CUSTOMIZING CLEAR SKIN – A comprehensive program helps both teens and adults deal with acne
BY LISA CRAWFORD WATSON | HEALTH MATTERS MARCH 2018
After hearing parents and their teens talk about the wide range of information they’d gathered about the causes and treatments of acne, and how many things they’d tried that didn’t work, Dr. Roya Javid decided to streamline the process for her patients by creating an Acne Treatment Center.
The board-certified dermatologist, whose Coastal Valley Dermatology practice is in Carmel, has an online source of information available as well as in-house access to practices and protocols to give patients a comprehensive and customized program.
“I prepared a detailed questionnaire for patients to fill out about their acne experience and what they’re trying to achieve. Everyone’s answers,” says Dr. Javid, “are a little different. I’ve also partnered with an FDA-approved lab to create customized formulations of acne medication, so I know exactly what my patients are using. And I give my patients a full written treatment plan.”
Dr. Javid takes “before” pictures at the start of treatment, and “after” pictures, once the treatment has started taking affect, so patients can see the change in their skin’s appearance.
“It’s always good to see the smiles as patients’ skin improves,” she says. “I can see their confidence increase.”
WHAT CAUSES ACNE?
The cause of acne has long been a source of debate. Is it chocolate? Dairy products? Sweat? Chocolate has sugar, says Dr. Javid, which, like dairy products, can cause inflammation. Sweat does not cause acne, but the additional buildup of bacteria that occurs while sweating can contribute to acne.
Here’s what actually happens. Hormones stimulate and enlarge the sebaceous glands in the skin, which secrete oil. The oil builds up at the base of the pores. An adolescent’s raging hormones create more oil, which clogs pores.
A teen’s oily hair against the face can further clog the pore, as can makeup. And dead skin cells, not adequately sloughed off, also can clog pores. A plug forms in pores and hair follicles, and bacteria grows, which stimulates inflammation, causing redness, swelling and pus, resulting in acne.
Blackheads are dirt and debris that gets oxidized. Whiteheads result when a thin layer of skin forms over the debris, creating small, flesh-colored bumps. Both types of plugged pores can develop into swollen, tender inflammations or pimples, or deeper lumps. Cysts, a more severe form of acne, are swellings below the skin’s surface that become inflamed, tender, and sometimes infected. For some people, acne continues into adulthood.
HOW TO CLEAR UP ACNE?
“When they come in for their first visit, patients often are concerned about present acne as well as potential scars,” says Dr. Javid. “Whether it’s active acne, red or brown tones, or scarring, I address all of that.”
In addition to prescription medication, Coastal Valley Dermatology provides patients with a customized acne kit, including special cleansers and moisturizers. Dr. Javid also offers patients a complimentary liquid nitrogen facial every time they come in, which immediately helps to dry out pimples on the face. Then she discusses other treatments she can do to cleanse and condition the skin.
One option is a teen acne facial performed by an in-house esthetician to help with extracting blackheads, removing whiteheads, and absorbing oil. Because the esthetician has access to patients’ medical records, she can devise a treatment that will complement their care, rather than running the risk of drying or irritating the skin by using too many active-ingredient products or counteracting Dr. Javid’s customized plan.
“I’m trying to streamline each acne treatment plan by keeping it all in house,” says Dr. Javid. “Particularly with teens, it’s all about consistency, explaining, reinforcing and reminding.”
BROADBAND LIGHT TREATMENTS
Dr. Javid also administers a “Forever Clear BBL,” or broadband-light treatment, to help heal and condition the skin.
“A lot of practitioners use blue light to treat acne. I take it a step further,” she says. “I use three lights. Blue light helps kill acne-causing bacteria, deep down in the pores. I use a yellow light to address inflammatory papules—the redness that occurs during and after a pimple.”
Dr. Javid also employs an infrared light, which goes even deeper to help shrink sebaceous glands, and help the body’s healing process from the inside out.
“It’s a three-step light process,” she says, “which is not painful. I use a chiller on the face, so it’s being cooled and soothed at the same time.”
When treating deeper cystic acne, Dr. Javid considers prescribing Accutane, an FDA-regulated oral retinoid, which is a derivative of vitamin A. There is controversy around the drug because it has potential side effects, such as sun-sensitive skin, hair loss, dry eyes, achy joints and dry skin, among others, and it is known to cause severe birth defects in developing fetuses.
Thus, anyone taking the drug must be enrolled in the “I Pledge” program, which includes a promise that any woman will submit to two negative pregnancy tests, and commit to using two forms of birth control, before receiving the drug.
“My view is that a lot of other medications are more toxic,” says Dr. Javid. “I have an open line of conversation with my patients to know how they’re doing. I’ve taken only one patient off Accutane because it affected his moods. It’s generally a six-month treatment and can work really well.”
REMOVING THE TRACES
Once the acne is under control, Dr. Javid turns her attention to any acne scars. After assessing the different types and degrees of scarring, she generally uses a Halo laser treatment. This fractional laser helps build new collagen in the skin and minimize the scar. Depending on the level of scarring, the patient may need more than one treatment.
Dr. Javid’s protocol for treating adolescent and adult acne is generally the same. However, some adults actually have rosacea, which is on the spectrum of acne. This also presents with the inflammatory papules and redness of acne but not the typical blackheads and whiteheads of adolescent acne. If it is rosacea, she also will treat it with broadband light, but on a different frequency or setting.
“We’ve had a lot of success in our Acne Treatment Center,” says Dr. Javid. “Much of it has to do with consistency. Because I know the patients’ history and what they’re trying to achieve, I can customize a comprehensive program consistent with their needs. And as long as they follow it regularly, we can anticipate good results.”