Welcome to the Acne Institute of Omaha (at Advanced Dermatology of the Midlands), your partners in treating your acne. Acne Institute of Omaha is a clinic that is focused on delivering the best care to patients with acne through dermatology providers who have a special interest in education of patients, optimal treatment strategies for acne, and involvement in ongoing dermatology research focusing on acne.

The Special Clinical Approach of Acne Institute of Omaha

At Acne Institute of Omaha we have developed our own unique and specialized clinical approach to provide the best care to acne patients. Some of the most important highlights of these features include:

Photographic Monitoring

We obtain a standard set of baseline photographs of each acne patient, which are maintained in their chart, utilized to track progress, and updated as needed. Our dermatologists feel that this tracking mechanism is very important for the best outcomes. Surprisingly, this is not utilized by most clinics caring for acne patients.

Personalized Schematic Worksheets

When developing treatment plans for each of our acne patients, we don’t take anything for granted. Most importantly, we want to make certain that the plan is thoroughly illustrated for everyone. At Acne Institute of Omaha, we have developed a unique diagrammatic action plan worksheet that we design for each patient at every office visit.  We want to maximize our patients’ understanding of their care plan and find that this tool is the absolute best way to do that.

Extended Hour Appointments

Our patients have busy lives, with school, work, or personal commitments. Taking this into consideration, we have special extended hour appointments for acne patients.

Education and Acne Institute of Omaha

We not only strive to provide the best clinical care to acne patients, but we also want to educate the general public on acne. This is accomplished through our web blasts, posts, and blogs.

Ongoing Research at Acne Institute of Omaha

Our pharmaceutical studies division is actively involved in ongoing clinical trials. Our dermatology providers meet on a monthly basis to review dermatology publications on acne, discussing these and translating them into clinical practice where applicable. This enables us to provide the most up-to-date care, using evidence-based medicine, for all skin conditions, including acne.

What is acne?

Acne is a condition in which there is dysfunction in the pore resulting in formation of abnormal skin spots, including:

  • blackheads
  • whiteheads
  • papules
  • pustules
  • nodules
  • cysts
  • and/or scars

Acne Treatment & Management Basics

Lifestyle

Diet- The role of diet in acne remains poorly understated. Many patients find that a well-balanced diet that is low in greasy, fried foods may help their acne. Also, skim milk is thought by some to worsen acne at times.

Hygiene/routine- Natural oils on the skin may contribute to acne. For this reason, we recommend a good routine of washing the face twice daily, and washing other areas affected by acne on a once daily basis. Our preferred cleansers (non-medicated ones): Dove Bar Soap, Cetaphil Foaming Facial Cleanser, or CeraVe Foaming Cleanser.

OTC/non-prescription

There are some medicated products available over-the-counter to treat acne:

  • Benzoyl Peroxide – Available in medicated cleansers (eg. Panoxyl/Foaming Face Wash) and creams or gels. This active ingredient may help improve acne. It works best when used in conjunction with certain prescription acne treatments. Keep in mind, it may bleach fabrics.
  • Differin – The only medicine available in the retinoid class over-the-counter, Differin may help some types of acne by reducing blackheads and whiteheads. It may cause skin irritation and sun sensitivity.
  • Salicylic Acid – This active ingredient is in many cleansers and skin peels. At the strengths available over-the-counter, we find it may be minimally helpful for acne.

Medical/Clinical Acne Management Omaha

Acne Institute of Omaha uses a multi-pronged approach, taking into consideration the whole patient, including their grade of acne, complications, and history when designing and implementing treatment plans for each of our patients. Though there is no exact “one size fits all” approach that covers all acne patients, the standard treatments for acne can be separated into major categories. Keep in mind that the best treatment (or treatments) for each patient needs to be carefully selected and adjusted over time, based on the grade of acne and response to previous treatments.  These general medication categories include the following: topical antibiotics, topical retinoids, comedolytics, and oral medications.

How We Grade Acne

In practice, we use a five-point system, which runs numerically from 0 to 4. In grade 0 acne a person may have clear skin at times, with periodic, episodic outbreaks. In extreme contrast, grade 4 acne sufferers have larger, deeper, cystic acne sores that can cause scarring. In most cases, acne is milder, grading out at a level of 1 or 2.

Grade What we see
0 Episodic outbreaks with clear periods
1 Blackheads and whiteheads
2 Grade 1 + pimples/pustules
3 Grade 2 + greater severity with larger or more extensive spots
4 Cysts, nodules, scars

 

At Acne Institute of Omaha, all of our dermatology providers are thoroughly experienced in diagnosing and grading acne vulgaris. This is critically important as it allows us to choose the best treatments for each of our patients and to track their progress.

Complications of Acne

  • Pigment alteration – In some patients, especially those with medium or darker skin types, acne spots may heal leaving areas of reduced or increased pigmentation.
  • Scarring – Acne sores may heal leaving permanent damage to the skin. The skin may be sunken or puckered in, similar to the aftermath of chicken pox.
  • Pain – Acne sores can be painful at times. This is especially true for the deeper cysts and nodules.
  • Psychological – In addition to embarrassment, acne can have a profound affect on how we see ourselves. It can lower our self-confidence and self-esteem. This is true in both children and adults who suffer from acne. This impact on our lives is frequently overlooked, and for this reason some people may not see the necessity for treating acne. This category of complications is the most important reason to seek treatment. For us at Acne Institute of Omaha, it is the most important reason we do what we do, offering thorough comprehensive acne care to patients.

Special Types of Acne

  • Adult Female Acne – Acne in most adult women differs from acne in teens in some notable ways. These differences often mean treatments need to be different. More Information
  • Back Acne (“Backne”) – On the back, acne can be especially difficult to treat. This is due to both the difficulty of reaching to apply medication here and also other factors. Pressure from chairs or clothing (especially if damp or tight-fitting) can contribute as well. Many patients will use an applicator wand to reach the back. You may find these at your pharmacy or Amazon.
  • Acne Mechanica – As with back acne, pressure against the skin (or heat/friction) may plug pores, triggering acne. Examples include backpack straps, chinstraps, etc…
  • Acne Medicamentosa – Certain medications may cause or worsen acne. These include prednisone, testosterone, some types of contraceptive hormones, and others.
  • Pomade Acne – Greasy or oily substances on the skin can also clog pores, leading to acne. The classic example is hair pomade. Many gel-like haircare products may do this. Vaseline/petroleum jelly is another possible cause.

Conditions That Mimic Acne

  • Pityrosporum Folliculitis – This is an acne-like eruption on the torso. Women tend to be affected more often than men.
  • Rosacea – The papulopustular type of rosacea can look identical to acne. In fact, some patients may have it and acne simultaneously.
  • Perioral Dermatitis – This is a form of rosacea, where patients have acne-like bumps around the mouth, nose, or eyes.

Medications

Topical Antibiotics

  • Ketoconazole
  • Sodium sulfacetamide
  • Sodium sulfacetamide /sulfur
  • Plexion
  • Ovace
  • Avar
  • Clindamycin
  • Mupriocin
  • Erythromycin
  • Dapsone
  • Aczone
  • Metronidazole

Topical Retinoids

  • Adapalene
  • Adapalene /Benzoyl peroxide
  • Differin
  • Tretinoin
  • Epiduo
  • Epiduo Forte
  • Retin-A
  • Retin-A Micro
  • Tretinoin micronized
  • Tazarotene
  • Tazorac

Comedolytics

  • Benzoyl peroxide
  • Benzoyl peroxide/clindamycin
  • Onexton
  • Benzaclin
  • Duac

Oral Medications

  • Trimethoprim/sulfamethoxazole
  • Cephalexin
  • Clindamycin
  • Doxycycline
  • Erythromycin
  • Minocycline
  • Tetracyline
  • Isotretinoin
  • Claravis
  • Accutane
  • Amnesteem
  • Sotret
  • Absorbica