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Acne: What’s The Deal?

Most patients attribute their acne breakouts to oily skin, hormones during a menstrual cycle or stress. Acne patients buy multiple products for acneic skin that include salicylic acid, benzoyl peroxide and sometimes even just dousing the lesions with alcohol. This causes a stripping of the acid mantel (a slightly acidic film that protects your skin from bad bacteria, viruses and other contaminants) which creates an unbalance in your skin’s pH. When the acid mantle is stripped, your skin goes into replenish mode- replenishing the essential protective film and making up for what was stripped out. More acneic lesions can surface now starting that stripping process all over again. We have even encountered patients that are put on topical medications from their doctors for minimal acne. While the thought of a medication clearing up your acne sounds ideal, it is actually like putting a Band-Aid on and not taking care of the internal issue. Acne is very misunderstood condition of the skin where common misconceptions cloud the reality of the situation. A multi-faceted, continuous approach is needed to control the condition. There is no “cure.”


Acne is an inflammation in the skin that can be characterized by red lesions on the face, neck, chest, back and shoulders. Its common medical name is Acne Vulgaris.



  1. Comedomes – A comedome forms when a hair follicle has become clogged with oil and dead skin cells.
  2. Blackhead – A blackhead is also known as an open comedome. The black comes from the sebum’s exposure to oxygen.
  3. White Heads – A white head is also known as a closed comedome. A thin layer of skin covers the opening of the matter deterring oxidation.
  4. Papules – Papules are comedomes that become inflamed, forming small red or pink bumps on the skin’s surface. This form of acne can be sensitive to the touch and can worsen without professional extraction and treatment.
  5. Pustules – Pustules resemble a white head but usually have a red ring around it. It is typically filled with white or yellow pus.
  6. Nodules – Nodules are large, inflamed bumps that are very sensitive to the touch and sometimes very painful. They typically appear as a red lesion with no opening visible for extraction.
  7. Cysts – Cysts are large, pus-filled lesions that look similar to a boil. Cysts are most often painful to the touch.


You have Mild Acne if:
You have mild acne if you have fewer than 30 total lesions on an area. The types of lesions are usually open and closed comedomes.

You have Moderate Acne if:
You have moderate acne if 30 to 125 total lesions are visible on an area. The types of lesions are usually open/closed comedomes and pustules.

You have Severe Acne if:
You have severe acne if you have open/closed comedomes, pustules, multiple cysts and nodules. The cysts and nodules are usually extremely inflamed and appear purple. Cysts and nodules can leave acne scarring as well.


Let’s lay some foundation: your skin is your largest organ. Your skin is an organ of elimination as well as protection for your bones and internal organs. Your skin consists of sebaceous glands which are found all over the body except on the soles of your feet and palms of your hands. You skin excretes wastes and toxins out of your body through the sebaceous glands.

The foods you eat play an enormous role on not only your weight but your skin as well. Some of the foods you consume may cause an allergic response and toxic reaction in your body without you even knowing it! Now your immune system is fighting the food as if it were an invading organism. This can cause an inflammation in the skin as your body processes the toxin by elimination. We find that dairy, soy, wheat/gluten and sugar are often culprits of acne.


The main components to battling acne are simple: eat a healthy, balanced diet and have a medical grade home regimen. Examples of foods that help fight acne are whole grains, beans, veggies. Cut back on the pasta, white rice, white bread, sugars and dairy. As for medical grade products we really gravitate towards the Epionce Lytic Gel Cleanser. This cleanser is great for acneic skin as it gently but deeply cleans the skin. Other products we like for acne are Revision Brightening Facial Wash, Revision Hydrating Serum and Epionce Lytic Sport Treatment. Consider a Hydrafacial once a month for a deep clean as well. Hydrafacial is an office favorite for acne. This treatment uses a blend of glycolic acid and salicylic acid to deeply clean the skin. We then finish your treatment with an infusion of antioxidants to brighten and hydrate the tissue.

Owner / On-Site Medical Director at Wisconsin Vein Center & MediSpa | Website

Dr. Deborah Manjoney is a board-certified surgeon and physician with extensive training, including cardiothoracic surgery. She founded the Wisconsin Vein Center & MediSpa in 2002, where she specializes in vein treatments and minimally invasive aesthetic procedures. Dr. Manjoney is nationally recognized, having spoken at conferences, received awards, and contributed to medical publications.