Acne Vulgaris

A Modern, Barrier-Focused Dermatology Approach

At Aesthetics & Medical Lasers of Colorado – Dermatology, we treat acne as more than just clogged pores. Acne is a chronic inflammatory skin condition driven by hormones, bacteria, skin-barrier damage, microbiome imbalance, and inflammation. Our advanced, evidence-based approach focuses on healing the skin barrier, calming inflammation, and restoring healthy skin biology—not just suppressing breakouts.

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What Is Acne Vulgaris?
Acne vulgaris is a long-term inflammatory disorder of the pilosebaceous unit (the hair follicle and oil gland). It commonly affects the face, chest, shoulders, and back and can occur at any age.

  • Blackheads (open comedones)
  • Whiteheads (closed comedones)
  • Red bumps (papules)
  • Pus-filled bumps (pustules)
  • Deep painful lumps (nodules and cysts)
  • Scarring
  • Dark spots after acne heals (post-inflammatory hyperpigmentation)

Personalized Skin Care

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The Four Main Causes of Acne

Modern dermatology recognizes four key factors that work together to create acne.

1. Too Much Oil (Sebum Production)

Oil glands become overactive—mainly due to hormones like testosterone and DHT.

  • Seen in puberty, adult hormonal acne, and PCOS
  • Oil becomes thicker and more irritating
  • Antioxidants in the oil (like vitamin E) become depleted
  • Stress hormones (cortisol) make oil thicker and more inflammatory
  • Hormonal shifts during the menstrual cycle worsen pore blockage

2. Clogged Pores (Follicular Hyperkeratinization)

When dead skin cells don’t shed normally, they build up inside pores and create blackheads and whiteheads. Trapped oil and bacteria then cause swelling, redness, and inflammation, making the pore lining rigid and irritated. Once a pore is blocked, it becomes the perfect environment for acne breakouts to develop.

  • Trapped oil and bacteria then cause swelling, redness, and inflammation, making the pore lining rigid and irritated.
  • Once a pore is blocked, it becomes the perfect environment for acne breakouts to develop.

3. Bacteria Overgrowth (Cutibacterium acnes)

Acnes is a normal skin bacterium that becomes harmful when it overgrows inside clogged pores.

  • Some strains form protective biofilms that make them harder to eliminate and trigger inflammation, leading to redness, swelling, pus, and tenderness.
  • This immune reaction increases the risk of long-term scarring—simply put, bacteria trapped in blocked pores wake up the immune system and create painful, inflamed breakouts.

4. Inflammation and Oxidative Stress

When bacteria and clogged pores trigger the immune system, white blood cells rush to the area and release inflammatory chemicals.

  • This makes the skin red, swollen, tender, and damaged, slows healing, and increases the risk of scarring and dark marks after acne clears.
  • Oxidative stress from inflammation, pollution, and UV exposure further weakens the skin barrier and worsens breakouts.

Why Acne Happens: Common Triggers

Modern dermatology recognizes four key factors that work together to create acne.

Hormones

  • Puberty
  • Menstrual cycle changes
  • PCOS
  • Testosterone or DHT sensitivity

Diet

  • High-glycemic foods (sugary and processed carbs)
  • Dairy products These increase insulin and IGF-1, which stimulate oil production.

Stress

  • Raises cortisol
  • Increases oil thickness
  • Worsens inflammation

Skincare Products

Some ingredients clog pores and worsen acne (“acne cosmetica”), including:

  • Heavy oils
  • Squalane
  • Cholesterol
  • Silicones

Environmental Factors

  • Mask wearing
  • Tight clothing or helmets
  • Pollution
  • Humidity
  • Friction

Who Gets Acne?

Acne is one of the most common skin conditions.

  • Affects up to 95% of teenagers
  • Occurs in 12–54% of adults
  • More common in adult women
  • About 70–80% of adult acne continues from the teenage years
  • 20–40% begins after age 25

People with darker skin tones have a higher risk of dark marks and scarring, and acne can vary by ethnicity, with more inflammatory acne in Asians and more comedonal acne (blackheads and whiteheads) in Caucasians.

Untreated acne can lead to long-term, sometimes permanent skin changes such as acne scarring and post-inflammatory hyperpigmentation (dark marks). These conditions can be emotionally distressing and significantly more expensive and difficult to treat later on. For this reason, early and effective acne management is crucial to protect both your skin health and your long-term appearance.

Our Modern, Barrier-First Approach to Acne

At Aesthetics & Medical Lasers of Colorado – Dermatology, we believe healthy skin starts with a healthy skin barrier. Rather than simply drying out the skin or relying only on antibiotics, we focus on restoring normal skin function, reducing inflammation, and preventing future breakouts.

How We Treat Acne

▼ Step 1: Repair the Skin Barrier

Every treatment begins with restoring healthy skin.

Our goals are to:
• Restore the skin’s natural pH
• Repair the skin barrier
• Reduce inflammation
• Balance the skin microbiome
• Normalize skin cell turnover

Many patients notice significant improvement from these foundational steps alone.

▼ Step 2: Gentle Medical Skincare

We recommend barrier-friendly skincare that helps:

  • Calm inflammation
  • Unclog pores
  • Reduce acne-causing bacteria
  • Protect healthy skin

Common ingredients include:

  • Polyhydroxy acids (PHAs)
  • Ceramides
  • Peptides
  • Antioxidants

▼ Step 3: Prescription Medications

When needed, prescription medications may include:

  • Retinoids
  • Azelaic acid
  • Benzoyl peroxide
  • Topical or oral antibiotics (used short-term when appropriate)

Treatment plans are personalized to maximize results while minimizing irritation.

▼ Step 4: Advanced Light & Laser Treatments

For moderate to severe acne, we may recommend:

  • Blue Light Therapy
  • IPL Phototherapy
  • Laser treatments

These therapies help reduce acne-causing bacteria, decrease inflammation, and speed healing.

▼ Step 5: Professional Acne Treatments

In-office treatments can improve acne and skin texture, including:

  • Acne facials
  • Gentle chemical peels
  • Professional extractions
  • Barrier-supportive skincare treatments

▼ Step 6: Lifestyle & Nutrition

Healthy habits can make a difference.

We discuss:

  • Low-glycemic nutrition
  • Dairy reduction (when appropriate)
  • Stress management
  • Anti-inflammatory lifestyle choices

Acne Scars

Treating acne early helps prevent permanent scars and dark spots.

When needed, we offer:

  • Fractional CO₂ Laser
  • Microneedling
  • PRP & PDRN (Salmon DNA)
  • Chemical Peels
  • Medical-grade skincare

Acne Scars & Dark Marks: Why Early Treatment Matters

Treating acne early helps prevent long-term skin damage. Without treatment, acne can lead to:

  • Permanent acne scars
  • Dark marks (post-inflammatory hyperpigmentation)
  • Uneven skin texture and tone

These conditions are often more difficult and expensive to treat than acne itself.

Treatments We Offer

To improve acne scars and pigmentation, we offer:

  • Fractional CO₂ Laser
  • Microneedling
  • PDRN (Salmon DNA) Therapy
  • PRP Therapy
  • Gentle Chemical Peels
  • Medical-grade skincare

When Is Accutane Needed?

Isotretinoin (Accutane®) may be recommended for:

  • Severe acne
  • Acne causing scars
  • Acne that has not improved with other treatments

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