Let's talk acne

Tuesday, September 20, 2016

By: Molly Soto

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Let's talk acne Nick Grimm


Whether you’re a teenager or well into your 30s, acne can cause self-consciousness and frustration. The good news is that identifying what type of acne you have and how you can fight it can help you feel a little less worried when another blemish appears on your face. 


Here are the four major types of acne and how Nick Grimm, PA-C, who offers dermatology services with Plastic Surgery & Skin Specialists by BayCare Clinic, treats them.


Comedonal Acne

This is one of the most common types of acne, occurring if the pores have become clogged. It shows up as whiteheads and blackheads.  Whiteheads are sebum oil gland material that hasn’t been exposed to the air.  Blackheads are oil gland material that has oxidized; that’s why they turn black.


“We generally treat patients with topical retinoids and see how they do after a few months,” Grimm says. “We recommend this in combination with general cleansing to remove surface dirt, debris and oil.  This combination typically works well.”


Inflammatory Acne

This type of acne appears when the pores are clogged and are accompanied by an inflammatory process as a response to the clogging.


“If you think of it like kink in a hose, all the water builds up at one end of the hose … that’s what’s happening with the obstructed oil glands,” Grimm says. “They eventually fill up and then rupture under the skin, causing the inflammatory process to happen in the midst of it.”


Patients who struggle with inflammatory acne often also have comedonal acne. They are treated with topical medications and oral antibiotics.


Cystic Acne

This is one of the most severe types of acne, with the inflammation being located deep in the layers of the skin. This type presents a high risk for scarring. 


“It is often hereditary, so when I see a patient that has family history of this type of acne, we generally want to be proactive with treatment right away to prevent scarring,” Grimm says.


Treatment involves oral retinoids, which are more aggressive than the other forms of treatment. Isotretinoin (brand name Accutane) is frequently prescribed but it carries some risks. 


“We keep a very close eye on anyone undergoing this form of treatment,” Grimm says.


Hormonal Acne

This type of acne usually is seen in adult women because of a drop in estrogen levels. It’s most often related to the menstrual cycle.


“Hormones bind to oil glands to make them more productive, like a key to turn on an engine,” Grimm says.


To treat hormonal acne, oral contraceptive pills or certain types of blood pressure medications are used to help blunt the effect of those hormones on oil glands.


When should someone seek treatment?

“We tell patients to come in when they are ready. Some patients are comfortable with their acne and others aren’t,” Grimm says. 


“People can schedule an appointment even if they’re just thinking about treating their acne and I can make recommendations for over-the-counter medications as well.”


To request an appointment with dermatology services at Plastic Surgery & Skin Specialists by BayCare Clinic, please use our online form.


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BayCare Clinic,, is the largest physician-owned specialty-care clinic in northeastern Wisconsin and Michigan’s Upper Peninsula. It is based in Green Bay, Wisconsin. BayCare Clinic offers expertise in more than 20 specialties, with more than 100 physicians serving in 16 area communities. BayCare Clinic is a joint partner in Aurora BayCare Medical Center, a 167-bed, full-service hospital. Follow BayCare Clinic on Facebook and Twitter.