St. Louis area.

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Understanding Acne in St. Louis​

What is acne?

Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. This can cause the formation of pimples, blackheads, whiteheads, and other types of blemishes on the face, neck, chest, and back. Hormonal changes, genetics, and certain medications can also contribute to the development of acne. It is a chronic condition that can have physical and emotional effects on those who suffer from it.

 

Recognizing Different Types of Acne

There are several different types of acne, including:

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1. Whiteheads: Small, round, and white in color, these are closed comedones, which means that the pore is closed and the top of the pimple is white.

2. Blackheads: These are also comedones, but the pore is open, which causes the top of the pimple to be black.

3. Papules: These are small, red, and tender bumps that can appear on the skin.

4. Pustules: These are similar to papules, but they have a white or yellow center that is filled with pus.

5. Nodules: These are large, hard bumps that form deep within the skin and can be painful.

6. Cysts: These are large, pus-filled lumps that form deep within the skin and can cause severe inflammation.

7. Conglobate Acne: This is a severe form of acne that involves a combination of nodules, cysts, and pustules.

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Who's at Risk: The Prevalence of Acne

Acne most commonly affects teenagers and young adults, but it can occur at any age. Acne is most common in people between 12 and 25, but it can also affect older adults. Acne is also more common in individuals with oily skin, and people with a family history of acne are also more likely to develop it. Acne can affect both men and women, but it is more common in men.

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Acne is a very common condition that affects many people. According to the American Academy of Dermatology, acne is the most common skin condition in the United States, with an estimated 50 million people affected each year. Acne is most common among teenagers and young adults, but it can occur at any age. It is estimated that 80% of people between the ages of 11 and 30 have acne to some degree.

 

Where Acne Typically Appears

Acne commonly appears on the face, but it can also appear on other parts of the body, such as the neck, chest, and back. The face is the most common area affected by acne because it has the most sebaceous glands, which produce oil. This oil can mix with dead skin cells and clog pores, leading to the development of acne. The chest and back are also common areas for acne to appear because these areas have a large number of sebaceous glands as well.

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The Telltale Signs of Acne

Recognizing Different Acne Symptoms

The physical symptoms of acne include:

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1. Pimples: These are small, red or white bumps that can be filled with pus.

2. Blackheads: These are small, dark-colored bumps that appear on the skin.

3. Whiteheads: These are small, white bumps that appear on the skin.

4. Papules: These are small, red, and tender bumps that can appear on the skin.

5. Pustules: These are similar to papules, but they have a white or yellow center that is filled with pus.

6. Nodules: These are large, hard bumps that form deep within the skin and can be painful.

7. Cysts: These are large, pus-filled lumps that form deep within the skin and can cause severe inflammation.

8. Scarring: Acne can cause scarring that can be both physical and emotional.

9. Redness and Inflammation: Acne can cause redness and inflammation in the affected areas.

10. Dryness: Acne medication can cause dryness to the skin.

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It's important to note that not all individuals with acne will experience all of these symptoms, and the severity of symptoms can vary from person to person.

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Triggers of Acne

Acne is caused by a combination of factors, including:

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1. Hormonal changes: Hormonal fluctuations, such as those that occur during puberty, pregnancy, and menstrual cycles, can lead to an increase in oil production and the development of acne.

2. Genetics: Acne can run in families, and people with a family history of acne are more likely to develop it.

3. Bacteria: A type of bacteria called Cutibacterium acnes (C. acnes) can contribute to the development of acne by causing inflammation in the hair follicles.

4. Hair and skin products: Certain hair and skin products can clog pores and contribute to the development of acne.

5. Medications: Certain medications, such as steroids, can cause acne as a side effect.

6. Diet: Some studies suggest that diet may play a role in the development of acne, but the evidence is not conclusive.

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It's important to note that acne is a complex condition that is influenced by multiple factors, and the specific cause of acne can vary from person to person.

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Causes of Acne Breakouts 

There are several common triggers of acne, including:

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1. Hormonal changes: Hormonal fluctuations, such as those that occur during puberty, pregnancy, and menstrual cycles, can lead to an increase in oil production and the development of acne.

2. Stress: Stress can lead to an increase in the production of certain hormones, such as cortisol, which can contribute to the development of acne.

3. Diet: Some studies suggest that high-sugar foods can exacerbate acne (click to see entire list).

4. Cosmetics: Some cosmetics, such as heavy makeup and hair products, can clog pores and contribute to the development of acne.

5. Exposure to heat and humidity: Exposure to high temperatures and humidity can lead to an increase in oil production and the development of acne.

6. Certain medications: Certain medications, such as steroids and lithium, can cause acne as a side effect.

7. Touching the face: Touching the face with dirty hands can transfer bacteria and oil to the face and contribute to the development of acne.

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Foods to Avoid for Clear Skin 

Evidence suggests that certain foods may contribute to the development of acne. These include:​

1. Dairy products: Studies have shown that a diet high in milk and other dairy products can increase the risk of developing acne.

2. High-glycemic-index (GI) foods: Foods with a high GI, such as white bread, pasta, and sweets, cause a rapid increase in blood sugar, which can lead to an increase in oil production and the development of acne.

3. Processed foods: Processed foods are often high in sugar, fat, and preservatives, which can contribute to the development of acne.

4. Chocolate: Some studies have suggested that chocolate may contribute to the development of acne, but more research is needed to confirm this.

5. Fried and greasy foods: A diet high in fried and greasy foods can contribute to the development of acne.

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Foods that Flare-Up Acne

There is some evidence to suggest that certain foods may improve acne.

These include:​

1. Fish and fish oil: Foods that are high in omega-3 fatty acids, such as salmon and other fatty fish, as well as fish oil supplements, may help to reduce inflammation and improve acne.

2. Leafy greens: Leafy greens, such as spinach and broccoli, are high in vitamins and minerals that can help to improve skin health and reduce the risk of acne.

3. Antioxidant-rich fruits and vegetables: Fruits and vegetables that are high in antioxidants, such as berries and leafy greens, may help to reduce inflammation and improve acne.

4. Probiotics: Foods that are high in probiotics, such as yogurt and kefir, may help to improve gut health and reduce the risk of acne.

5. Whole grains: Whole grains, such as brown rice and quinoa, are high in nutrients and have a lower glycemic index (GI) than refined grains, which may help to improve acne.

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Diagnosis of Acne​

How Our Dermatologists Diagnose Acne

At Mid-County Dermatology, our St. Louis dermatologists, Dr. Feigenbaum and Dr. Gibstine, will typically perform a visual examination of the skin and ask the patient about their medical history and any symptoms they may be experiencing. They may also ask about any medications the patient is taking and any skincare products they are using.

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During the visual examination, our dermatologist will look for the presence of blackheads, whiteheads, pimples, and other types of blemishes. They will also check for any signs of scarring or discoloration, which can be a result of previous acne.

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In some cases, the dermatologist may take a culture to rule out other conditions that may resemble acne, such as gram-negative folliculitis or rosacea.

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Conditions Mistaken for Acne

Several skin conditions can mimic acne and cause similar symptoms, including:

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1. Rosacea: A chronic skin condition that causes redness, inflammation, and visible blood vessels on the face.

2. Folliculitis: An infection of the hair follicles that can cause red, itchy, and painful bumps on the skin.

3. Perioral dermatitis: A rash that appears around the mouth and can cause red, bumpy, and scaly skin.

4. Hidradenitis suppurativa: A chronic skin condition that causes painful lumps and abscesses in the armpits, groin, and under the breasts.

5. Keratosis pilaris: A condition that causes small, hard bumps on the skin, most commonly on the arms and legs.

6. Pseudofolliculitis barbae: A condition that causes small, red, and itchy bumps on the skin, most commonly on the beard area in men.

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 Acne Treatment Options in St. Louis

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Acne is a chronic condition that can be treated with a combination of topical and oral medications, as well as lifestyle changes. The specific treatment plan will depend on the type, severity, and location of the acne, as well as the individual's overall health and medical history.

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Topical acne treatments:

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1. Retinoids: These medications, such as tretinoin, adapalene, and tazarotene, are derived from vitamin A and help to unclog pores and reduce the formation of blackheads and whiteheads.

2. Antibiotics: Topical antibiotics, such as clindamycin and erythromycin, help to reduce the number of bacteria on the skin and reduce inflammation.

3. Benzoyl peroxide: This over-the-counter medication helps to unclog pores, reduce the number of bacteria on the skin, and reduce inflammation.

4. Salicylic acid: This over-the-counter medication helps to unclog pores and reduce the formation of blackheads and whiteheads.

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Oral medications for acne:

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1. Antibiotics: Oral antibiotics, such as doxycycline and minocycline, azithromycin, and trimethoprim-sulfamethoxazole, help to reduce the number of bacteria on the skin and reduce inflammation.

2. Hormone therapy: Hormone therapy, such as oral contraceptives and oral spironolactone, can be used to regulate hormonal fluctuations that can contribute to the development of acne.

3. Isotretinoin/Accutane: This oral medication is a powerful oral vitamin A medication that helps to unclog pores, reduce the formation of blackheads and whiteheads, and reduce the number of bacteria on the skin.

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Lifestyle changes that help manage acne:

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1. Keeping the skin clean: Gently washing the affected area with a mild cleanser twice daily can help remove excess oil and bacteria.

2. Avoiding certain skincare products: Heavy makeup, oils, and other pore-clogging products can contribute to the development of acne.

3. Avoiding certain foods: Some foods, such as dairy products and high-glycemic-index (GI) foods, may contribute to the development of acne.

4. Managing stress: Stress can increase the production of certain hormones that contribute to the development of acne.

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It's important to work with a board-certified dermatologist to develop a personalized treatment plan that takes into account the individual's unique needs and preferences. Acne treatment can take time to be effective and it's important to be patient and consistent with the treatment plan. The dermatologist will also regularly monitor the treatment's progress and make adjustments as necessary.

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Timeframes for Acne Improvement

The length of time it takes for acne to go away can vary depending on the type and severity of the condition, as well as the individual's response to treatment. In general, most people will see improvement in their acne within 4-6 weeks of starting treatment, although the maximum benefit can be seen at 12-16 weeks.

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Mild to moderate acne, characterized by a few blackheads, whiteheads, and pimples, can often be effectively treated with over-the-counter medications and lifestyle changes. In these cases, the acne may start to improve within a few weeks and should be cleared up within a few months.

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Severe acne, characterized by large numbers of blackheads, whiteheads, pimples, and cysts, may require prescription medications and can take longer to improve. In these cases, it may take several months to see improvement and up to a year to achieve clear skin.

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It's important to note that, in some cases, acne may be a chronic condition that requires ongoing treatment to manage. Also, it's important to follow the treatment plan as prescribed by the dermatologist, even if improvement is seen, to avoid relapse and to get the best results.

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Effective Acne Prevention Tips

Here are a few tips that can help prevent acne and acne flare-ups:

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1. Keeping the skin clean: Gently washing the face twice a day with a mild cleanser can help to remove excess oil and bacteria. It's important to avoid over-washing and scrubbing the skin, as this can irritate the skin and make acne worse.

2. Avoiding certain skincare products: Heavy makeup, oils, and other pore-clogging products can contribute to the development of acne. It's important to choose non-comedogenic and oil-free products, and to remove makeup before going to bed.

3. Avoiding certain foods: Some foods, such as dairy products and high-glycemic-index (GI) foods, may contribute to the development of acne. It's important to maintain a healthy and balanced diet that is low in sugar, processed foods, and saturated fats.

4. Managing stress: Stress can lead to an increase in the production of certain hormones that can contribute to the development of acne. It's important to find ways to manage stress, such as through exercise, meditation, or yoga.

5. Protecting the skin from the sun: Sun exposure can worsen acne and increase the risk of scarring. It's important to use a sunscreen with a minimum SPF of 30 and to avoid prolonged sun exposure.

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Understanding Your Acne's Prognosis​

What to Expect When You Have Acne

Acne is a condition that may appear during teenage years and early adulthood, but it can also persist and affect people throughout adulthood. It's important to work with a board-certified dermatologist to find the best treatment plan that targets the underlying causes of your acne. Several medications and therapies are available, and it may take some trial and error to find the one that works best for you. Keep in mind that different people may respond differently to treatments, so what works for one person may not work for another with similar symptoms.

 

Acne's Impact on Scarring Explained 

Acne can lead to scarring when the condition goes beyond the surface of the skin, causing damage to the deeper layers. Inflammation and breakdown of pore walls can cause scarring. It is normal to feel anxious about scarring. Our dermatology team will assess the type of acne and the scarring before providing a treatment plan. There are several treatment options available for acne scars, including topical creams, laser therapy, microneedling, chemical peels, and surgery.

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Acne's Impact on Mental Health 

Acne can have a significant impact on one's mental health, as it can affect one's self-image and self-esteem. The development of acne can often be out of one's control, particularly if it is caused by hormones. This can lead to stress, which can further exacerbate the condition. Acne can be particularly challenging for teenagers and young adults. If the symptoms of acne are causing anxiety or preventing you from participating in social activities, it's important to speak with your skin specialist or mental health professional for support.

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Frequently Asked Questions About Acne Treatment

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How long does acne treatment take to work?

Most patients see initial improvement within 4-6 weeks of starting treatment, with maximum benefits typically achieved at 12-16 weeks. Mild to moderate acne often responds within a few weeks to over-the-counter treatments and lifestyle changes, while severe acne may require several months of prescription medications. Your dermatologist will monitor your progress and adjust treatment as needed to achieve optimal results.

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What's the best acne treatment for adults?

Adult acne treatment depends on the specific type and severity of your condition. Our dermatologists commonly recommend a combination approach that may include topical retinoids, antibiotics, benzoyl peroxide, or hormonal therapies. For women, oral contraceptives or spironolactone can be particularly effective for hormonal acne. Severe cases may require isotretinoin (Accutane). During your consultation, we'll evaluate your skin and medical history to create a personalized treatment plan.

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Do you treat acne scarring?

Yes, we offer comprehensive acne scar treatment options at our practice. Treatment methods include topical creams, laser therapy (we refer our patients to a laser specialist), microneedling, chemical peels, and surgical procedures, depending on the type and severity of scarring. Our dermatologists will assess your specific scarring pattern and recommend the most effective treatment approach. It's important to treat active acne first to prevent new scarring while addressing existing scars.

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Is acne treatment covered by insurance?

Many acne treatments are covered by insurance, including prescription medications and dermatologist consultations for medical acne treatment. Coverage varies by insurance plan and specific treatments. Cosmetic procedures for acne scarring may not be covered. We recommend checking with your insurance provider about your specific benefits. Our office staff can help verify coverage and discuss payment options during your appointment scheduling.

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Can diet affect my acne?

Research suggests certain foods may influence acne development. High-glycemic foods (white bread, pasta, sweets), dairy products, and processed foods have been linked to increased acne in some studies. However, diet affects everyone differently. We recommend maintaining a balanced diet rich in omega-3 fatty acids (fish, fish oil), leafy greens, antioxidant-rich fruits and vegetables, probiotics, and whole grains, which may help improve skin health.

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What's the difference between over-the-counter and prescription acne treatments?

Over-the-counter treatments typically contain lower concentrations of active ingredients like benzoyl peroxide and salicylic acid, making them suitable for mild acne. Prescription treatments offer stronger formulations and additional options like retinoids, prescription antibiotics, and hormonal therapies. Severe or persistent acne usually requires prescription medications for effective treatment. Our dermatologists can determine which approach is most appropriate for your specific condition.

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Should I stop wearing makeup if I have acne?

You don't need to stop wearing makeup entirely, but choosing the right products is important. Look for non-comedogenic, oil-free makeup that won't clog pores. Remove all makeup before bed and consider using makeup sparingly during active breakouts. Some makeup can actually help conceal acne while your skin heals, boosting confidence during treatment. Our team can recommend suitable products for acne-prone skin.

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Why is my acne getting worse as an adult?

Adult acne can be caused by hormonal fluctuations (menstrual cycles, pregnancy, menopause), stress, certain medications, skincare products, and genetic factors. Unlike teenage acne, adult acne often appears on the lower face, jawline, and neck. Hormonal imbalances and increased stress levels in adulthood can trigger or worsen acne. A dermatological evaluation can help identify the underlying causes and develop an appropriate treatment strategy.

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How do I know if I need to see a dermatologist for my acne?

Consider seeing a dermatologist if you have moderate to severe acne, over-the-counter treatments haven't worked after 6-8 weeks, you're developing acne scars, or acne is affecting your self-esteem and quality of life. Additionally, if you're unsure whether your condition is acne or another skin condition, a professional evaluation is recommended. Early treatment can prevent scarring and achieve better long-term results.

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What should I avoid doing to my acne?

Avoid picking, squeezing, or popping acne lesions, as this can lead to scarring and infection. Don't over-wash or scrub your face aggressively, which can irritate skin and worsen acne. Avoid using multiple acne products at once without guidance, as this can cause excessive dryness and irritation. Also, don't expect overnight results – consistent treatment over several weeks is necessary for improvement.

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Schedule Your Acne Consultation

Ready to achieve clear, healthy skin?

Contact our experienced dermatology team today.

Call/Text: 314-994-0200

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