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Acne
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NYC Acne Treatment Center
NYC Dermatologist Center This service should not be used in place of a visit, call,
consultation with or the advice of your healthcare provider. Communicate promptly with your provider with any
health related questions or concerns. Acne
Acne is a very
common skin problem that shows up as outbreaks of bumps called pimples or zits. These usually appear on the face, neck, back,
chest, and shoulders. Acne can be a source of emotional distress, and severe cases can lead to permanent scarring. What
Causes Acne? Acne begins when the pores in the skin become clogged and can no longer drain sebum (an oil made by the
sebaceous glands that protects and moisturizes the skin.) The sebum build-up causes the surrounding hair follicle to swell.
 Hair follicles swollen with sebum are called comedones. If the sebum stays beneath the skin, the comedones
produce white bumps called whiteheads. If the sebum reaches the surface of the skin, the comedones produce
darkened bumps called blackheads. This black discoloration is due to sebum darkening when it is exposed to
air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.
Bacteria called
Propionibacterium acnes (P. acnes) that normally live on the top of the skin can enter the clogged pores and infect
the sebum. This causes the skin to become swollen, red, and painful.
Infected sebaceous glands may burst, releasing
sebum and bacteria into the surrounding skin, creating additional inflammation. In severe cases, larger nodules and cysts
may form in the deeper layers of the skin.
What Are the Different Types of Acne? Acne can be categorized by
its severity: - Mild acne describes a few scattered comedones (whiteheads or blackheads) with minimal
inflammation (no pustules).
- Moderate acne describes a denser collection of comedones as well as red,
inflamed, pus-filled lesions (pustules).
- Severe acne, also called nodular or cystic acne, describes
widespread and deep lesions that are painful, inflamed, and red. This form of acne is likely to lead to scarring if left untreated.
 
Mild acne with comedones on the forehead Moderate acne with pustules Who
Gets Acne? Anyone can get acne, but it appears most often in teenagers, whose surging levels of androgen (a type of
hormone) create larger and more active sebaceous glands. Acne may continue for people in their twenties and thirties, and
even women over forty. Acne also appears more commonly in people whose parents had acne. What Factors Make Acne Worse?
Acne lesions can come and go. These factors can cause acne to flare: - Changing hormone levels in women 2 to
7 days before their menstrual period, during pregnancy, or when starting or stopping birth control pills
- Oil from
skin products (moisturizers or cosmetics) or grease in the workplace (for example, a kitchen with fry vats)
- Pressure
from sports helmets or equipment, backpacks, tight collars, or tight uniforms
- Environmental irritants, such as pollution
and high humidity
- Squeezing or picking at blemishes
- Hard scrubbing of the skin
What Are The
Treatment Options for Acne? Almost all cases of acne can be effectively treated. Treatment goals are to heal existing
lesions, stop new lesions from forming, and prevent scarring.
Acne treatments aim to control one or more of the
underlying causes of acne. For instance, topical retinoids, such as Differin or Retin A Micro, may help unclog sebaceous glands
and keep pores open. Antibiotics may be used to fight the P. acnes bacteria. Accutane or hormonal agents, such as birth control
pills, may be used to reduce sebum (oil) production.
Before Treatment
After Treatment 
A. Topical medications (applied to the skin) Over the counter - Benzoyl
peroxide—This is found in many products including Clearasil and Proactiv. It is a mild antibiotic that kills
the P. acnes bacteria. It is available in different concentrations. Higher concentrations are more likely to irritate
the skin. It does not unclog blocked pores so is not as helpful for reducing whiteheads and blackheads.
- Sulfur
and salicylic acid—These have some mild ability to break down whiteheads and blackheads.
Prescription
- Topical retinoids (Differin, Retin A Micro, Tazorac, tretinoin)—These are among
the most effective and commonly used acne medications. Topical retinoids are unique in their ability to unclog swollen pores.
They may be used alone for mild acne or combined with other medications for moderate-to-severe acne. They may also be recommended
for long-term use, even after the acne is under control, to keep the skin clear.
- Topical antibiotics—Antibiotics
applied to the skin, such as clindamycin (Clindagel) and erythromycin, kill the P. acnes bacteria that leads to inflammation.
B. Oral medications (taken by mouth) - Oral antibiotics—These medications, which include
tetracycline, doxycycline (Adoxa, Doryx), and minocycline (Dynacin, Solodyn), act systemically and can reach bacteria in the
deep layers of the dermis. They are also used for their anti-inflammatory effects.
- Oral contraceptives
(Ortho Tri-Cyclen, Yaz)—For women who experience hormonally triggered acne, birth control pills may be prescribed to
reduce sebum production.
- Anti-androgen drugs—Some drugs used for other medical conditions are
known to reduce androgen levels, such as spironolactone (Aldactone). These may be used in some cases of acne.
- Isotretinoin
(Accutane, Sotret)—Isotretinoin remains the most effective treatment for severe acne or acne that does not respond to
other treatments. Isotretinoin treats all causes of acne: excess sebum, clogged pores, bacterial overgrowth, and inflammation.
Most patients take the medicine for 15-to-20-week periods that may be repeated if necessary. Treatment requires monthly office
visits, monthly lab tests, and strict contraception. It is critical that women of child-bearing age do not get pregnant while
taking isotretinoin because of the serious risk of birth defects. The iPledge program was developed to reduce the likelihood of birth defects and other side effects.
Many of these medications have
side effects, such as burning, redness, and irritation. With some medicines, such as topical retinoids, these side effects
usually decrease or go away after the medicine is used for a period of time. If side effects are severe or don't go away,
tell your doctor. C. Procedures For persistent lesions that are inflamed or unresponsive to medications, some
doctors recommend additional methods, including extraction, light therapy, or corticosteroid injections. How Will
I Choose a Treatment Plan? Your doctor will recommend a treatment based on these factors: - Severity
of your acne. Mild acne may respond well to a topical retinoid alone. Moderate acne may respond better to a combination
of topical retinoid with an antibiotic or other medication. Severe acne with scarring may need treatment with an oral retinoid
(Accutane, Sotret).
- Results of previous treatments. Medications may be added in a step-wise fashion,
only if previous treatments are found to be ineffective.
- Degree of scarring. More aggressive therapies
may be started earlier if acne scars have already started developing.
- Gender. Some treatments are
available only for females, such as birth control pills.
Whatever your treatment plan, it is important
that you give it enough time to work. This may mean waiting 6 to 8 weeks to see results. While the older acne lesions are
healing, the medication is hard at work keeping new lesions from forming. Staying on your medication is the most important
step to getting acne under control.
How Can I Keep My Acne Under Control? After your acne clears,
your doctor may recommend that you continue therapy with a topical retinoid to keep it under control. It is always a good
idea to maintain good skin care and use skin care products labeled as “non-comedogenic” (do not promote acne)
What About Self Care and Prevention? For ongoing self-care and prevention of acne, follow a few simple guidelines:
- Clean skin gently—Use a mild skin cleanser twice a day, and pat skin dry. Harsh cleansers and
astringents can actually worsen acne.
- Do not pop, squeeze, or pick at acne lesions, as this can promote
inflammation and infection. Keep hands away from your face and other acne-prone parts of the skin.
- Limit sun
exposure—Tanning only masks acne at best. At worst, sun exposure can lead to skin damage, especially if you
are using an acne treatment that makes your skin more sensitive to sunlight and UV rays (this includes tanning booths).
- Choose
cosmetics with care—As mentioned above, choose non-greasy skin products, and look for words like “non-comedogenic”,
“oil-free”, and “water-based”. Some facial products contain active acne-fighting ingredients, such
as benzoyl peroxide or salicylic acid, to help keep mild acne at bay.
- Be patient with your treatment—Find
out how much time it should take for your acne treatment to work (generally 6-8 weeks) and then stick with it. Stopping treatment
early may prevent you from seeing good results or even cause a relapse of symptoms. Your skin may look worse before it begins
to improve. You may need to try more than one type of treatment.
Images courtesy of
DermAtlas, © 2001-08 ___________________________________________________________________ This
information is for general educational uses only. It may not apply to you and your specific medical needs. This information
should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional.
Communicate promptly with your physician or other health care professional with any health-related questions or concerns.
Be sure to follow specific instructions given to you by your physician or health care professional.
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Our goal at NYC Dermatology is to be the Tiffanys of Skin Care.
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 physicans 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
skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results.
We also support our patients with a very fine medical staff . Please take a moment to explore our top of the line winning
website. My philosophy is simple…Experience Counts and Quality Matters. Please allow
me to solve your skin problems. After all, at NYC Dermatology , our philosophy is if you look great you will feel great
with gorgeous skin.” Best
Regards, Dr. Rothfeld
 
Dermatologists are physicians specializing in the diagnosis and treatment of diseases and tumors of the skin and its appendages. There are medical and surgical sides to the specialty. Dermatologic surgeons perform skin cancer surgery (including Mohs' micrographic surgery), laser surgery, photodynamic therapy (PDT) and cosmetic procedures using botulinum toxin (Botox), soft tissue fillers, sclerotherapy and liposuction. Dermatopathologists interpret tissue under the microscope (histopathology). Pediatric dermatologists specialize in the diagnoses and treatment of skin disease in children. Immunodermatologists specialize in the diagnosis and management of skin diseases driven by an altered immune system including blistering (bullous) diseases such as pemphigus. In addition, there is a wide range of congenital syndromes managed by dermatologists. Physician assistants and nurse practitioners with specialized training or extensive experience in dermatology also work in this specialty. Subspecialties The skin is the largest organ of the body and the most visible. Although many skin diseases are isolated, some are manifestations of internal disease.
Hence, a dermatologist is schooled in aspects of surgery, rheumatology (many rheumatic diseases can feature skin symptoms and signs), immunology, neurology (the "neurocuteaneous syndromes", such as neurofibromatosis and tuberous sclerosis), infectious diseases and endocrinology. The study of genetics is also becoming increasingly important.
Venereology, the subspecialty that diagnoses and treats sexually transmitted diseases, and phlebology, the specialty that deals with problems of the superficial venous system, are both part of a dermatologist's expertise.
Cosmetic dermatology
Cosmetic dermatology has long been an important part of the field, and dermatologists have been the primary
innovators in this area. In the 1900's dermatologists employed dermabrasion to improve acne scarring and fat microtransfer
was used to fill in cutaneous defects. Dermatologists specializing in cosmetic dermatology typically use non-invasive procedures
to reverse the signs of aging. Botox has been used since it was FDA approved for the treatment of wrinkles. It is used to
minimize wrinkles such as frown lines and crow's feet. Fillers are used to "fill in" lines on the face and to
minimize the appearance wrinkles. Brand names of fillers include Restylane, Perlane, Juvederm, Radiesse and Cosmoplast among
many others. Dermatologists are also the pioneers of energy based treatments for the skin and these include lasers, intense
pulsed light, radiofrequency, infrared light and photodynamic treatments.
Dermatologic surgery (dermasurgery) is performed by all dermatologists. Surgery is an integral part of dermatology residency
training; thus all dermatologists are well trained in cutaneous surgery. In North America specialized training through a 1
year dermatologic surgery fellowship is available upon completion of the dermatology residency, and usually focuses on training
in Mohs' micrographic surgery. Most dermatologic surgeons who have a special interest in this field apply for fellowship status with the American College of Mohs Micrographic Surgery
and Cutaneouis Oncology; or the American Society for Dermatologic Surgery. Techniques available to a dermatologic surgeon include lasers, traditional scalpel surgery, electrosurgery, cryosurgery, photodynamic
therapy, liposuction, blepharoplasty (cosmetic eyelid surgery), minimally-invasive facelift surgery (e.g., the S-lift), and
a variety of topical and injectable agents such as dermal fillers including fat transfer and hyaluronic acid. Some specially
trained dermatologic surgeons perform Mohs' surgery, which can be an effective method for the treatment of recurrent, indistinct, or difficult skin cancers.
Any mole that is irregular in color or shape should be examined by a dermatologist to determine if it is a malignant melanoma, the most serious and life-threatening form of skin cancer. Following a visual examination and a dermatoscopic exam (an invaluable
new instrument that illuminates a mole without reflected light), a dermatologist may biopsy a suspicious mole. If it is malignant,
it will be excised in the dermatologist's office.
The first step of any contact with a physician is the medical history. In order to classify a cutaneous eruption, the dermatologist
will ask detailed questions on the duration and temporal pattern of skin problems, itching or pain, relation to food intake,
sunlight, over-the-counter creams and clothing. When an underlying disease is suspected, an additional detailed history of
related symptoms will be elicited (such as arthritis in a suspected case of lupus erythematosus).
Dermatology has the obvious benefit of having easy access to tissue for diagnosis. Physical examination is generally done under bright light and preferably involves the whole body. At this stage, the doctor may apply Wood's light, which may aid in diagnosing types of mycosis or demonstrate the extent of pigmented lesions, or use a dermatoscope which enlarges a suspected lesion and visualizes it without reflected light. The dermatoscope is helpful in differentiating
a benign naevus from melanoma or a seborrheic keratosis from a mole. A morphological classification of dermatological lesions is important in the diagnosis of dermatological disorders. Dermatologic diagnosis is often dependent upon pattern recognition
of lesions and symptoms.
Culture or Gram staining of suspected infectious lesions may identify a pathogen and help direct therapy.
If the diagnosis is uncertain or a cutaneous malignancy is suspected, the dermatologic surgeon may perform a small punch biopsy (using a local anesthetic) for examination under the microscope by the dermatologist who is a trained dermatopathologist.
The skin is obviously accessible to topical local therapy. Antibiotic creams can help eliminate infections, while inflammatory skin diseases (such as eczema and psoriasis) often respond to steroid creams or topical anthralin. Dermatologists are innovators of new immune enhancing treatments, like topical imiquimod for
superficial cancers and injection immunotherapy for warts as discussed below.
Topical medications treat many dermatological diseases, but dermatologists also use oral medications. Antibiotics and immune suppressants or immune enhancing agents (injection immunotherapy or topical imiquimod) for dermatological diseases or tumors. Isotretinoin ("Accutane") is used for severe cystic acne vulgaris and often produces a lifetime remission of this disfiguring disease. Isotretinoin prescribing in the U.S. is now controlled
by a cumbersome FDA governmental website called iPLEDGE. Various new modalities of treatment are in the foray; with the advent of laser technology things are quite promising.
Photomedicine involves the use of ultraviolet light, often in combination with oral or topical agents, to treat skin disease (e.g., psoriasis or mycosis fungoides).
Surgical intervention by a dermatologic surgeon may be necessary, for example, to treat varicose veins or skin cancer. Varicose veins can be treated with sclerotherapy (injecting an agent that obliterates the vein) or the long-pulsed Nd:YAG
laser. Skin cancers can be managed with excision (including Mohs cancer surgery), cryosurgery, x-ray, or with the recent topical immune enhancing agent imiquimod. (See above section on "Dermatologic Surgery" for more details.)
Trained in Dermatology, NYC Dermatolgy by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding Dermatologist
in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist,
Dr. Rothfeld in Manhattan treats the most difficult cases until the problem clears. Dr. Rothfeld, a Board
Certified Dermatologist at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never
give up until the problem is cleared. Dr. Rothfeld, a board certified dermatologist in nyc who practices Dermatology
in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous
and will not give up until the condition resolves. Dr. Rothfeld is recognized as one of the best Dermatologists in NYC
by the entertainment industry.NYC Dermatology is
under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist.
To enhance every aspect of your
skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures.. NYC
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 board certified dermatologist in NYC specializing
in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld is
known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include
full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and
laser resurfacing. NYC dermatology specializes in chemical peels, vein injections, laser, restylane, Perlane,
Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
As an expert in the field of dermatology and cosmetic dermatologic
surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high
profile national magazines.
Our goal at the manhattan office of Board Certified Derrmatologist , Dr.
Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology
and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board
Certified Dermatologist at NYC Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at
our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services,
and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services
including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne
photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser
Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well
as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media office and including different offers and many more. We offer a variety of services from
Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for
a consultation. Beauty Is Forever! and Dr. Rothfeld
at NYC Dermatologist has over 20 years of experience with his beauty tips.
.
During
your office consultation and examination you will be provided with a detailed plan of the treatments that will benefit
you most. NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic
dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser
hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan,
services including general dermatology, wrinkle fillers such as Restylane®, Captique, Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®,
Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne,
rosacea, skin cancer and surgery. Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical
hair transplants, and lasers in the country. Acne Photodynamic Treatment
- Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser - Cosmelan Depigmentation Treatment - Glycolic
Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction
- - Surgery - Minimal Scar Technique - Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy
- Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments
- Velasmooth Our cosmetic surgeon includes Dermatologist Dr. Gary Rothfeld Board Certified Dermatologist
at NYC Dermatology. Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical
skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan
office in NYC
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NYC Dermatology - Manhattan Dermatology - Skin Institute of
New York - Skin Cancer Doctor- NYC Cosmetic Dermatology- Cosmetic Dermatological Surgery - New York City -
Board Certified Dermatologist
Manhattan Office
Dr. Gary Rothfeld
NYC Dermatology
- Board Certified Dermatologist - New York, NY
30 E. 60th St. Ste. 805
Manhattan, New York 10022
212.644.9494
1.800.BLEMISH
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