Acne and rosacea are two common skin disorders that affect people of all ages and skin types. While they may often get confused because of similar facial redness and bumps, the conditions are characteristically distinct in the ways they form and how they affect the skin.

The Laser & Skin Surgery Center of New York’s board-certified dermatologists have the expertise, experience, and devices necessary to get these conditions under control. One of our award-winning dermatologists, Dr. Roy Seidenberg, conducted a webinar explaining how easy it is to treat acne and rosacea, as well as to manage their symptoms. Below, we share the highlights.

Acne can range from the occasional pimple to extreme, ongoing breakouts that might go on for several years, or even decades.

We understand that acne affects more than your skin. We know how even the mildest breakout can negatively impact your psyche, self-confidence, and self-esteem. But is acne making depression and anxiety worse? Or is it the other way around? According to Dr. Seidenberg, it’s a little bit of both.

Causes of Acne

Factors that can increase your likelihood of an acne breakout include:

• Genetics
• Hormones
• Stress
• Mechanical factors, such as make-up
• Diet (e.g., research shows that cow’s milk as well as a high-glycemic diet may exacerbate acne)

Like other conditions that plague many people, misconceptions have developed over the years about what causes acne and the best way to treat it. Here are some of the most common acne myths and fast facts that debunk them:

MYTH: Acne is an infection
Acne is not an infection of the skin but an inflammatory condition. It is caused by dead skin cells that collect and clog your pores, sebaceous glands that produce too much oil in the follicles, bacteria (Cutibacterium acnes) build-up in the pores that eat the oil, and white blood cells (pus) coming into the follicle leading to breakouts.

MYTH: Exfoliating is an effective treatment
Exfoliation as an acne treatment is overrated. Over-exfoliation will only lead to increased dryness or irritation.

MYTH: Spot treating is the way to go
While it’s very tempting to spot treat, it does not work because the pimple is already there. You need to apply your medication to the whole area daily to prevent breakouts.

MYTH: Medications provide instant results
You have to be patient because acne medications don’t work quickly. The skin has to undergo a cellular turnover, which may take anywhere between 3-6 weeks. Birth control pills may take three months to produce results. However, a cortisone injection can make a big pimple heal quickly.

A Progressive Disease

The epidermis goes right down into the hair follicle, so it’s all continuous right down to the hair shaft. Every single hair follicle has its own tiny little nerves, muscle, oil gland, artery, and blood vessel, and the hair follicle goes deep.

We typically shed our skin, which is composed of keratin, similar to our hair and nails. The skin we shed goes out into the air as dust. If the skin in the follicle doesn’t grow (“keratinize”) properly in the follicle, you get a little plug. The oil gland releases sebum, which accumulates and along with bacteria build-up, results in the following types of acne lesions:

• Early comedones – non-inflammatory acne (whiteheads and blackheads)
• Later comedones – accumulation of shed keratin and sebum
• Papules – small, red, and raised bumps, may be tender but often are not
• Pustules – small, red pimples containing white or yellow pus, can be tender
• Nodulocystic Acne – larger, tender inflamed, often painful lumps beneath the skin’s surface

Acne Treatments

Some patients respond quite well to topical or oral medications for managing their acne.

Topical medications include:

• Retinoids (Retin-A, Differin, EpiDuo, Tazorac) [also have anti-aging properties]
• Benzoyl peroxide
• Azelaic acid (Finacea, Azelex)
• Minocycline (Amzeeq)
• Clascoterone (WinLevi)

Oral medications include:

• Tetracycline antibiotics (Tetracycline, Doxycycline, Minocycline, seracycline)
• Hormone (androgen) blockers (Spironolactone)
• OCPs
• Isotretinoin (Accutane) – requires ongoing monitoring while on the medication

Rosacea may not be a serious medical skin condition, but it can make you feel self-conscious whenever your skin flares up. It may also worsen and lead irreversible changes if left untreated.

What is Rosacea?

Rosacea is a common, chronic but variable, inflammatory skin condition that causes redness, flushing, enlarged blood vessels as well as acne-like pimples and pustules.

Certain factors might increase the risk of a rosacea flare-up, including:

• Sun exposure
• Emotional stress
• Hot weather
• Wind
• Heavy exercise
• Alcohol consumption
• Hot baths
• Cold weather
• Spicy foods
• Face masks
• Certain skincare products
• Heated beverages
• Certain cosmetics

Subtypes of Rosacea

While chronic facial redness is the most common trait associated with rosacea, this is only one symptom of one type of rosacea. There are 4 subtypes of rosacea:

Subtype 1: Facial redness (erythematotelangiectatic rosacea)

• Flushing and persistent redness
• Visible blood vessels may also appear

Subtype 2: Bumps and pimples (papulopustular rosacea)

• Persistent facial redness with bumps or pimples
• Often seen following or with subtype 1

Subtype 3: Skin thickening (phymatous rosacea)

• Skin thickening and enlargement
• Usually appears around the nose (known as rhinophyma)

Subtype 4: Eye irritation (ocular rosacea)

• Styes
• Irritation, burning, or stinging

Rosacea Treatments

Like acne, rosacea treatments might include topical or oral medications.
Topical medications include:

• Ivermectin (Soolantra)
• Azaleic acid (Finacea, Azelex)
• Minocycline (Zilxi)
• Metronidazole
• Sulfa-based

Oral medications include:

• Low-dose Doxycycline – it’s anti-inflammatory, but not an antibiotic
• Tetracycline Antibiotics (Tetracycline, Doxycycline, Minocycline, Seracycline)
• Isotretinoin (Accutane) – used less frequently for rosacea than acne

You don’t have to suffer from acne or rosacea forever. By being aware of their causes and triggers and devising the best treatment plan with your dermatologist, you can reverse or prevent symptoms. The board-certified physicians at Laser & Skin Surgery Center of New York are world-renowned for their expertise in cosmetic treatments using the most effective techniques and treatments available today. To learn more, contact our Manhattan and Southampton, New York offices.