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Acne & Dark Spots

What is acne?
What causes acne?
What happens after oil glands get plugged?
How is acne treated?
What are dark spots?
Why do we get dark spots?
How does the Dr. Earles Skin Care System stop dark spots?
Why does the Dr. Earles Skin Care System work better than other products to treat dark spots?

What is acne?

Acne is an inherited disorder. If you have acne, rest assured that some family member, if not mom or dad, one of your grandparents—remember, you have four—has had acne. There is no evidence that it is related to food or water intake, cleanliness or rest. So all-day pop, greasy foods and sweets do not cause acne. They are not good for you but play no roll in causing or aggravating your acne. You may sleep like Sleeping Beauty, but if you have acne when you go to sleep, you will have it when you wake up. Again, acne runs in families and if you inherit the gene, you are likely to get it, no matter what.

Some things that do affect acne, for better or worse, include heat and humidity, oils applied to the skin and stress. These all tend to make acne worse. Hormones such as birth control pills and pregnancy usually improve acne. Some women, however, experience initiation of or aggravation of acne during pregnancy. Although birth control pills may improve acne, the do not seem to shorten its course; rather, it tends to arrest acne. For example if a woman is on birth control pills from ages 22 to 30 and would have normally had five years of acne during this time, the acne is likely to resume and continue through the ages 30 to 35. Thus far, it seems that acne requires its dues paid in full.

Whereas acne is usually considered to be a “teenage disease,” it may occur anytime, even in the twenties or thirties for its first episode. It may have a short course or a long one. It may start in the early teens or pre-teens and be gone by twenty; or may last until the forties. There is no way to know when it will start and when it will end. As there is not yet a cure for acne, the object is to clear the skin of its lesions with active therapy, and to keep it clear with maintenance therapy until it has run its course.
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What causes acne?

Acne is caused by the plugging of the sebaceous or oil glands. These glands are located all over the body except the palms and soles and are found in greatest number on the scalp, face, back and chest, hence the location of acne in these areas. Because of the inherited tendency for the oil glands to narrow or become plugged up in people with acne, the oil can not get to the outside of the skin. It thus builds up under the skin making a small bump or comedone, its scientific term. Sometimes this bump has a blackhead because the trapped top of the oil plug turns black on exposure to air. Sometimes the opening is white, which we refer to as a whitehead. Occasionally the opening is so small it either cannot be seen, or isn’t there at all. This type of lesion is called a closed comedone. These are all the types lesions that cause the occurrence of acne, puss bumps, zits, dark marks or blemishes, widened pores (in some people) and scarring.
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What happens after oil glands get plugged? How acne forms on your skin.

After the oil glands get plugged-up, bacteria on the skin surface enter the blocked gland. While oil can’t get out of the skin, bacteria can definitely get in. After entry, they eat the oil, which is food for them. This breaking and entering, accompanied by ‘refrigerator raiding’ is noticed by the white blood cells (police force of the body) which attack the bacteria. During this battle, the weapons of the white blood cells and the death of the bacteria cause redness and swelling, producing a puss bump. This initially red bump turns yellow and is frequently painful. This “inflammation” can cause continued redness, dark marks and scar formation. Sometimes one gland will push together with one of its neighbors or become very large before it breaks, causing a sizeable inflammation known as a cyst. Occasionally, cysts do not go down completely when they heal and correspondingly form a hard lump in and under the skin, which is called a nodule, giving rise to lumpy skin. Thus, the results of inheritance, oil gland plugging, bacterial action and inflammation and the body’s reaction to these invasions cause those undesirable appearances and changes in the skin we associate with acne.
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How is acne treated?
As the cause of acne is the plugging of the oil glands, major efforts are directed at their unplugging and prevention from future plugging. There are four main treatments:

1.Exfoliants

Exfoliating the skin means ‘lifting the top layer’ from over the plugged-up pores. This, in effect, peels the skin. Products that accomplish this are called ‘Exfoliants.’ They may come in liquids, gels, lotions or creams. Exfoliants are usually applied at bedtime but are sometimes applied in the morning as well. The resulting peeling can range from being mild enough to be barely noticeable to such frank visibility that others may wonder—‘what’s going on with your face?’ Varying degrees of redness, dryness or flaking may accompany peeling. Frequently, this flaking can be covered with make-up. If peeling is excessive, it’s advisable to reduce the frequency of exfoliant use. For example, if you are using the Dr. Earles Exfoliating Acne Peel every night, reduce its application to every other night and use a moisturizer on off nights. In general, the faster and the more you peel, the faster your skin clears. Your job or activities or personal desires determine how fast we can proceed.
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2.Cleansing and Hydration

Cleansers are used to remove oil (which can hinder exfoliation), dead skin cells and the dirt and grime accumulated on the skin throughout the day. They also help to kill bacteria, the invaders of the oil glands. The best cleansers, like the Dr. Earles Medicated Cleansing Wash, go beyond oil removal and deliver strong, acne-fighting medicine. Cleansers, especially when accompanying exfoliants, can be very drying. Sometimes the dryness can irritate the soft skin around the nose and mouth. Consequently, it’s very important to stay moisturized when using a cleanser. Many moisturizers, like the Dr. Earles Hydrating Cream can also aid the acne-fighting process through hydration and blending. Hydrating the skin serves to calm it down and heal the dried out areas. Also, blending agents like hydroquinone even out the skin and protect from discoloration or blemishes left by severe acne.
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3.Prescription Medication

When over-the-counter (OTC) methods and conventional therapy is not effective treating severe acne, forms of prescription medication are very useful. One of the most powerful prescription medicines is Accutane, a cousin of vitamin A. It is especially useful in nodular/cystic and pustular acne. Accutane is an internal medication, taken orally and does not affect blemishes or scarring. It is known to cause significant side effects and is only available through prescription. Many people, in addition to having their lesions clear, experience a prolonged remission (months to years) of all acne, which for some people is permanent. There are a myriad of other medications that use strains of vitamin A, anti-bacterial medicines and exfoliants to combat acne. Some of them work for almost everyone, while others are much more targeted.
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4.Surgery

Acne Surgery: Despite all efforts at removing blackheads and whiteheads medicinally, they occasionally just won’t come out. In this case, it’s necessary to remove them with special instruments designed for this purpose. These instruments are called ‘Comedone’ extractors and the process is called Acne Surgery. When performed properly, it cleanly removes serious acne without scarring or blemishes. This procedure is very useful in removing stubborn lesions and can remarkably shorten the treatment for patients with otherwise untreatable acne. At the R. Martin Earles, M.D., P.C. Medical Practice, we give the patient nitrous oxide or laughing gas for comfort. Acne Surgery is usually covered by most insurance companies.

Dermabrasion and Dermaplanning: These are procedures where machines are used to remove the top layers of skin to reduce scarring from acne. They are useful for some types of scars and are usually done in the winter months.

Laser Resurfacing: Lasers are used to reduce acne scarring and skin irregularities by removing the top layers of the skin with laser light. They can be very effective. Not everyone is a candidate for this procedure and sometimes pigmentation problems may occur with people of color.
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What are dark spots?

Hyperpigmentation or Ďdark spotsí are areas on the skin where the cells that produce color (melanocytes) start making too much pigment. This concentration of pigment in one area creates patches (spots) on the skin that are darker than the surrounding skin. The more pigment present in the skin, the more likely a person is to produce dark spots. Paradoxically, very dark-complexioned people are the most likely to have dark spots, but because they are already so dark, they are much less noticeable on them. People whose complexions vary from beige to medium-brown are most susceptible to noticeable dark spots.
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Why do we get dark spots?

Dark spots are the skinís natural reaction to injury. The pigment-producing cells in the skin react to injury by doing what they normally do, but in a hyperactive way; hence the term, ďHyperpigmentationĒ. While we tend to see dark spots as unsightly and undesirable, they are actually perfectly natural. Acne is the most common injury to the skin and happens most frequently on the face. Because of this, we notice dark spots on our faces first, but there are dark spots all over our bodies, often attributed to other causes than acne. Eczema, ringworm and physical injury are all common causes of non-facial dark spots.
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How does the Dr.EarlesSkin Care stop dark spots?

I recognized early in my career that People of Color suffer from acne and other related conditions differently than other races. Products that address acne without treating dark spots are essentially useless to people with brown skin. My Skin Care System has agents that 1) act against dark spots and 2) prevent future outbreaks of dark spots. Working together, our products kill acne-causing bacteria, lighten existing dark areas and heal the skin from earlier inflammation.
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Why does the Dr. Earles Skin Care System work better than other products to treat dark spots?

First, the System stops acne, which is the root cause of facial dark spots in most cases. Itís one thing to treat the symptom, but itís another to treat the cause. To effectively stop dark spots, we have to first stop the thing thatís causing them. Second, our system uses a combination of ingredients to treat dark spots. One ingredient doesnít always work for everyone; therefore, by using multiple agents to stop dark spots, we can effectively treat the issue more effectively for more people. Itís like throwing a good party. To really get a good party going, you canít just have one kind of person there. You need a number of different kinds of people there. Thatís what gives people something to talk about and creates the right environment for a good party. Treating a complex, naturally-occurring issue like dark spots requires a number of different ingredients. We need to create the right environment on your face to work on the dark spots.
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