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                                     Pimples Treatment Center
Acne vulgaris, or acne, is a skin problem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, whiteheads, pimples, or zits.
When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or, it can be bigger, solid, red lumps that are painful (cysts). 

Most young people get at least mild acne. It usually gets better after the teen years. But many adult women do have acne in the days before their menstrual periods. 

How you feel about your acne may not be related to how bad it is. Some people with severe acne are not bothered by it. Others are embarrassed or upset even though they have only a few pimples. 

The good news is that at Pimples NYC at the Pimples NYC Treatment Center there are many good treatments that can help you get acne
under control.  
What causes acne? 

Acne starts when oil and dead skin cells clog the skin's pores. If germs get into the pores, the result can be swelling, redness, and pus. See a picture of how pimples form. 

For most people, acne starts during the teen years. This is because hormone changes after puberty make the skin more oily.

You do not get acne from eating chocolate or greasy foods. But you can make it worse by using oily skin products that clog your pores. 

Acne can run in families. If one of your parents had severe acne, you are more likely to have it. 

What are the symptoms? 

Symptoms of acne include whiteheads, blackheads, and pimples. These can occur on the face, neck, shoulders, back, or chest. Pimples that are large and deep are called cystic lesions. These can be painful if they get infected. They also can scar the skin. 

How is acne treated? 

To help control acne, keep your skin clean. Avoid skin products that clog your pores. Look for products that say “noncomedogenic” on the label. Wash your skin once or twice a day with a gentle soap or acne wash. Try not to scrub or pick at your pimples. This can make them worse and can cause scars. 

For a few pimples, you can get an acne cream without a prescription. Look for one that has benzoyl peroxide or salicylic acid. These work best when used just the way the label says. 

It can take time to get acne under control. Keep using the same treatment for 6 to 8 weeks. You may even notice that it gets worse before it gets better. If your skin is not better after 8 weeks, try another product. 

If your pimples are really bothering you or are scarring your skin, see your doctor. A prescription gel or cream for your skin may be all you need. Your doctor may also order antibiotic pills. A mix of treatments may work best. If you are female, taking certain birth control pills may help. 

If you have acne cysts, talk to your doctor about stronger medicine. Isotretinoin (such as Accutane) works very well, but it can cause depression, birth defects, or high cholesterol. Let your doctor know if you have had depression before taking this medicine. And if you are female, you must protect against pregnancy by using two forms of birth control. Even one dose of this medicine can cause birth defects if a woman takes it while she is pregnant. 

What can be done about acne scars? 

There are skin treatments that can help acne scars look better and feel smoother. Ask your doctor about them. The best treatment for you depends on how severe the scarring is. You can have scar tissue removed or have a shot of juvederm. Juvederm smoothes a pitted scar by plumping up the skin underneath. You may get the best results with a combination of treatments.
Acne management
General principles of treatment
Acne can be effectively treated, although response may sometimes be slow.
Where possible, avoid excessively humid conditions such as a sauna, working in an unventilated kitchen or tropical vacations (but ultraviolet light helps).
Try not to apply irritant oils or cosmetics to the affected skin.

Abrasive skin treatments can aggravate both comedones and inflammatory lesions.
Try not to scratch or pick the spots
No relationship between particular foods and acne has been proven.
Management of mild acne
Most patients with mild acne can be treated with topical agents (gels, solutions and lotions) that can be obtained over-the-counter in New Zealand without prescription. Most people just use topical agents for facial skin as they can be difficult to apply to one's back. Extra vitamins and minerals have not been proved to help.
Wash affected areas twice daily with a mild cleanser and water or an antiseptic wash.
Acne products should be applied to all areas affected by acne, rather than just put on individual spots.
A thin smear should only be applied to dry clean skin at nighttime.

Acne products may work better if applied in the morning as well.
They often cause dryness particularly in the first 2-4 weeks of use. This is partly how they work. The skin usually adjusts to this.
Apply an oil-free moisturizer only if the affected skin is obviously peeling.
Avoid applying oily cosmetics such as foundation or sunscreen.
It may take several weeks or even months to see convincing improvement.
Discontinue using product if severe irritation results. See your doctor for advice.
Suitable topical agents for mild acne that can be obtained without prescription include:
Antiseptic washes (Acnederm wash™, Benzac™ AC Wash, Dalacin™ T Prewash, Oxy™ Daily Skin Wash)
Mild salicylic acid preparations to exfoliate and unplug the follicles (Neutrogena® Oil-free Acne Wash and many others)
Benzoyl peroxide cream / lotion / gel (PanOxyl™ Acne Gel, Brevoxyl™ Cream, Oxy-10™, Clearasil™ Ultra Acne Cream, Benzac AC Gel)
Azelaic acid (Skinoren™ cream, Acnederm™ medicated lotion)
Hydrogen peroxide in stabilised cream (Crystacide®)
Tea tree oil products
Topical agents for mild acne which require prescription include:
Antibiotics, such as clindamycin solution (Topicil™) or erythromycin solution (Stiemycin™) and gel (Eryacne™) are best used with benzoyl peroxide or azelaic acid to reduce the chance of antibiotic resistance.
Retinoids i.e. tretinoin (Retin-A™), , adapalene (Differin™).

Blue light acne treatment is a new procedure recently found to be safe and helpful for mild to moderate acne.
See your doctor or dermatologist for advice if your pimples fail to clear up within six weeks or you have severe acne.
Management of moderately severe acne
Treatment for moderately severe acne usually includes topical agents. In addition, a doctor or dermatologist may prescribe an oral medication, usually for at least six months.
Suitable oral medications include:
Antibiotics such as tetracycline, minocycline, doxycycline or erythromycin
In females, estrogens and antiandrogens such as Diane 35™/Estelle 35™ or spironolactone
Some patients are helped by nonsteroidal anti-inflammatory agents such as ibuprofen or naproxen
For resistant or persistent acne, oral isotretinoin may be more suitable
See your doctor or dermatologist for advice if your skin problem fails to improve within three months or you have severe acne.
Management of severe acne
Treatment for severe acne requires oral treatment. Patients should be under the care of a dermatologist.
Many patients will be treated with oral isotretinoin. Dr. Gary does not use oral isotretinoin.
If this is not suitable, the following may be used:
High dose oral antibiotics for six months or longer
In females, especially those with polycystic ovary syndrome, oral antiandrogens such as oestrogen/cyproterone or spironolactone may be suitable long term. 

Systemic corticosteroids are sometimes used for their antiandrogenic effect. Flutamide and finasteride also been reported to be of benefit in hyperandrogenic women. At this time, these medicines are registered for treatment of prostatic cancer (and in the case of finasteride, for androgenetic alopecia) in males only, in New Zealand.
Physical treatments for acne
Sunlight is anti-inflammatory and can help briefly. However, exposure to ultraviolet radiation results in ageing skin and can eventually lead to skin cancer.
Cryotherapy (freezing treatment) may be useful to control new nodules.

Intralesional steroid injections can be used to shrink older nodules.

Comedones can be expressed or removed by acne surgery(comedone extractraction).
Microdermabrasion can help mild acne but usually does not in my opinion.

Blue light and sometimes red light phototherapy systems appear helpful. Treatment is often delivered twice weekly for four weeks. The effect may be enhanced by use of a photosensitising agent (photodynamic therapy).

Note: X-ray treatment is no longer recommended for acne as it may cause skin cancer.
New York Dermatology by Board Certified  Dermatologist Dr. Gary Rothfeld  is a board certified NYC  Dermatologist with a  New York City office in Manhattan, New York  providing expert skin care, dermatology, and cosmetic dermatology services.  A Park Avenue practice with an international reputation in general, cosmetic, and surgical dermatology.

I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. My goal is, quite simply, to provide the type of dermatologic care which I  would seek for my own family. This is a very important point, since physicians often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their hair and skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results 

Dr Gary sees every patient himself and  believes in personalized care. The Doctor does not employ any physician assistants, nurse practitioners, or other physician substitutes to do his treatment. He sees every patient himself at every visit.
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