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Facing the Facts about Acne

July 26, 2017 1:00 PM with Dr. Luzheng Liu

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While acne is often depicted as an adolescent problem that’s supposed to go away by the time you reach adulthood, the truth is that over 50 million Americans of all ages experience this often chronic irritation. Acne can appear almost anywhere on the body in varying forms, and often leaves behind scars or hyperpigmentation that are difficult to get rid of. Before you run to the skincare aisle, get some expert advice from Dr. Luzheng Liu, NorthShore Dermatologist. She’ll be taking your questions on acne, including types, causes and treatment options, as well as providing expertise on addressing and preventing breakouts and scarring.

Dr. Luzheng Liu (NorthShore) - 12:56 PM:
Ready to chat

Kathryn (Moderator) - 1:00 PM:
Our chat on acne is now open. You can submit questions at any time during out chat.

Dr. Luzheng Liu (NorthShore) - 1:00 PM:
Hi I'm Dr. Luzheng Lisa Liu, a general dermatologist at NorthShore. Glad to be here answering your questions about acne.

  Catherinne (Aurora, IL) - 1:00 PM:
Acne was no big issue as a child or teen.Now, at the tender age of 32, all of sudden I can't get rid of it. Outbreaks on my face and back are recurring. Why am I all of sudden getting all this acne at this age and nothing has changed in diet or lifestyle for the mot part? What can I do to stop these outbreaks?
Dr. Luzheng Liu (NorthShore)
Hi Catherinne: you are not alone! About 15% of adult females and about 7 % adult males have persistent acne issues. Adult acne often is associated with menstruation cycles in females. Adult acne is annoying, but can be successfully treated with medications.

  Lucy (Niles, IL) - 1:04 PM:
Why does some acne have white/yellow pus and other acne just has whiteheads or blackheads? What are the causing factors and remedies for the different types?
Dr. Luzheng Liu (NorthShore)
Great question Lucy! Yes, acne has several different types due to different pathogenesis, different genetic background, ethnic background and skin care routines. The most common types are comedones, inflammatory popular acne, hormonal acne, cystic acne. Treatments are different for various types of acne.

  Sam (Chicago, IL) - 1:06 PM:
What can I do about the lumps formed after popping pimples?
Dr. Luzheng Liu (NorthShore)
Stop popping pimples, Sam! Popping or squeezing pushes inflammation both up and down. As a result, the size and depth of acne may both increase, so is the risk of scarring. If you've already popped acne and got lumps, apply warm compress 2-3 times a day (3 min each time) with wash cloth can speed up the resolution. Rule #1 for acne patient: no popping! Rule #2 for acne patient: no popping! Rule #3 for acne patient: no popping!

  Kit (Evanston, IL) - 1:14 PM:
I've seen a lot of estheticians offer services and products to treat acne. How is their approach different from that of a dermatologist?
Dr. Luzheng Liu (NorthShore)
Estheticians usually apply chemical peels or perform acne extraction to treat acne. They also sell commercial products. Dermatologist evaluate the type, severity of the acne, and recommend medical treatment with topical or oral medications. Some dermatology office also offer esthetical treatment as well.

Dr. Luzheng Liu (NorthShore) - 1:16 PM:
Due to technical difficulty, I miss one questions about treatment of back acne.

  Jim (Forest Park, IL) - 1:17 PM:
What causes back acne and how can I treat? It's so hard to see or reach these area to even know it's there sometimes to be able to treat. How can I stop it from occurring?
Dr. Luzheng Liu (NorthShore)
You are right, Jim. It is very hard to apply topical medications on the back. If the acne is mild on back, I would recommend over the counter acne body wash with salicylic acid, or lactic acid, or benzoyl peroxide. It's easier to use these products in the shower. Lather up on your skin and keep it for a few minutes, then rinse off. If acne is more severe, you may need oral medications to treat it. The most user friendly acne topical medication is clindamycin or erythromycin solution. Both are prescription medications.

  Naurin (Skokie, IL) - 1:17 PM:
What is the best way to get rid of pigmentation on the face left from acne?
Dr. Luzheng Liu (NorthShore)
The post acne hyperpigmentation can be pink, red or brown. The pink marks face relatively fast, but the red and brown marks will take months to years to face. The darker a person's normal skin color is, the longer it will take. I would recommend sun protection with daily SPF 30+ even in the winter time; OTC bleaching products have various degree of benefit. You may want to look for ingredients like kojic acid, hydroquinone, vitamin C, lactic acid, glycolic acid et al. Prescription strength hydroquinone can also help. Most of the time, you don't need special treatment. Time will heal the marks.

  Nidhi (Chicago, IL) - 1:21 PM:
Can we use essential oils for preventing acne, alongside something like a daily lotion (I use blood orange with my regular CeraVe lotion)? I have normal skin, but for the occasional breakouts.
Dr. Luzheng Liu (NorthShore)
Various essential oils do have anti-inflammatory benefit. But they are not for everyone, simply because everyone has different skin texture. For some, the essential oils work great in mild and occasional breakouts; for others, they could clog the pores and make acne worse. If you like your current products and think they are helpful, go for it!

  Essie - 1:24 PM:
Hi Dr. Liu ! I'm 25 & I have acne appearing mostly on my chin. Sometimes it's like playing "pop the weasel" because once one simmers down, another one starts appearing elsewhere. I've heard this may be due to hormonal imbalances. I am currently using spironolactone and tretinoin ointment. Will this hopefully rid my issue or is there something that could possibly expedite clear skin? Thank you!
Dr. Luzheng Liu (NorthShore)
Hi Essie, you are on the right treatment if your acne tends to flare up 1-2 weeks before period starts. Spironolactone is highly effective and safe for hormonal acne. Some of the birth control pills can provide additional benefit. But birth control pills can have very different effects on acne depending on the types.

  Jennifer (Glenview, IL) - 1:27 PM:
Is to good to exfoliate the skin on a daily basis? If so, what type of exfoliator is good for the skin?
Dr. Luzheng Liu (NorthShore)
For most of my patients with normal, dry or sensitive skin, I do not recommend daily exfoliation. At most once a week would be sufficient. I prefer enzyme based exfoliation creams over mechanical exfoliation creams with microbeads. Over the counter retinol-containing serum or cream can also very gently exfoliate skin without peeling, and can be used on daily bases.

  Carlos (Des Plaines, IL) - 1:30 PM:
For patients with acne/skin lesions related to toxicities from chemotherapeutic agents ( Avastin, Zelboraf), what would be possible options for oral pharmacological treatment?
Dr. Luzheng Liu (NorthShore)
Carlos, medication-induced acne is more common now due to the development of many new therapies. If acne is bothersome for patients, dermatologists sometimes prescribe oral medications doxycycline or minocycline to prevent or manage drug-induced acne.

  Molly (Chicago, IL) - 1:33 PM:
My 19 year old daughter has acne and has been on various topical and antibiotic meds for the past year. This summer, she is working at a camp, and when she came home this weekend, her acne actually looked different. She has little marks (sort blends with skin color) all over her face. Has the acne taken a different form? Does she just need to exfoliate? The doctor took her off her antibiotic pills due to her job as a summer camp counselor who is out in the sun all week.
Dr. Luzheng Liu (NorthShore)
Hi Molly: Many oral and topical acne medications increase the sun sensitivity of our skin and increase of risk and severity of sun burn. I'm not sure what you meant by "little marks". You may want to take your daughter to her doctor's office for evaluation. Having said that, moderate sun light is often beneficial for acne :)

  Marisol (Chicago, IL) - 1:37 PM:
I have acne and have already tried so many products and nothing works - what could I possibly do next?
Dr. Luzheng Liu (NorthShore)
Marisol: If you have tried many over the counter products without success, I would recommend you see a dermatologist for evaluation and treatment. Depending on your age, skin types, types/ severity of the acne, and overall health, there are different medications and approaches for acne. It is important to be treated with the right regimen.

  Stephanie (Skokie, IL) - 1:41 PM:
What are some products/ingredients to look for when it comes to acne on those with sensitive skin?
Dr. Luzheng Liu (NorthShore)
Hi Stephanie, it is always a challenge to predict what you could tolerate well and what could be irritating if you have sensitive skin. In general, I would recommend products with "hypoallergenic", "noncomedongenic" on the labels. I do like products with benzyol peroxide and salicylic acid, but please start with lower concentration. A new acne product on the market called Adapalene 0.1% (generic name) or Differin (brand name) is well tolerated by most individual including young teenagers. It is the only FDA approved over the counter product for acne. Used to be prescription medication until recently.

  Lajuana (Chicago, IL) - 1:46 PM:
Does microdermabrasion help relieve or reduce acne and/or marks from hyperpigmentation on darker skin?
Dr. Luzheng Liu (NorthShore)
Microdermabrasion gently removes the most superficial layers of the dead skin and improves the texture and fine lines. However, it is very superficial, there is no convincing or data in the literature to prove its efficacy as acne treatment or hyperpigmentation.

  Katherine (Evanston, IL) - 1:49 PM:
I see a lot of beauty magazines/blogs/etc. refer to pimples as an "infection." I think identifiying them as such could lead to hazardous thoughts/remedies in non-medical lay-folk if they're not. So are pimples considered an infection?
Dr. Luzheng Liu (NorthShore)
I can't agree with you more, Katherine! Acne is NOT skin infection, Instead, acne is the result of inflammatory reactions to sebum, keratin debri and the products from the normal microbes living in the skin. Acne is NOT contagious.

  Minerva (Mount Prospect, IL) - 1:52 PM:
I am a 34 year old with severe acne. My dermatologist says its nodular acne and she recommends Isotretinoin but my question to you is are there over-the-counter washes that I could also use to reduce this? Also, is there anything I should look for when choosing makeup (so I don't break out more)?
Dr. Luzheng Liu (NorthShore)
Hi Minerva: I would recommend over the counter cleanser with salicyclic acid and /or benzoyl peroxide. When choosing makeup or moisturizer/sunscreen, please make sure they are labeled as "non-comedongenic", meaning do not clog the pores. For nodular cystic acne, I agree with your dermatologist that isotretinoin would be the right treatment.

  Grace (Chicago, IL) - 1:55 PM:
I seem to be getting a lot of whiteheads and clogged pores and a bit of "back-ne." What could be causing all these whiteheads and occasional pimple breakouts and how do I get rid of them for good (or as long as possible)?
Dr. Luzheng Liu (NorthShore)
Hi Grace, whiteheads are closed comedones, the type of acne that develop from clogged pores. Without prescription medications, I would recommend over the counter adapalene (brand name is Differin) product, together with facial and body cleasers with benzoyl peroxide or salicylic acid. Other tips include healthy diet, loose-fitted clothing, avoid long hair on the shoulder and back all the time (tons of sebum on the hair!), and frequently change pillow cases.

Kathryn (Moderator) - 2:01 PM:

This will be the end of our chat. Thank you for your questions - due to the high volume, we have many that we were unable to get to, and we will work on providing additional content to answer these questions.

For more information on acne treatment, or to schedule an appointment with a specialist like Dr. Liu, you can contact the Department of Dermatology

For inquiries about chemical peels, microdermabrasions and facials, you can contact the NorthShore Med Spa.


Dr. Luzheng Liu (NorthShore) - 2:01 PM:
I think time is up. Great chatting with everyone!
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