Dr. Smita Ramanadham

Dr. Smita Ramanadham

April 14, 2020

I’ll admit, as a Plastic Surgeon, I’m not typically the first stop when people are interested in treating their acne. One of three things generally happen. The first is patients come in to the office because of the scars their acne leave behind and they want these treated but are still having active breakout. Two, they come in for other facial aging concerns, and we discuss overall good skin health as an important way to build a strong foundation for any future facial treatments. Three, they have already tried many other treatments and just want new options. In this scenario, they may have been on birth control, oral antibiotics, or even Accutane and no longer want to take pills to treat their acne or they are about to start these treatments and want to try one more thing first.

Why do I care about acne as a Plastic Surgeon? Well, this was me. I have a vested interest in helping people feel the way I now feel after addressing my acne. My story- I had acne as a teenager as many of us do. During medical school, it would make a sporadic appearance every so often, usually at the time of exams, obviously stress related but would go away. Then I was a resident and my breakouts were worse and were constant. I realized I couldn’t necessarily control my stress because, well, I was a resident, so I saw my dermatologist for help. She had prescribed birth control pills, Cetaphil face wash, antibiotic pills, and Retin-A. This helped but then my nails started to discolor from the antibiotics. I decided that while I hated my acne, I didn’t want to take pills that other risks. The Retin-A controlled my acne until I hit a plateau. I bumped up the dosage, tried other skin care products, but to no avail. My acne returned. It was at this time that ZO Skin Health was introduced to the market and I started a regimen for acne that I still use to this day. I’ve tweaked it and added to it but the core is the same. I can 100% say that I no longer break out unless I get lazy and stop using my products.

So, let’s talk a little more about this.

What is acne? Acne is not just your usual pimple. It can include blackheads, whiteheads, papules (bumps), cysts, or other nodules. While we generally think of teenagers as getting acne, adult acne is quite common. This can be related to our diets, our stress level, hormones, or can be bacterial in nature. This is why in some instances, acne can improve by making lifestyle changes, taking birth control pills to normalize our hormones, or by using topical or oral antibiotics to target the bacteria.

Acne generally appears when two things happen. Dead skin cells that are normally shed don’t because of excess sebum (oil) production. The skin cells then clog those pores and acne appears. This is compounded by bacteria that get within these pores and multiply causing inflammation and red, tender lesions.

It’s important to treat this for several reasons. It can cause embarrassment and low self-esteem. This cannot be underestimated. As you treat these patients, and as their acne improves, you can actually see a difference in how they carry themselves, how they interact with you, and you can even see this in their before and after photographs. They exude confidence. The acne can cause dark spots or hyperpigmentation that can take weeks or months to improve. This is typically more common in darker skin colors or those that have a higher concentration of melanin. Finally, acne can cause permanent, irreversible, deep scars that almost look like craters on the skin.

The treatment depends on the grade of acne which ranges from mild (grade 1) to severe (grade 4). It’s generally aimed at controlling the causes of acne and ranges based on its’ severity. Some treatments reduce bacteria, some reduce oil production, and some help unclog pores by promoting the shedding of skin cells. Most treatments include daily cleansing with soaps that are not harsh and won’t strip your skin, some form of an acid, most commonly benzoyl peroxide, salicylic or glycolic acid, and a Vitamin A derivative. The more severe and cystic your acne, the more it may be necessary to try oral treatments such as antibiotics or isotretinoin (Accutane). You can take this a step further by using various laser treatments.

What do I usually tell my patients? I often offer a trial of topical treatments. Whether their acne is mild or they have more severe forms and no longer want to use pills or want to delay using pills, this may be a good option. I have found that ZO Skin Health is a great line that is therapeutic and, in my experience, works great for acne. I have tried many other medical grade products but this, I would say, is the best. I also want to point out that I am not paid by or sponsored by ZO so this is an unbiased opinion. Not only have most of my patients found improvement in their acne and acne scarring but I have as well. People’s results will vary and some may not get a huge improvement but despite this, these products are simultaneously improving your overall skin health and are working on minimizing fine lines, sunspots, and aging.