Dr. Gross, top New York dermatologist, talks to us from his Manhattan Surgery and answers our questions on how to control break-outs and keep our skin blemish free.

There are some things in life that you always hope to find, the perfect suit, a brilliant handbag, stunning stiletto shoes, the right man (in that order) and a good dermatologist. Sure we like to look good and buy the latest fashions and even once in a while we’ll travel miles to make our hair perfect for that special night out. This is the way things are, but finding someone who can make your skin beautiful is absolutely priceless. It gives us a great a sense of accomplishment to have found not only one of the fi nest dermatologists worldwide, but also someone who is approachable, friendly, reliable and above all very helpful. Fortunately for our readers we are willing to take advantage of that fact and have asked Dr. Gross to help us answer some of the most common questions about our skin.

What is the most common myth about acne?

My patients have the common misperception that eating a chocolate bar or a menstrual cycle will cause them to break out the very next day. I have found this to be untrue. Anatomically, the oil gland duct (or the tube that connects with the surface skin at what we see as the pore) is a long tortuous pathway with a lot of surface area. Therefore as the oil/waxy deposit forms it actually does so beneath the surface and is not seen. As it works its way up, then the clogged gland becomes identified as an acne lesion which is flat. It can take 2-3 weeks before a pimple even appears visible on the surface. This is because the pores are very deep and it takes time for the bacteria to build up before the pimple will become inflamed, swollen and red on the surface. This is what we refer to as “bumpy” acne vs. “flat” acne which can be categorized just as a clogged pore.
How can we prevent break-outs?

Flat acne can be categorized as the beginning stages of clogged pores and blackheads when there is no infection or inflammation present. Flat acne may begin to form up to 30 days prior to the appearance of bumpy acne which is described as infected  and inflamed and often becomes elevated on the surface of the skin. By effectively treating flat acne, you will minimize the amount that reaches the unsightly bumpy stage thus preventing future break-outs before they occur. To treat flat acne, I recommend the All-Over Blemish Solution which goes deep into the skin to disband plugs and blockages while delivering active ingredients. To treat bumpy acne, you need both the Correct & Perfect Spot Treatment because you must flatten the raised blemish and draw out the infection and the All-Over Blemish Solution because those with bumpy acne have flat acne – even if it’s not obvious.

When should you be concerned about your skin and see a dermatologist? It is time to see a dermatologist about adult acne when over-the counter products are failing to improve your condition. Also, you should schedule a visit if you have: -scarring from acne in the past -painful bumps above or below the skin -pimples that last for weeks or leave red marks behind -acne that is getting worse and not better.

How can we convince people not to pick at their spots? However tempting it may be to pop a pimple, I urge my patients to try their hardest to resist. When a dermatologist drains a pimple, they apply downward pressure perpendicularly to the skin’s surface. But when people try to do it themselves, they usually squeeze from the sides which ends up backfiring because it causesinfection to go down deeper into the pore. This may permanently enlarge pores or even make infection worse. If the temptation is too much, try washing your face with a clean wash-cloth. If the pimple is ready to “pop”, this is all the pressure needed to drain it.

How much does clean skin really come into play with acne or skin blemishes?

Acne is an oil quality issue, not an oil quantity issue. Acne is characterized as a blockage of an oil gland by one’s own oils which become viscous and heavy so they are unable to fl ow properly through the pores. This blockage leads to the formation of a blemish. Although clean skin is very important, over-cleaning the skin will not reduce break-outs. In fact, if you are not careful it might dry out the skin, which can cause MORE break-outs.

What ingredients do you recommend that make a difference?

I recommend looking for products that contain Bisabolol, an active ingredient derived from Chamomile Extract that helps soothe redness and reduce infl ammation. Salicylic Acid is also a good ingredient and so is Sulfur which controls the oil that feeds the bacteria. I also recommend using products that contain a chelator that blocks the action of calcium and magnesium. These two elements can cause oils to become comedogenic and form waxy plugs which clog pores and lead to break-outs. All of these ingredients can be found in the new MD Skincare ® acne collection.

What difference do over the counter creams and lotions make to common acne?

OTC products are usually very simple formulas using benzoyl peroxide or salicylic acid. Simply look at a label and you will see
the similarities. If these simple formulas do not work for a person, they must try cosmeceutical products or prescriptions. Trial
and error with OTC products is usually quite simple because there are only 2 active ingredients, meaning there is very little
difference between the majority of the products out there.

Why do so many not work?

The problem with many OTC products is that they are very drying. In developing my All-Over Blemish Solution, I incorporated a
revolutionary lipid-loving delivery system (where like dissolves like) that does not dry the skin but goes deep into the pores to
disband waxy plugs and blackheads – which is the fi rst step of acne.

What is the main ingredient to look for other than benzoyl peroxide?

For the Correct & Perfect Spot Treatment, I chose to use Sulfur as the main ingredient. Sulfur controls the oil that feeds bacteria,
thus reducing spots altogether. It also calms through osmosis to relieve swelling and draws out the infection to fl atten the blemish. The blemish must be fl at before it can be eradicated.

Would you ever advise hormone control or the pill to younger women?

If topical creams are not improving your skin, you can talk to a doctor about a prescription drug treatment for acne, which could
range from an oral contraceptive to a more serious treatment, like Accutane. These types of treatments are not for everyone
though, so you are best off talking to your dermatologist about the next steps if products are not working for you. However, if you are under the suspicion that stress might be the cause for your acne, a lifestyle change might be necessary.

Getting enough Vitamin B every day, and regular exercise will also help. Remember, however, to wash your make-up off before working out, and washing both your face and body afterwards.

What should a dermatologist do before prescribing treatment?

Acne, despite being so widespread, is a very complicated disorder. It can be caused by stress, hormones, genetics, etc. Inorder to successfully diagnose a patient’s condition and prescribe a treatment, a dermatologist must understand the particular complexities in the individual patient. While different types of acne share many similar characteristics, each case is different, and effective treatment is only achieved by knowledge of the different types of acne, coupled with education on the part of the patient. Once both parties are educated, treatment options can begin to be discussed. Will you always be available for questions through your web-site or through your clinic?