Acne handout | dermatology associates of wisconsin, s.c.
Your skin maintains its smooth, soft appearance due to the water content of the outer layer cells. These
cells are like sponges, they can hold a lot of water. To keep the water from evaporating from these cells,
your skin makes oil to form a protective layer, just like a piece of plastic wrap around a sandwich keeps
the bread from drying out. In the winter when humidity is reduced, water evaporates more readily from
your skin cells leading to dryness, flaking, irritation around the hair follicles of the thighs and arms
occasionally to redness, itching, and general discomfort. Therefore, the first thing to do for dry skin is to
establish a good oil layer. Most important is to leave your natural oils in place. Soap is very efficient at
fold areas. Use super fatted soaps, which are not as efficient at removing oils or soap substitutes.
super fatted soaps: Basis, Dove, Olay, Neutrogena, and Cetaphil
Non-soap liquid cleansers: Neutrogena, Cetaphil, CeraVe, Vanicream
The rinsing action of a shower removes more oil from the skin than a bath. A bath is a more effective
method of allowing the skin to soak up water. It takes the skin about 15 minutes submerged in water to
soak up a sufficient amount of water to counteract severe dryness indicated by “prune fingers”. It takes
only 30 minutes for this water to evaporate again. Therefore, to trap the water absorbed in showers and
baths, it is helpful to apply oil, occlusive cream or emollient lotion to the still damp skin. Occlusive creams
are usually preferred if your skin is very dry (lotions are diluted creams). Avoid “medicated” and scented
preparations as they may contain ingredients that will irritate dry skin.
Bath Oils: Alpha Keri Oil, Neutrogena Sesame Oil, Baby Oil, Olive Oil
Lotions: Cetaphil Lotion, CeraVe Lotion, Curel Lotion, Vanicream Lotion Occlusive Creams: Cetaphil
Lips: To prevent chapped lips, follow much the same procedure. A wax chapstick (unflavored or
unscented) is preferable to creams or lotions. Wax prevents evaporation of water and also protects the
skin from saliva and foods which act as irritants. Lips that are already dry and cracked can be very
difficult to treat because of secondary infections from bacteria of the mouth and constant irritation from
saliva. When lips are chapped, apply warm water compresses to them for approximately 15 minutes;
then apply chapstick or plain Vaseline. See a physician if this does not improve.
Hands: Minimize hand washing and avoid irritating the thin skin on the back of the hands by washing
only the fingertips. Do no apply soap to red, cracked, irritated skin. Moisturize hands immediately after
cleansing. An occlusive cream is best used to moisturize hands.
Acne areas: Use lipid free products only. Look for products designed for the face and say “oil-free”,
“non-acnegenic” or “non-comedogenic”. Examples are: Neutrogena facial moisturizer, Purpose,
Tetracycline (inexpensive, works well): Can cause upset stomach in about 10% of patients. It makes you a
little more sensitive to the sun. If you are going to be out in the sun for longer than 20 minutes, sunscreen SPF
15 or greater should be applied. In women, it can increase the frequency of yeast infections. It,
theoretically, may make birth control pills less effective.
Minocycline (much more expensive, works better): Can cause lightheadedness in a small number of
people. Long term use can lead to some of the medicine being deposited in the skin. This shows up as small
blue spots in the mouth, on the face, and in scars. It almost always goes away when you stop the medicine.
In women, it can increase the frequency of yeast infections. It, theoretically, may make birth control pills less
effective. Rarely, people may develop "lupus-like" symptoms with muscle and joint aches and fatigue.
Doxycycline (more expensive, works better): The old doxycycline and generic doxycycline are absorbed in
the stomach and have a high incidence of sun sensitivity. The new doxycyline (Doryx – brand) is a pellet
that by-passes the stomach and is only absorbed in the small intestine. This has almost completely
eliminated the sun-sensitivity side effect. Some people get a little light headed. It, theoretically, may make
birth control pills less effective. It does not get deposited in the skin or give the rare “lupus-like” symptoms
that could potentially be seen with minocycline. It is generally taken one time per day. It is not known if it is
as effective as minocycline however.
Erythromycin (inexpensive, works well): Can cause upset stomach in about 25% of patients. If this happens,
try taking it with food or taking an antacid (Tums, Rolaids) when the symptoms develop. In women, it can
increase the frequency of yeast infections. It, theoretically, may make birth control pills less effective.
Accutane can potentially “cure” acne, but is a very expensive therapy. There are some significant side
effects that must be endured. Accutane is a teratogen, which means that it can cause birth defects if you
become pregnant. Therefore females of childbearing potential must be on birth control during therapy.
Lab tests are drawn on a monthly basis during therapy to monitor for potential serious side effects. Monthly
appointments are required by law to obtain a prescription for accutane. Average length of therapy is 5
If you are a woman and you become pregnant, stop all of your acne medicine immediately and contact
If you have any questions or problems with your acne medication, please feel free to contact your doctor
Pat and Jerry Blakey Interview by Jean Bouteiller Dr. Walker was dedicated and worked tirelessly. Pat was impressed with how he came to the house when someone was sick, often late at night. He would sit at the side of the bed, “and he had that way of looking at you, like he could see right through you. I think he had more than just a medical ability, he really had the ability to see into you,”
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Your skin maintains its smooth, soft appearance due to the water content of the outer layer cells. These
cells are like sponges, they can hold a lot of water. To keep the water from evaporating from these cells,
your skin makes oil to form a protective layer, just like a piece of plastic wrap around a sandwich keeps
the bread from drying out. In the winter when humidity is reduced, water evaporates more readily from
your skin cells leading to dryness, flaking, irritation around the hair follicles of the thighs and arms
occasionally to redness, itching, and general discomfort. Therefore, the first thing to do for dry skin is to
establish a good oil layer. Most important is to leave your natural oils in place. Soap is very efficient at
fold areas. Use super fatted soaps, which are not as efficient at removing oils or soap substitutes.
Tetracycline (inexpensive, works well): Can cause upset stomach in about 10% of patients. It makes you a
little more sensitive to the sun. If you are going to be out in the sun for longer than 20 minutes, sunscreen SPF
15 or greater should be applied. In women, it can increase the frequency of yeast infections. It,
theoretically, may make birth control pills less effective.