Hitting Acne Where It Hurts; Successful Treatment Offered by Laser Dermatologist

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Severe Acne requires hard-hitting treatment. Orange County laser dermatologist Nissan Pilest plays the trump card when battling resistant and severe cystic acne by using a combination of Photo Dynamic Therapy, Vbeam and Fraxel Laser.

You could see that the pain of his skin was nothing compared to the pain in his soul. He was distraught, angry and visibly fought to hold back the tears.

Severe Acne requires hard-hitting treatment. Orange County laser dermatologist Nissan Pilest plays the trump card when battling resistant and severe cystic acne by using a combination of Photo Dynamic Therapy, Vbeam and Fraxel Laser.

The following case study is one of Dr. Pilest's success stories:

When Erik was 12, he started getting pimples. His mom bought antibacterial soap, a scrub pad and some benzoyl peroxide lotion. He religiously scrubbed his face three times a day. Things only got worse.

By the time Erik arrived at the office of Orange County Dermatologist Nissan Pilest, the 15 year-old was in big trouble with his skin.

The physician recalled, "His face and neck were covered with extremely painful cysts, pus-filled pimples and angry red acne scars. Acne punished not just his face, but his back and shoulders, too. It was a summer day and he wore a turtle neck sweater and a baseball cap pulled low over his eyes.

"You could see that the pain of his skin was nothing compared to the pain in his soul. He was distraught, angry and visibly fought to hold back the tears."

When Erik came in that first day, he scowled at everyone, mumbled that it was his mother's idea and complained that he didn't have any reason to be there, "since nothing's going to work anyway."

Dr. Pilest told Erik he was delighted to have him in the office because he could see the future. He promised Erik that he would " look definitively different in a matter of weeks."

Erik's acne was in the 'severe' class - resistant to topical products, extremely sensitive, and impervious to previous attempts to control the problem. Erik had seen another doctor early on in his bout with acne and had been prescribed antibiotics. Like most teens, he took them sometimes, sometimes he "forgot" and eventually he decided they didn't make enough difference for him to take them at all. He believed his acne was incurable. His grades were dropping, he was becoming a loner and his mother was, as she called it, at her wit's end...and scared for her son's well-being.

The first treatment Erik was given was a newer procedure called Photo Dynamic Therapy (PDT) He needed a heavy hit and he needed it right away.

Dr. Pilest noted that this treatment is always performed in a medical office. The skin is prepped with a degreasing cleanser and a topical solution that has light-triggered action (called Levulan) is applied to any area that has acne present. After letting the Levulan penetrate the skin, a special light is used to start the solution's action. Basically it begins a "seek and destroy" mission, by both killing the acne bacteria that is housed deep in the skin and shrinking the sebaceous glands; these glands produce sebum - the food source for acne bacteria.

It's not a completely painless procedure. Some people describe it as burning or stinging or a hot sensation. But it's generally not nearly as painful as trying to squeeze an acne cyst -- something most everyone with bad acne is prone to do. The skin gets red, peels and for a couple of days the majority of PDT patients hide out. But the improvement is dramatic and quick.

PDT was the pivot point in Erik's out-of-control acne. In a matter of weeks he was actually looking forward to going to the office. His skin was in the process of making big improvement. So was his attitude. The funny guy who had been trapped behind that angry acne was coming out of hiding and the entire office stall said they looked forward to his visits as much as he did.

Dr. Pilest followed the PDT with Clearlight treatments, an RX topical twice a day and a special cleanser. Erik was advised to stop using hair wax that was causing extra little breakouts on his forehead and forbidden to use scrub pads Once the acne was under control he had a short series of Vbeam laser treatments to take the red out of his scars.

Dr. Pilest reminded us, "Managing acne is serious business. Acne is not nice. It will take advantage of lapses in your prescribed routine. If you forget or get a little lazy, your acne is not going to give you a break. A home treatment plan of acne products, some of which are prescription, is required as part of your plan to keep your skin clear. If you break the rules, the only one to suffer is you."

Erik is on a program today that includes maintenance Clearlight sessions, his prescribed daily skin care routine and plenty of water instead of sodas or milk.

Sometime soon Dr. Pilest will begin smoothing Erik's scars with Fraxel laser. He shared, "Acne ravaged Erik's skin and despite the technology at hand, it will be impractical to think he will have perfect looking skin. Yet the changes on all levels would have been impossible even a few years ago."

Erik is 16 now, has a girlfriend, and this past year joined a speech team at his high school that puts him on stage. He was in the doctor's last week. He showed Dr. Pilest a picture of his new girl and as he settled in for his Clearlight, he shook his hand and said, "Thanks, doc. I can't believe how different my life is now."

The doctor responsible for Erik's new view on life beamed as he said, "This is what I go to work for."

Dr. Nissan Pilest is a well-known laser specialist in Orange County, Ca. He has had special interest in resistant acne and acne scarring for much of his 27 year career as a corrective and cosmetic dermatologist. His practice, Total Dermatology, is in the Sand Canyon Medical Center in Irvine. A board certified Dermatologist, Dr. Pilest is also an associate professor at the University of California Irvine. The practice maintains an educational web site at Total Dermatology Consultations can be arranged by calling 949-727-3800 or 877-DrPilest

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