Our treatment Options for Acne

Medical evaluation for acne

Dr. Parvin Shafa’s experience in medical and cosmetic dermatology gives her the unique ability to evaluate each patient from inside and out. Click here to be scheduled for medical evaluation and treatment of your acne.

What type of hormonal imbalance can cause acne?

After a medical evaluation you may need treatment for the underlying diseases or conditions that may be the cause of your acne. Here are a few example of hormonal imbalance that can cause acne.


Commonly used retinoid are as followed:

  • Retin-A (Tretinoin, Retinoic acid)
  • Tazorac (Tazarotene)
  • Acitretin (Soriatane)
  • Differin (Adapalene)
  • Isotretinoin (accutane)

Retinoids are derivatives of Vitamin A that are made by the body as well as in the laboratory as a medication. Retinoids are the main key treatment for acne as well as therapy of various diseases such as psoriasis.

These agents normalize the shedding of the hair follicle lining and also have direct anti-inflammatory effects, thereby preventing the blockage of pores and decreasing the formation of comedones, unplugging existing comedones, and allowing other topical medicines (such as antibiotics) to enter the follicles.


  • Retinoids are essential elements for vision.
  • They regulate the growth of the bone and tissue.
  • They regulate cell proliferation and epithelial cell growth.
  • They regulate immune function and activate tumor suppressor genes.


  • Main indication for retinoids use is the treatment and control of acne by regulating cell growth of the hair follicles and skin.
  • It is a treatment for psoriasis by regulating cell proliferation and epithelial cell growth.
  • Retinoids are commonly used as a topical and oral antioxidants to reverse sun damage (photoaging) and prevent signs of aging.
  • Isotretinoin, the oral version of retinoids is used for prevention of cancer such as leukemia by regulating immune function and activating tumor suppressor genes. It is also used as chemotherapy for the treatment of brain and pancreas cancer because of its ability to kill rapidly dividing cells


Topical retinoid containing products can initially cause skin irritation such as redness, flaking, burning and dryness of the skin. To minimize the risk of these unwanted effects, start using the medication twice a week and slowly increase the frequency to every evening as tolerated.

Wash the skin with recommended cleanser and cool or lukewarm water twice a day. Avoid using hot water and pat skin dry. Apply a pea-sized amount of the cream to the entire face by dotting it on then gently smearing it across the skin. Avoid vigorous rubbing of the skin or using the cream in thin areas such as around eyes and under lower lips.

Avoid using moisturizer immediately after Retin-A application. After a few hours or later during the day you may apply non-comedogenic moisturizer. If the skin is irritable, you can use a thin layer of OTC hydrocortisone cream 1% up to three times a day for just a few days. If irritation continues, please contact Dr. Shafa’s office for advice or a follow up appointment. You may also decrease the frequency of the Retin-A cream use to 2 or 3 times a week until your skin gets used to the product.

Antibiotics (topical or oral)

The major effect of the use of antibiotics is to control the infection caused mainly by a bacteria called P. acne. Your options include:

  • Tetracycline
  • Doxycycline
  • Minocycline
  • Clindamycin
  • Erythromycin
  • Azithromycin
  • Sodium sulfacetamide
  • Ampicillin
  • Keflex

Azelex (Azelaic acid)

Azaleic acid is a unique compound. It occurs naturally in the skin and is well tolerated by most people, and can be safely used for years. It does not cause sun sensitivity or significant local irritation however dryness or lightening of the skin where it is applied is possible. It can easily be combined with other acne products such as Benzoyl peroxide, topical antibiotics and/or tretinoin.

Azelex properties include:

  • Antikeratinization: unclogs pores and decreases the abnormal shedding of the skin cells, improving non-inflammatory acne in the process.
  • Antibacterial effect that reduces the population of P. acnes without inducing resistance to this bacteria.
  • Anti-inflammatory effect that improves inflammatory type acne.
  • Improvement of acne related skin discoloration.

Prednisone for acne

Prednisone is a steroid with a powerful anti-inflammatory agent used to control severe cystic or nodular acne. It can be administrated:

  • Topically
  • Orally
  • Injected into acne lesions

Intralesional Corticosteroid Injection

Some cystic acne may become severely large and inflamed. With this type of acne, you may benefit from the immediate control of the surrounding swelling and inflammation with an anti-inflammatory agent such as diluted steroids, which can be injected into just the inflamed nodule. This lessens the inflammation and the cause of pain and swelling and promotes healing. Such an intralesional steroid injection works by “melting” the cyst over a period of 3 to 5 days.

Minor Acne Surgery

Acne surgery is the manual treatment of stubborn acne lesions or correction of acne scars. These are all are performed by Dr. Shafa under sterile conditions with topical or local anesthesia. At OC MedDerm Center, we are experts in the proper technique appropriate for “acne surgery”. Our goal is to perform pain free skin surgery. Local and topical anesthesia can be used so that you do not even feel that your skin is being touched.

Drainage and Surgical Extraction

Some types of deep cystic acne respond slowly or poorly to medication alone. Drainage of large, painful, swollen, and infected cystic acne lumps immediately reduces the pain associated with these cysts, helps the lesion heal faster, and decreases the likelihood of permanent discoloration and scarring.

Chemical Peels

Acne specific chemical peels such as salicylic acid at different strength is one of our acne treatments that we offer at our office. This can help control active acne as well as promote skin rejuvenation, including the correction of acne related skin discoloration and scars. Click here to learn more about chemical peels.

Comedone Extraction

For certain types of acne, such as some forms of comedones with hard, large, dry contents, it is beneficial to remove the contents of the lesions manually. By doing so, we can achieve better and faster results. Afterwards, we can prevent the formation of such skin lumps with the proper acne treatment. Dr. Shafa uses a tiny, sterile device to extract whiteheads and blackheads with minimal to no discomfort. This procedure should only be performed by an expert under sterile conditions.


Microdermabrasion is another alternative to unplugging acne pores. It uses a unique technique to scrub the skin with crystals, which is followed by the suctioning of tiny pores with a vacuum device. Microdermabrasion also stimulates collagen formation in the skin resulting in the improvement of acne scar appearance. It is also performed to rejuvenate skin and correct discoloration.

Acne Soothing Masks

Some of the masks we use are specially made for acne. They kill bacteria, decrease the oiliness of the skin and have a soothing effect by controlling skin inflammation (swelling, redness and associated pain). Masks may be applied after extractions or microdermabrasions to facilitate the healing process following these procedures. We offer a variety of masks that nourish your skin with vitamins, minerals and topical healing.

Home therapy for acne

This is the oldest technique for treating acne and it is found in some over-the-counter acne products. It induces a continuous and mild drying and peeling of the skin. This gentle treatment is a very acceptable option to start with and may provide fast and effective results even for swollen and infected lesions.

  • Alcohol and acetone
  • Benzoyl peroxide
  • Salicylic acid
  • Aluminum chloride
  • Sulfur and Rosorcinol
  • Zinc