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Acne Treatment

Acne Treatment

Acne Treatment

Please refer to my earlier post ‘Acne Grading,’ for a discussion of how to assess acne severity.


All grades:


Avoid or significantly reduce eating processed or highly refined carbohydrates, those foods with a high glycemic index.

Sugars, breads, pastas, chips, rice, sweetened beverages.

Add either an omega-3 supplement daily or regularly eat cold water fish.

Sardines, salmon, tuna, and anchovies among others.

Pre- and Pro-biotics

Inulin, from raw onions, and potato starch are prebiotics that feed healthy gut bacteria.  Probiotics are healthy gut bacteria and can be obtained from foods, such as fermented dairy like yogurt or raw sour krout, or from supplements, such as Prescript-Assist.

Acne Homework Kit

Extra Strength Corrective Pads, twice daily

A salicylic acid and glycolic acid facial cleasing pad combination with antibacterial, keratolytic and mild exfoliative properties

Corrective Mist, twice daily

A niacinamide (vitamin B3) mist with anti-inflammatory and anti-bacterial properties.

Tretinoin 0.025, 0.05 or 0.1%, once daily in the evening

Retin-A for opening comedones and preventing their return.  The 0.025% preparation is for Retin-A naive clients with higher strengths as needed.


Grade 1:

Grade 1 clients should consider Blemish Busters 101 on either the eight treatment first month or starting directly with the maintenance months.


Grade 2:

Start Blemish Busters 101.  Grade 2 client should consider a Blemish Busters 201 or 202 for more serious or recalcitrant cases, such as those that have been on Retin-A and are still having breakouts.  At grades 2 and above we may also recommend adding azeleic acid 20% (brand name Azelex from Allergan) and a possibly a topical antibiotic.  For women, the addition of hormonal based therapies are an alternative for grades 2 and above.


Grade 3:

Start Blemish Busters 202.  Grade 3 clients should consider Blemish Busters 301 once or twice and then a less aggressive protocol like Blemish Busters 101.  At grade 3 we may recommend an oral antibiotic, especially for cases where the acne involves multiple areas or hard to reach spots like the back.


Grade 4:

Grade 4 acne is a significant medical issue with possible long term sequelae, like scarring.  The grade 4 acne requires immediate action, like referral to a dermatologist for oral isotretinoin.  Alternatives do exist, such as a program of Blemish Busters 301 followed by 101 or 202, along with topical tretinoin, azeleic acid and high dose oral antibiotics; again for women, the addition of hormonal therapy is an option.


Thank you for your time and attention,

Robert Zieber, MD
De Luz Medical Aesthetics


Next week acne scarring.

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