Doctor’s Corner Q&A Acne: Everything You Need to Know But Were Afraid to Ask

Welcome to NDDA’s “Doctor’s Corner!” We’ve revived one of our most popular newsletter articles – a candid monthly conversation with each of our board-certified dermatologists in their area of expertise. Here, we’ll address your biggest skincare concerns: their causes, treatments and the myths that surround them. Read on for the kind of in-depth information and one-on-one advice you’d normally have to leave your living room to get! While no article can replace a personal assessment of your skin, we hope this monthly feature will arm you with the knowledge necessary to take the first step towards the best skin of your life.

March: Acne (Dr. Melissa Rubenstein, NDDA Board Certified Dermatologist)

There’s no shortage of information on acne. From online bloggers to cosmetic companies and even traditionally held opinions about why and when it occurs – acne is one subject everyone has an opinion on. And if you struggle with acne, you may be listening to well-intentioned, but ineffective falsehoods.

Acne, does not have the multiple single causes most people assume (a poor diet, raging hormones during teenage years), says Dr. Melissa Rubenstein, one of NDDA’s senior physicians and NDDA’s resident acne expert. And most fixes people try on their own (a restricted diet, an elaborate skincare routine) can be ineffective at best and actually contribute to the problem (at worst).

“I’ve seen cases where a 12-year-old girl’s acne looks as bad as an 18 year-old-boy’s acne,” says Dr. Rubenstein. “And parents often ask me to tell their kids the breakouts are the result of greasy junk food. I wish I could say they were – but that’s just not what acne is.”

“Incentives for clean eating aside, diet actually has little to do with the development of an acne problem, with one exception – overconsumption of dairy has been linked to acne in several studies and may play a role in making it worse. And while hormones can and do play a role in acne, they are not the root cause,” says Dr. Rubenstein.

Q: So what is the cause of acne?

A: “All acne has the same origin – essentially, it’s an immune response. Our bodies produce oil to protect our skin, and sometimes, when there is excess oil production, the cells in our body react more aggressively to that oil production. Patients can move between categories of severity – from mild to severe, and back again. Their acne can be totally mild and then suddenly flair or intensify – and we don’t know what causes that transition.”

Q: Is acne just a part of life, or can it be eliminated?

A: “Acne is not something you can or should face alone. From really severe cases to even mild outbreaks, there’s a solution for everyone. While there are different treatments for different people, it’s more about learning how to manage that underlying cause – inflammation and immune response – to get clear skin. There’s no reason to suffer through it or wait for it to get better. Don’t just chalk it up to diet or stress, see a board certified dermatologist who understands acne, and get it treated.”

Q: What are the most effective treatments you’ve seen?

A: “Accutane is the gold standard, but there are many other medications that address the underlying medical needs of each case. There are short term oral antibiotics and other anti-inflammatory drugs that can initially get the problem under control and can be followed with a good skincare regimen that includes daily creams and retinoids depending on what your skin will respond to and tolerate. In cases where hormonal fluctuations play a role, for example in women in their 20’s, hormonal agents (similar to birth control) can be used.”

Q: Why should I see a board certified dermatologist for acne?

A: “With acne, knowledge is power, and it’s a totally solvable problem – no matter how severe, or mild your case is. But, you need to know what’s going on with your own skin. This is not something that at-home trial and error can effectively fix. Finding a provider who will be more aggressive with treatment if necessary makes a huge difference. And finding someone with the knowledge and experience to guide you through can turn your acne problem around for good. Look for a provider who feels comfortable using different medications. No one should have to live with acne if there are good treatments available and they want clear skin. I like to use a combination of products with prescriptions to tailor treatment to every patient’s unique skin.”

Q: Spa treatments (microdermabrasion and chemical peels) are marketed as effective for acne. Is this a myth or do they really work?

A: “Microdermabrasion and chemical peels can actually be very effective when used in conjunction with treatment to help you maintain clear skin”. “I recommend these to patients a lot” And they work at all different levels of severity. These treatments, when done in a true medical spa setting are so advanced now they can be closely tailored to a patient’s individual needs. For example, at NDDA, you can visit with any one of our three aestheticians, Joni, Becky and Allison and assess with the physician’s oversight the different strengths of peels available to help you meet your own skin’s needs and achieve specific results. They also help with scarring that is a result of acne. Again, the guiding principle here should be – find someone who knows your skin! First, a board certified dermatologist who can make specific recommendations to an aesthetician, and then an experienced aesthetician who can tailor your spa treatment to the doctor’s recommendation. This isn’t a ‘one-size-fits-all’ proposition. While the root cause of acne is the same, the way you treat it for your own body will be different than the next person. And the same is true for the spa treatments that supplement your daily regimen. Make sure to go to an experienced aesthetician – with your doctor’s recommendations in hand – who will listen to your concerns, tailor your treatment and get you the best results.”


Dr. Melissa Rubenstein

Dr. Melissa Rubenstein is a board certified dermatologist trained at Baylor College of Medicine and UT Southwestern. She is an acne expert and enjoys helping patients deal with their acne no matter how mild or severe it is – with life changing results. Her philosophy is that no one should have to live with acne and knowledge is power when it comes to your own skin. Read more about Dr. Rubenstein here . . . 

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North Dallas Dermatology Associates8144 Walnut Hill Lane Suite 1300
Dallas Texas 75231
Fax: (214) 420-7380

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Mon-Thurs: 8:00AM – 4:00PM
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, Doctor’s Corner Q&A Acne: Everything You Need to Know But Were Afraid to Ask