What Bubbles Up From Underneath The Surface


People who get acne more easily than others get it for various reasons.  However, all these reasons lead to one culprit beyond any person’s control: hormones.

Hormones are produced by a number of glands within the body and are the chemical messengers that help regulate multiple functions, including the activity of oil glands in the skin.  Unfortunately, when skin oil glands are maturing or are in a state of higher activity stimulated by hormone changes, they can be capable of developing into inflammatory lesions we call acne.

Acne is actually caused by a complicated series of skin events.  Dead skin cells stick around hair follicles and form a plug within a skin pore which is the genesis of all acne.

If an individual has a family history of acne-prone skin that has been passed on to them, fluctuations in hormones can fuel the fire by stimulating the oil glands to produce more oil.  Since the oil flows into a pore that is blocked, the oil thickens and becomes what we call sebum.

sebumThe sebum irritates the lining of the pore and producing inflammation and redness.  Infection with skin bacteria then makes an inflamed area into an infected one, a pimple.

Hormone fluctuations can be caused by multiple factors including:

  1. puberty
  2. emotional stress
  3. menstrual cycles
  4. birth control hormonal therapy
  5. pregnancy
  6. perimenopause
  7. medical conditions such as polycystic ovary syndrome (PCOS) and rosacea.

Certain foods are also associated with hormone fluctuations and acne, including dairy products and high carbohydrate (especially “junk”) foods.

Although many men develop acne around the time of puberty due to testosterone surging, most of the other hormone changes causing acne affect women disproportionately.  My wife jokes that that’s how she knows God is a male since a female God would not have tolerated all these design problems.

With hormone fluctuations so common and frequent,  is clear skin ever possible?  Of course, the answer is a resounding YES.

The proper use of various skin care products in combination with other medical treatments can control this overall process.  Cleaning the skin of excess oil with a salicylic wash and toner can be very helpful.

acneproneI have packaged a sequence of products that have been very helpful into a Maine Laser Skin Care Acne Prone Skin Kit.  I recommend this kit as the first line of defense against acne.

Depending on the severity of the acne breakouts and the person’s medical condition,  other more intensive therapies may be needed.  These include topical or oral antibiotics, hormonal medication to reduce fluctuations, and facial peels with extraction of clogged pores.

Our aesthetician, Denise Gidney, uses a new therapy called Hydrafacial MD, which can clean and hydrate the pores in those with acne.  Even I have been shocked to see how much she is able to clean from patients’ faces during the first session alone.

As noted in previous newsletters, laser treatments are also very useful in reducing oil gland size and production.  With a laser beam’s precision and intense focus, they help reduce the source of the sebum and its irritating effects.

If there is one thing that I have learned over my years in medicine,  it is that every person is unique and that there is not one solution that fits everyone universally.  There is no substitute for a good skin exam and baseline pictures to analyze the individual’s acne, assess the effectiveness or failure of previous treatments, and formulate a plan to treat.

As always, initial consultations are free and no obligation.  I hope that this information and the links above are helpful for you or someone you know or love who has acne breakouts.

Give us a call at 207-873-2158 to arrange a visit with me and my staff.  Feel free to forward this information to anyone this may help.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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