A Modern, Barrier-Focused Dermatology Approach
Acne Vulgaris
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)
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)
C. 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
Why Acne Happens: Common Triggers
Modern dermatology recognizes four key factors that work together to create acne.
Who Gets Acne?
Acne affects people of all ages and skin types. Nearly 95% of teenagers experience acne, and it remains common in adults, affecting 12–54% of people, with women more often affected than men. About 70–80% of adult acne persists from adolescence, while 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.
A Smarter Way to Treat Acne
Our Barrier-First AZOVA-Inspired Model Instead of over-drying the skin or relying only on antibiotics, we focus on restoring healthy skin biology.
Our Barrier-First AZOVA-Inspired Model
Instead of over-drying the skin or relying only on antibiotics, we focus on restoring healthy skin biology.
Acidify the Skin Barrier
Healthy skin has a slightly acidic pH that keeps bacteria under control.
Gentle exfoliating acids (PHAs):
- Restores normal skin pH
- Suppresses harmful bacteria
- Improves healing
- Delta gluconolactone
- Lactobionic acid (These are the most skin-friendly acids for acne-prone skin.)
Restore Skin Barrier Lipids
A damaged skin barrier leads to more inflammation and breakouts.
- Repairs the lipid bilayer
- Supports ceramide production
- Reduces irritation
- Improves moisture balance
Balance the Skin Microbiome
Healthy bacteria protect your skin.
- Reduces harmful bacterial overgrowth
- Disrupts acne-causing biofilms
- Improves skin resilience
Calm Inflammation
- Reduces redness and swelling
- Lowers scarring risk
- Speeds healing
Reduce Oxidative Stress
- Antioxidants restore vitamin E levels
- Neutralizes damaged oil (oxidized squalene)
- Protects follicles from irritation
Normalize Skin Turnover
- Prevents clogged pores
- Reduces blackheads and whiteheads
Avoid Irritants and Toxins
- Eliminates comedogenic skincare
- Avoids harsh or allergenic ingredients
The Role of Acetic Acid and Vinegar
Acetic acid (derived from vinegar) helps break down bacterial biofilms, control acne- causing bacteria, balance the skin’s pH, and support a healthy skin microbiome. When used correctly, it can improve acne without damaging the skin barrier.
Our Integrated Acne Treatment Program-The Hierarchy of Acne Treatment A Smarter, Barrier-First Approach
At Aesthetics & Medical Lasers of Colorado – Dermatology, we treat acne by first restoring healthy skin biology before turning to aggressive medications. This approach helps calm inflammation, protect the skin barrier, and achieve longer- lasting results.
Restore Healthy Skin Biology (Our Foundation)
We start by fixing what’s broken in the skin:
- Balance skin pH (acidify the skin barrier)
- Repair the lipid barrier
- Support the skin microbiome
- Reduce inflammation
- Lower oxidative stress
- Normalize skin cell turnover
- Avoid irritating or pore-clogging products
This step alone significantly improves acne for many patients.
Prescription Topical Treatments (Used Selectively)
When needed, we may add prescription topical treatments to support clearer skin while protecting the skin barrier. Topical retinoids help prevent clogged pores and reduce inflammation, azelaic acid calms redness, controls bacteria, and fades dark marks, and benzoyl peroxide kills acne-causing bacteria inside pores. These medications are used carefully in our practice to avoid over-drying or irritating the skin.
Topical and Oral Antibiotics
Topical and oral antibiotics may be used short-term for inflamed acne, but they are not a long-term solution. While they can temporarily reduce acne-causing bacteria and inflammation, they also carry risks such as antibiotic resistance, disruption of the skin microbiome, and high relapse rates once stopped. For these reasons, we use antibiotics sparingly and focus on safer, biology-based treatments whenever possible.
- Reduces harmful bacterial overgrowth
- Disrupts acne-causing biofilms
- Improves skin resilience
Light-Based Acne Treatments
Light-based treatments are non-invasive options that help reduce acne-causing bacteria and calm inflammation. Blue light therapy (around 415–420 nm) targets acne-causing bacteria inside pores, while IPL (typically 400–700 nm) and laser acne treatments (such as 1064 nm Nd:YAG) reduce redness, inflammation, and oil gland activity. These therapies can be safely combined with skincare and medical treatments to improve acne control and speed healing.
- Reduces redness and swelling
- Lowers scarring risk
- Speeds healing
“Acne Facials” and gentle Chemical Peels
“Acne facials” are gentle, in-office treatments designed to clear clogged pores and calm inflammation. These sessions typically include professional extractions and gentle PHA chemical peels, which exfoliate without irritating sensitive or acne- prone skin. Treatments are usually performed weekly for 4–6 weeks to gradually improve breakouts, texture, and skin clarity.
Lifestyle and Dietary Optimization
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.
Isotretinoin (Accutane) — When Truly Needed
Isotretinoin is reserved for severe acne, scarring acne, or acne that does not respond to other treatments. In our practice, it is used thoughtfully and without long-term antibiotics or harsh topical regimens. Every acne plan is personalized based on your skin type, hormones, and lifestyle to achieve safe, long-lasting results.
Vision of Beauty
Foundational Therapy — Product Examples
Barrier-Repair Skincare (Ceramides, Peptides, PDRN)
Products that strengthen the skin barrier, calm inflammation, and support healing:
Topical and Oral Antibiotics
Topical and oral antibiotics may be used short-term for inflamed acne, but they are not a long-term solution. While they can temporarily reduce acne-causing bacteria and inflammation, they also carry risks such as antibiotic resistance, disruption of the skin microbiome, and high relapse rates once stopped. For these reasons, we use antibiotics sparingly and focus on safer, biology-based treatments whenever possible.
- Rejuran PDRN Repair Serum — a salmon DNA (PDRN)–based serum that promotes skin repair, reduces inflammation, and improves barrier function
- CLMD Barrier Repair Cream — formulated with ceramides and peptides to restore the lipid bilayer and soothe acne-prone skin
- Ceramide-rich moisturizers (e.g., CeraVe Moisturizing Cream, La Roche- Posay Cicaplast Baume B5)
- Peptide serums (e.g., The Inkey List Peptide Moisturizer)
Gentle PHA Exfoliations and Toners
Helps clear clogged pores without irritating sensitive or acne-prone skin:
- CLMD PHA Exfoliating Toner — gentle exfoliation with polyhydroxy acids for smoother texture and clearer pores
- PHA serums (e.g AXIS-Y PHA Resurfacing Glow Peel - 10% , The Ordinary PHA 10%)
- PHA exfoliating pads for sensitive skin
Beauty That Speaks Visually
Acidification Support — PHAs
Supports healthy skin pH and reduces acne-causing bacteria:
- CLMD Acidifying Toner — helps restore the skin’s natural acidic pH
- PHA toners and lotions designed for acne-prone skin
Microbiome-Supportive Products
Balances the skin microbiome and reduces acne-causing bacterial overgrowth
- CLMD Microbiome Serum — formulated to support healthy skin bacteria and reduce inflammation
- Probiotic and postbiotic moisturizers or serums
- Barrier-friendly toners and mist
Antioxidant Restoration (Vitamin E, Glutathione)
Calms oxidative stress and speeds healing from breakouts:
- Medicube Glutathione Serum or Cream — boosts antioxidant defense and brightens post-acne marks
- CLMD Antioxidant Serum — formulated with vitamin E and soothing antioxidants
- Vitamin E serums or creams
- Antioxidant moisturizers with vitamins C + E
Acne Scars and Post Inflammatory hyperpigmentation- The Importance of Early Acne Treatment
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.
Even after breakouts heal, acne can leave behind scars, redness, and uneven skin tone. At Aesthetics & Medical Lasers of Colorado – Dermatology, we offer advanced, skin-restoring treatments to improve texture, tone, and overall skin clarity, including fractional CO₂ laser, microneedling, salmon sperm DNA (PDRN) microinfusion therapy, PRP therapy, and gentle PHA chemical peels.
We also provide a carefully curated selection of dermatologist-approved skincare products with proven safety and effectiveness, available both in our office and through our online store at aestheticsonlinestore.com.
Early care leads to better outcomes. Our team is here to help you achieve clearer, healthier skin and prevent long-term damage.
Vision of Beauty
Foundational Therapy — Product Examples
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.
Products that strengthen the skin barrier, calm inflammation, and support healing:
Why Choose Aesthetics & Medical Lasers of Colorado – Dermatology?
We offer physician-led, expert dermatology care with a patient-centered and holistic approach to acne treatment. Our modern, barrier-first philosophy combines hormonal acne expertise, advanced laser technologies, microbiome-supportive care, and personalized treatment plans—all conveniently available at our Longmont and Fort Collins locations.
