Breaking Out: A Closer Look at Teenage and Adult Acne

Breaking Out A Closer Look at Teenage and Adult Acne

Trina Renea  0:07 

Hey everyone, welcome to Facially Conscious. I'm Trina Renea – a Medically Trained Master Esthetician here in Los Angeles, and I'm sitting with my rockstar co-hosts, Dr. Vicki Rapaport – a Board-Certified Dermatologist with practices in Beverly Hills and Culver City, Rebecca Gadberry – our Resident Skincare Scientists and Regulatory and Marketing Expert, and Julie Falls – our Educated Consumer who is here to represent you. We are here to help you navigate the sometimes confusing and competitive world of skincare. Our mission is to provide you with insider knowledge on everything from product ingredients to medical procedures, lasers, fillers, and ever-changing trends. With our expert interviews with chemists, doctors, laser-reps and estheticians, you'll be equipped to make informative decisions before investing in potentially expensive treatments. It's the wild-west out there, so let's make it easier for you, one episode at a time. Are you ready to discover the latest and greatest skincare secrets? Tune in and let us be your go-to girls for all things Facially Conscious? Let's dive in.

Hello, and welcome back to Facially Conscious. How are you guys doing today? I’m Trina.

Rebecca Gadberry  1:32 

I'm Rebecca. And I'm Vicki. Good morning. Good morning.

Dr. Vicki Rapaport  1:37 

And I'm Vicki. Good morning, everybody. Are you guys at all involved in the writer’s strike? Is that affected your life at all?

Trina Renea  1:42 

No.

Rebecca Gadberry  1:42 

Peripherally.

Dr. Vicki Rapaport  1:43 

Peripherally? So, we write our own stuff here. So, we're not on strike.

Rebecca Gadberry  1:52 

Well, we don't get paid. So.

Dr. Vicki Rapaport  1:56 

There's nothing to strike.

Trina Renea  1:57 

But I'm very supportive of the of the strikes.

Rebecca Gadberry  2:02 

Absolutely. We've got friends involved.

Trina Renea  2:04 

Oh, yeah. We have lots of friends.

Dr. Vicki Rapaport  2:07 

I think the writers are sexy. And I don't think a lot of people think that. I think you know people think stars are sexy, and directors are sexy.

Trina Renea  2:15 

Well, the writers are what makes the entire show. So, like without them, you have nothing that's right.

Rebecca Gadberry  2:21 

Even on reality shows you need writers.

Trina Renea  2:26 

So, crazy. All right, well, I'm going to start with the tip of the day. So, my tip of the day is – You do not have to live with acne. Is that true?

Rebecca Gadberry  2:44 

That's true. Virtually every case can be cured. Yes, that's true.

Trina Renea  2:47 

Yes, there are treatments out there that can help. And so, you should definitely contact a dermatologist or an esthetician in your area. And they can help you with extractions and products and medications that can help. You know, I always tell clients that that scars are very hard to get rid of. So, if you're scarring, especially get yourself some help, so that you don't have to spend the rest of your life trying to get rid of your scars. It's really important, especially when I see kids starting to scar, I send them straight to a dermatologist so that they can start getting their skin fixed. So, you don't have to live with it. So, get yourself help if you do have some acne problems.

Rebecca Gadberry  3:28 

Yeah, I think one of the points here is that while it can be cured, it needs to be cured with professional help. Don't try to do it on your own.

Dr. Vicki Rapaport  3:36 

Don't try this at home.

Trina Renea  3:39 

Please don't do it yourself at home. That's where you get more scoring when you start to pick your face. Don't pick your face.

Dr. Vicki Rapaport  3:45 

Well, on the coattails of your tip of the day. I'm going to introduce the episode today, which is Adult Acne versus Teenage Acne. And, you know, normally we end the episode with the question from a listener. But I think it's really important to start the episode with this question because this question triggered me and I when I say triggered me triggered doesn't always have to be negative but actually triggered me in a sort of positive way and also a way that I wanted to enlighten people about, adult acne versus teenage acne. So, the question from the listener was – I struggled finding a good dermatologist that can actually fix my acne problem. They all seem to try the same things over and over with minimal results. What can I do, desperate? Now, I don't know the age of this patient, but I assume this patient has adult acne and it is a very frustrating problem. So, we're going to talk today about what exactly is adult acne, how to treat it, how to manage it you haven't been to the dermatologist how to manage it at home. And I think the most important thing about adult acne is a definition first. My definition is broad. And so, adolescence is defined in actually in some people, your only outside of adolescence after age 26. So, in my definition of adult, it's acne and somebody who is above 25 years old. It doesn't necessarily have to be in the hormonal place of your face, meaning the chin and the lower half of the face. You can have adult acne on your chest, you can have adult acne on your back. It's just acne in your later years 25 and up.

Trina Renea  5:30 

So, is there a difference between teen and adult acne like the way it shows on the face? I mean, besides the placement of it, but acne is acne, right? Whether it's when you're a teenager and an adult, you get cysts, or pustules or papules or comedones, right?

Dr. Vicki Rapaport  5:48 

Correct. I mean, in the strict definition of the word, acne, yes, it's either blackheads and whiteheads, papules and pustules, cysts, yes. Where on the face adult versus teenage acne? In adult acne, yes, can more commonly be on the lower half of the face and the chin and the jawline. But adult acne can also actually be rosacea, which is scattered all over the face. So, it's not so strict about really the location and oh, it's on the chin. So it must be adult acne. And this is how you treat it. No, you have to still do the history of the present illness and find out what's happening in that patient's life to figure out you know, what could potentially be causing the acne, but typically, it's a hormonal trigger. So, an adult acne is very interesting because it is much more common in females and males. And why is that? Females have a menstrual cycle, females have hormones that oscillate and we are on birth control, we start and we stop and we change our birth control. You know, females can get pregnant, females go through menopause. There are so many reasons for adult acne. And in the end, it probably is mostly all hormonal. And what is that what I mean by hormonal is that the hormones are stimulating the oil glands to basically produce tons and tons and tons of oil. Oil glands get clogged, the bacteria eat the oil for food, the mortal coil, the more bacteria and then it just proliferates into this pile of sebaceous inflammatory acneiform problem.

Rebecca Gadberry  7:14 

Now, that inflammatory part comes from the bacteria excreting whatever they ate, in the form of an enzyme called Lipase, and that triggers the inflammation. I'm not clear here.

Dr. Vicki Rapaport  7:32 

I mean, inflammatory process is so multifactorial, and I think that the only thing that's not inflammatory and acne or the blackheads and whiteheads, right, those are just to clog pores. And so, some people don't necessarily have the inflammatory component. But as soon as you see a papule that's red, or a pustule, or assist, it's an inflammatory process.

Rebecca Gadberry  7:53 

Even if it's just red, right around the rim of it, that's inflammation.

Dr. Vicki Rapaport  7:58 

And I think that, you know, the biochemical storm that happens to cause inflammation. I mean, if we really want to go into it, I think that we interesting, but I don't know if that is something that is even worth talking about, in the sense that…

Rebecca Gadberry  8:18 

I bring it up, because when I had a question about it, and two, we're going to be talking about natural remedies for acne at a certain point. And there's some natural materials that work with the lipase. So, I thought I bring that in now, just to confirm …

Dr. Vicki Rapaport  8:34 

You're saying topical, topical things over-the-counter topicals. So, your definition of anti-inflammatory are ingredients that are helping like the lipase component of it, and which is amazing. If we can get topical treatments, that would be great. Oftentimes, we do have to go with oral options, right? Of course, you know, so going into how to treat the acne is something that I obviously do with prescription medication. Trina, you obviously do with topical things. You make things, Rebecca do extractions, yes.

Trina Renea  9:11 

Yeah. I have a question about… in adults, I see more women than men with acne. I mean, I see everybody has blackheads of some kind in some form in all people, but in women, particularly with adult women. I see that their acne if they're getting that acne, it's cyst mostly and in the chin area, but more on women than men and I wonder what that is that they're getting those cysts as an adult on the chin area. What is that?

Dr. Vicki Rapaport  9:55 

So, the hormones that are androgenetic hormones which are androgenetic in the definition is more like the male hormones that make us do male hormonal things such as make acne, grow hair, miss a period, those hormones are stimulating the oil glands, and most likely the oil glands in the chin area more susceptible to those hormones. So, again, if somebody has been on the birth control and stops the birth control, their hormones are out of sync to what their body was used to. And that can stimulate the oil glands. And again, in the chin hair, for whatever reason, they're just more susceptible to that stimulation. And you're right, women much more commonly will get this adult acne, men who have acne or are typically more a rosacea, type of acne for a man.

Trina Renea  10:45 

And can you please explain to our audience the difference between I know, we just went through a whole rosacea month, but can you explain for someone new to our show, what is the difference when you're looking at your face, if it's a rosacea acne? Or if it's a hormonal acne on your chin? Like, how do you know the difference?

Dr. Vicki Rapaport  11:06 

It's more about questioning the patient, I don't think you can know right away by staring at them.

Trina Renea  11:13 

They look similar.

Dr. Vicki Rapaport  11:15 

Yeah, they can look similar. Yeah. So typically, in a male with rosacea versus a female with adult acne, a male will have more scattered cysts on a chin, on the cheek, on the forehead, maybe one on the chest, whereas a female will have around the mouth, papules, pustules, around their period, they'll get a single cyst we know that's typically, you know, such a hormonal triggers, you know, the amounts of estrogens and even a little spike of testosterone around your period will introduce like a acneiform cascade. But I think it's hard to know exactly by staring at them. But if they give you a little bit of a history, you can figure it out as a dermatologist.

Trina Renea  11:56 

I'd like to also add for the audience. If you have a cyst, please don't pop it. Don't try and dig it out. Don't roll it around in your fingers. Don't try to get it out because it's encapsulated pea bacteria inside of a ball of and it's held there. If you pop it in it, it goes out into your skin, it can cause acne in other areas, it can also implode and cause scarring. And so, the best thing is to, if it's really bothering you, or It's throbbing, you can put a heat compress, right Dr. Vicki? Heat compress on there, not ice. Why? The difference?

Dr. Vicki Rapaport  12:38 

Well, heat will just be more circulation and will help it go down faster in its natural form than ice. Ice is nice, because it calms down inflammation, but the heat will just allow the circulation to be more brisk to heal it faster.

Trina Renea  12:53 

Okay. And then the other option is you can go to a dermatologist and have them injected with cortisone. And that will bring down the inflammation. You can also go to your esthetician who can put some benzoyl peroxide on it and do some high frequency current, which will help to kill the bacteria that's inside of the cyst. But whatever you do, just try not to touch it or pop it or irritate it.

Dr. Vicki Rapaport  13:17 

I can't tell you how many people will tell me to get rid of their cysts by popping it and I will tell them exactly that. If there isn't a pustule or a white head nearby. And it doesn't look or feel soft. I'm going to harm them. I'm not going to actually try… Can you just get it out Doctor? It's a ball of inflammation. You can't pop out a ball of inflammation. You can remove pus from a ball of inflammation, if it's looks like or feels like there is some puss in there. But most of the time I just inject it with steroid. But it's hard sometimes, I'd have to spend a long time explaining to the patient like I'm not going to be able to pop that out. Nor will you at home if you try.

Trina Renea  13:55 

Right, and when they spread their skin tight. They can see that there's white under there and they're like, but I can see it under there. Like it really drives people crazy. But that white that they're seeing is just the ball and it's not pop-able, it’s deep under the skin.

Rebecca Gadberry  14:11 

It’s like the outer skin, if you will, or the outer shell of the cyst that they're looking at. They're not looking at the actual pus inside the cyst.

Dr. Vicki Rapaport  14:21 

Right, and cysts will always heal. I mean, yes, they sometimes can scar but it's pretty unusual for like a single cyst to scar.

Trina Renea  14:27 

Just as long as you don't touch it.

Rebecca Gadberry  14:30 

I mean, you don't want in 10 years to be thinking about what you did tonight to get rid of that cyst and have a permanent scar. Absolutely. Now what about though when we watch things like I'm going to bring up another doctor, Dr. Pimple Popper. She goes in and she digs the cysts out, we see that but what's that all about?

Dr. Vicki Rapaport  14:53 

That's different. So, those are formed. Sometimes calcified, meaning hardened balls of dead skin and bacteria with a capsule. They're not inflamed anymore. They're not necessarily abscesses, abscesses are also very different full of pus inside, very important to drain those. But these cysts that we remove and excise surgically are calm balls of dead skin and bacteria. And when we excise them, they usually can be excise really beautifully in like, like a pearl like a little, they're often on bigger than a pearl, but they'll come out intact. And when you look at them under the microscope, it's basically just like I said, dead skin, and bacteria and like a keratin capsule, it's not that big of a deal. On the show, they're huge, right? She takes out these huge ones. That's pretty unusual for cyst to get that huge. And it's also a personal preference if people want to get them removed or not. Sometimes people live with them forever. They don't have to come out.

Trina Renea  15:53 

Yeah, it's more of a, I feel it and I don't like the way it feels. Which brings me to the, what are some of the psychological impacts of acne, both in teenagers and adults? And how can these impacts be managed or mitigated?

Dr. Vicki Rapaport  16:10 

I think that everybody is unique in that sense, like some people are really bothered by a tiny little cluster of acne that comes and goes on a monthly sort of timeframe. And they're mortified by it and other people come in, and they have scarring cystic acne, and they're like, What? What's wrong? Oh, I have oh, yeah, we could talk on my acne. So, the psychological impact is a personal threshold.

Trina Renea  16:37 

I have teenagers are like that.

Dr. Vicki Rapaport  16:40 

They not care.

Trina Renea  16:41 

They don't care, even though their face is full of acne.

Dr. Vicki Rapaport  16:45 

And then there are some that you know, want to go on Accutane and they have like one cyst every month. And so, again, you have to that's the art of medicine, you know, the history of present illness, try and figure out like how much it bothers me, that bothers them tremendously, then we'll be more aggressive about the treatment, that doesn't bother them. And you know, they won't use the medicine, then you come up with, like a more simple treatment plan.

Trina Renea  17:08 

So, with the Accutane, I know, there's like a lot of fear and parents about putting their kids on Accutane. I always, when I talk to a mom, about their child who is scaring, basically, if they're not scoring, I'll treat their acne alongside of a dermatologist doing extractions and helping them with their skincare and everything. But if they're scarring, I'm like, you know what, I think you should go straight to Accutane. And I tell them that because they can try all the topicals and the antibiotics and all those things. But it's just that slow process to get that going, if they're still scarring, and those scars are so hard to get rid of. So, if I see the scars happening, I'll be like, just go straight to Accutane, get rid of it and so your child doesn't have to live with this for the rest of their lives. Because the scars stay forever. They get less and less, but it's really hard to get rid of scars. So, sometimes I will tell them that.

Dr. Vicki Rapaport  18:15 

Well. And also, you know, this question from the listener about you know, they keep trying the same things over and over again, these dermatologist and nothing gets better. Sometimes you just need Accutane, if you're not going to get better with the things that are FDA approved to treat acne, topical, oral antibiotics, we do doxycycline, we do minocycline, we'll do Bactrim, we'll do Keflex, we'll try so many things. If you really are proving to be have such stubborn acne, adult acne, sometimes Accutane is the answer, and I hate to use the word cure, because it's hard to actually truly, truly cure acne, we manage it and until their body decides to stop making acne. But I do you think it's appropriate for some people and being afraid of Accutane, just because they're not informed and not educated about it. And we spend time to do that. And sometimes people will still not choose to do it. And other times people will choose to do and be so thankful.

Trina Renea  19:06 

I just had a client who chose not to do it. He's a 19-year-old boy. And he when went in to have to sign the papers, it scared him because it says it could cause suicidal something thoughts or something and he didn't want to sign something that said he was could potentially kill himself. And so, I said, that is not like, besides the fact that that doesn't happen and it's rare and they had to write that because of lawsuits and things. I said, you can go off of it. If you start feeling weird. It's not like you have to stay on it. You can go off at any time. If there's any side effects, you don't have to stay on it. So, you know try at least.

Dr. Vicki Rapaport  19:49 

I'm happy that somebody would really to take ownership or right of their fears, if they truly don't understand what they're signing and it's scaring them and they should ask more question. So, you know, you sign, you know, about 20 different side effect, your initial next to 20 different side effects that could potentially happen. And suicidal ideations are a potential side effect, a very rare, rare potential side effect. And like you said, if you have, and we discuss it with the patients as well as their parents in the room, if they have any kind of mood change, that's not normal, we stop it, we just stop the medication, everything goes back to normal. So, with Accutane, if they get any of the side effects of their signing on the dotted line, dry lips, dry eyes, belly pain, hair loss, all these things that potentially can happen. And if it does happen, it bothers them. It's 100% reversible when they go off the medication.

Rebecca Gadberry  20:43 

And one thing to add here is that when the studies are done on a drug that are then presented to FDA for the drug approval, during the drug approval process, the reporting has to be on everything that occurred in that population that was tested, it doesn't mean that it's because of the drug, it means that it occurred in that population. And kids that go on Accutane are going on it usually because they have bad acne. And the suicide rates among kids with bad acne is higher than the general population. The Accutane doesn't necessarily cause the thoughts of suicide, it's the bad acne.

Trina Renea  21:27 

I agree with that. And well, they're not, you know…

Rebecca Gadberry  21:32 

It's better to take the Accutane than to live with the bad acne if you're afraid of something like that.

Trina Renea  21:36 

I feel like sometimes the kids are already depressed because of acne, and so the depression is there. And then when you introduce the medicine, that's then drying out their lips and possibly their eyes and possibly giving them a stomachache, it makes it worse, right. And so, they just like they're already in that state.

Dr. Vicki Rapaport  21:57 

And also, I think that it's such a complex in the mental health is so complex. You know, unfortunately, there are children who have committed suicide, who whether had been on Accutane or we're on Accutane, and it was why not, you know, Accutane, like you said, does not, you know, speak to you in your brain and tell you to unfortunately, commit suicide, but it's a complex mental health disorder that may or may not have anything to do with the acne, you know, and like you said, some people have a face full of acne and aren't bothered by it. And I think that a lot of these kids aren't bothered by it. I don't know how we got off.

Rebecca Gadberry  22:35 

Yet, I think it's really good that if a child is going to be taking Accutane, that the parent is aware of this possibility. Whereas if they weren't on Accutane, they wouldn't be aware of the possibility and the possibility is there, regardless of whether they're on it or not. So, to watch for it, and be aware of it.

Dr. Vicki Rapaport  22:53 

You know, the number of suicide is, you know, spikes in his teenage years. Unfortunately, it's even worse these days. It's horrendous.

Trina Renea  23:05 

So, I want to talk about, I would like to end this sweet little episode on what are some of the effective treatments for teens and adult acne? And how like, how do they work like the step process that you guys do? Because I know you start with topicals and antibiotics, and then there's these steps? So, what are some of the steps? And are there any natural remedies or lifestyle changes that can help prevent or reduce acne?

Dr. Vicki Rapaport  23:35 

So, when I first started treating acne, it was just all about, what did I learn in residency and this prescription and that prescription and we didn't talk about skincare, we didn't talk about diet, and we didn't talk about lifestyle. And now of course, we talk about all that stuff. So, you know, I really do try and figure out with an adult acne patient, you know, are their periods regular? Are they on birth control? That's really important information. So, if their periods are regular and they're on birth control, then there's not a lot I can do hormonally. But sometimes we still will do something topical, which is topical Spironolactone or and additional oral Spironolactone. In addition to all the other things that we would naturally do for a teenager with acne, we still do with an adult with acne … Well, know what the topicals we would… Spironolactone is an anti-testosterone, a weak anti-testosterone.

Trina Renea  24:24 

So, it helps to stop the cysts from forming?

Dr. Vicki Rapaport  24:27 

Overall, stops the hormonal aspect of influence on that sebaceous gland. So yes, it's a hormonal way of getting at the acne. So, I think of acne as a three-legged. It's duel. It's oil hormones and bacteria. So, we kill it, we kind of get it the hormonal component with the Sprinter lactone. And then topically will curb the oil with either the retinoids and benzoyl peroxide, and then we also kill the bacteria with benzoyl peroxide. So, if the topicals such as retinoids and topical benzoyl peroxide is still not enough, then we'll add an Oral antibiotic and we do this in a stepwise fashion. So, you know, an answer to this person's questions like, I'd love to see what they were given. Were they just given the same topicals? And they weren't working? Why weren't they escalating to more, you know, stronger medications, have so many questions for this.

Trina Renea  25:15 

Well, I'm sure I mean, I can only imagine like, she goes into the doctor and they're like, okay, we're going to put you on benzoyl peroxide and retinol, and we're going to start there. And then she's like, already did that and then they go, okay, so we'll put you on, like they'll pick a different form of that a different brand, whatever, or a different percentage. And then they'll say, Let's introduce an oral then she got that doesn't work. So, she goes to the next one. She goes, I went on this this and they gave me this oral so then they'll give them a different oral.

Dr. Vicki Rapaport  25:48 

No, you're absolutely right.

Trina Renea  25:49 

And it's just this like process. I can only imagine that’s what happens.

Dr. Vicki Rapaport  25:51 

Sometimes it is frustrating when patients do doctor shop or hop around because if you really stuck with this, you know, don't think of it didn't work as the fact that the doctor wasn't a good doctor, they we don't throw everything at you when we first see you, we need to follow up with you. So be consistent. Be patient, if they were seeing an acupuncturist and herbalist. They would stick with that herbalist or acupuncturist, they don't go to a different acupuncturist, herbalist because they didn't fix them. So be patient with your doctor, communicate with your doctor they have we have lots of tricks up our sleeve. We need to build on what didn't work and really figure out what the problem is. And just quickly about the diet. We were not trained on how to counsel people in their diet, but we do know now that sugars, carbs and sugars will increase the insulin levels which will then affect all the other hormones. So, keeping the sugar levels and the carb levels low. I mean, fruits and vegetables, please, yes, please. You know the processed sugars, the processed carbs, like really, you just get them out of your diet. They asked us about you know, patients ask us about dairy all the time, again, weren't we weren't really trained. But we know now some dairy has lots of hormones in it, if you can be as organic as possible. It's complicated. If you can eat as clean as possible, you know, low sugars, low carbs, and low dairy. And you're still breaking out, it is not related to your diet.

Trina Renea  27:17 

Something that I as an esthetician, because I see dermatologist patients all the time who you know, they see the doctor every once in a while, as needed. But they'll put them you know, the doctor will put them on these medications, these topicals. And when I see them, they'll be like, oh, I stopped using it because it was drying out my skin. And so, I will then tell them if you can't stop using it, like we can adjust how you use it. And I can help you when ween you down or bring it up, like instead of not using it because that's also I think why people say ‘oh, it doesn't work like this, girl’ or this person who's saying that, you know, they doctor hop, but they don't follow through with the medication, like you said, and they're using, you know, don't stop using your medications. Just slow it down. Do it less until your body gets used to it.

Dr. Vicki Rapaport  28:12 

Call your esthetician, ask them for help. I think that you're absolutely right. But that's also because you're medically trained. So, I will tell patients all the time be consistently inconsistent, like you can be inconsistent. But get back on the medication once a week, twice a week, like I said, and don't completely stop it because it takes 6 to 12 weeks to work. And that's also a problem as a lot of doctors won't take the time to really give them expectations and how long it's going to take and what they're going to see. And I just think it's really important to stay in communication with that office, they will have many, many employees to help you.

Trina Renea  28:44 

Right. And I also feel like sometimes in some dermatologists’ offices, they don't know that I feel like patients are told, like – Hey, you can call in we have a nurse here that will talk to you at any time during the day with any questions you have. So, if the medication seems like it's drying you out or whatever, just give us a call and we'll readjust it or we'll give you something else… Like that little piece I feel like is missing in a lot of offices.

Rebecca Gadberry  29:10 

Well, we can also take ownership of our own authority here or whatever and ask if there's somebody that we could contact in the office rather than having them tell us.

Trina Renea  29:22 

Right. But a lot of patients don't know that because they don't know they're going to have the problems. And so, until they do so. Oh, yeah. We're telling you, you can ask you can ask us.

Dr. Vicki Rapaport  29:31 

And so many offices have emails now on apps and oh, there's so many ways to communicate and I will say you know the dirty secret of, I guess you know what I think not in my office because I spend tons of time with my patients. But the dirty secret is, dermatologists spend too little time with our patients. They're in way too much of a rush there. They literally see the patients in three seconds and then decide quickly what to give them and they really don't care if you don't call in tell them that you're not doing well, I don't actually, that's not true. That's the wrong word. They won't know if you're not doing it, because they're not going to wonder about you, if you don't follow them. So let them know Be the squeaky wheel, they will help you continuously help you.

Rebecca Gadberry  30:15 

Squeaky wheel, that’s really a good way to look at it.

Trina Renea  30:16 

And also, as a person out there, if you are with a dermatologist like that, and it's not comfortable and you feeling rushed, go find a dermatologist that will give you more time or at least they have an office staff that they say is very helpful. Or ask if there's somebody here I can talk to if I need to call, who do I ask for, you can if you find an office like that, that's the person that you should be with. And maybe that's the advice I can give to this listener is that find that dermatologist that gives you a little more time that has a staff that's going to help you and then stay with them and let them help you through the course don't hop around anymore, and really try and stick with.

Rebecca Gadberry  30:57 

So, it’s appropriate to Derm hop, if you're not getting a complete service and support. It's inappropriate to Derm hop if you're just being impatient, and you're not giving feedback to the doctor, getting feedback back.

Dr. Vicki Rapaport  31:09 

And I think a really good visual cue for the doctor is bringing your medications in. And if you really have used the whole tube or the whole bottle, and you're still not better that will really aid them in figuring out what's the next best medication for you. Because like you said, Trina, they're either stopping it. And then when you see the tube, you're like you literally have barely used this medication, you have to give it time.

Trina Renea  31:29 

Right. And that really bothers me like even as an esthetician. I mean, thank God in my 20-year career, I have only had to fire like two clients. But you know, one of them was so annoying because I tell them exactly what to do. I can help you. I help a lot of people, but you have to follow what I'm doing. And then he come in and complain about his acne. And he did nothing that I said he's like, no, I didn't do it. No, I didn't use it. No, I didn't follow. Like, oh, my god, like I told him, you know what Bill, I said, I'm going to give you one more chance. And so, I gave him one more chance. And when he came in, and he still hadn't done it, I said, you know what? I'm not the right person for you. You need to see a dermatologist. And I sent him away to a doctor, I gave him your information. I don't know if you ever followed through. But yeah, we finished it.

Rebecca Gadberry  32:15 

What's his name?

Trina Renea  32:19 

I don't even remember. But it was annoying. I have to say.

Rebecca Gadberry  32:25 

Well, you can't cast a spell and cure the acne, people need to be cooperative and do the homecare routine. And remember, these are drugs. So, they're dose dependent. Putting a little bit on the tip of your finger for your whole face isn't going to make the drug work, you've got to use the amount that the Derm tells you to use. And if they don't tell you to use a certain amount, ask them how much to use when you're talking to them.

Trina Renea  32:50 

That's right. So, Dr. Vicki, will you give us a takeaway?

Dr. Vicki Rapaport  32:54 

Am I going to give a take away? Yes, of course.

Rebecca Gadberry  32:58 

We’re getting organized here.

Dr. Vicki Rapaport  33:03 

I am going to give the takeaway of the day for the adult acne episode. The takeaway is the following. – If you are not getting cleared up by over the counter medications that supposedly the social media experts aren't touting, and the cell acid dots aren't working on you. And it's whether it's a star or a circle, you still have breakouts, go to a board-certified dermatologist, give them your story, tell them all about your acne, don't leave out any details. And they will get you on a regimen that will clear it up because most likely there is a hormonal component. And or most likely, you're not being consistent with your regimen. So, good luck.

Rebecca Gadberry  33:47 

And I'd like to add one thing not for recording or anything but we talked about natural remedies. We don't have the time right now. So, I will write a post and put it on the blog and natural remedies.

Dr. Vicki Rapaport  33:59 

Yeah, should do a takeaway with Rebecca with the natural remedies?

Rebecca Gadberry  34:06 

I don't think it's necessary. No, you know, there's so many elements on … Yeah, and I'm just referring everybody who's listening just to go to our blog, it's at www.faciallyconscious.com/blog. And it'll be up there at the time that this episode runs. And we'll stay there too.

Trina Renea  34:29 

Well, thanks for joining us, you guys and we will see you soon. Take care.

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