IN Better Health
by Leslie Cardé
DERMATOLOGY TODAY covers a myriad of treatments and encompasses everything from acne and skin cancers to aesthetic treatments which address the aging process. When patient Jennifer Williams, a nurse practitioner herself, decided to make an appointment with dermatologist Dr. Zeena Al-Dujaili, she had a number of issues on her plate that she wanted to discuss with her physician. “I initially came in for anti-aging treatments, but we began to discuss how to address my adult acne,” remembers Williams. “I didn’t have extremely visible facial acne that was as bad as many people endure, but most people didn’t know I had body acne which was not only embarrassing, but painful as well. With age, it was continuing to worsen.” Upon examination, Dr. Zeena found an abundance of acne on Jennifer’s back, which can occur for a multitude of reasons, including stress and heat, and hormonal changes – even coming off birth control pills. Regardless of any underlying causes, both doctor and patient decided to engage in tackling the problem. “There are different types of acne –comedonal 50
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(causing bumpy skin and oil-blocked hair follicles) and cystic (painful bacteria and pus-filled pimples),” explains Dr. Zeena. “The patient had a combination of these two types. We decided initially to treat it with a topical retinoid, but she really needed a stronger option, which was Accutane (isotretinoin) taken orally.” Isotretinoin has long been the gold standard for treating recalcitrant acne, but treatment must be followed closely by a licensed medical doctor, who monitors for any side effects. The drug cannot be taken by anyone who is pregnant or trying to become pregnant. However, used properly, it can be extremely effective. “The patient had previously been on antibiotics, to no avail,” notes Dr. Zeena. “After three or four months of Accutane, we noticed a remarkable difference, and at six months, the acne was gone. We now have her on topical tretinoin therapy, as maintenance.” For Williams, it wasn’t until her acne was gone that she realized how much of her life had revolved around her skin problems. “I recently went on my first beach vacation (with plenty of hats and SPF) since completing treatment,” recounts Williams. “I used to always have to worry when the breakouts would occur, plan for back-up outfits, have different make-up to try to cover it up, and basically plan my whole vacation around this problem. On this recent vacation, I texted Dr. Zeena and her staff a photo of myself on the beach, and thanked them for the confidence that I was able to pack with me.” Jennifer has now begun treatments to resurface the damaged skin that was the result of years and years of chronic acne. Skin damage, however, can occur over time from a factor much more common than acne... the sun. The damage that occurs from sun exposure is one of the major reasons that people age prematurely, acquiring excess lines, wrinkles and loss of skin elasticity. Skin
photos: MELANIE LANGTEAU MILESTONE PHOTOGRAPHY
with Jennifer Williams
