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Saving Face: How You Can Outsmart Your Acne

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  • Saving Face: How You Can Outsmart Your Acne
Saving Face: How You Can Outsmart Your Acne
Victor Czerkasij, MSN, NP-C
Saving Face: How You Can Outsmart Your Acne

Acne continues to be one of the most troublesome dermatological issues in America – and the single biggest reason why people see their dermatologist


By Victor Czerkasij, MSN, NP-C


Acne continues to be one of the most troublesome dermatological issues in America. It is the single biggest reason why people make an appointment to see a dermatology provider – making up 10% of all visits.

At its most basic, acne is a combination of two products: surface oil produced by the body called sebum, and a simple bacteria that is present on the surface of the skin, and enjoys living in the sebum. This ‘simple bacteria’ is officially called Propiniobacterium acnes, or just P. acnes. So the most basic of acne treatment is to either dry the oil, kill the bacteria, or a combination of both.

But as many families have learned, it’s not that easy!

  1. First, oil production may be so heavy, that it is very difficult to dry consistently. Sebum is generally produced based on the action of hormonal activity: estrogen for women, and testosterone for men. And during the teen years, you can be sure hormones are front and center during this time.
  2. Second, patients can react poorly to topical products. They come in many forms, such as foams, gels, washes, creams and solutions. Side effects can include intense drying, scaling or even blistering reactions. Worse, some can be absorbed into the skin and consideration has to be given to those effects.
  3. Third, antibiotics are not candy. The side effect panel for antibiotics can include nausea, dizziness, headaches, diarrhea and photosensitivity, just to name a few. Acne is increasingly resistant to antibiotics, and new acne strains make it difficult for antibiotics to work. In addition, for some patients, once the antibiotics are discontinued, the acne returns.

It is unfortunate that acne often becomes an issue during a sensitive time in a teen’s life. The adolescent years are, in particular, a key phase, when a person’s appearance and social standing among peers is very important. Depression is a very real issue with teens, and according to many studies, can be heightened with acne. Scars may result, and inflammatory blisters and cysts are a painful distraction. Assessing the quality of life among teens suffering from acne is an important action for sensitive providers to include in their visits.

One very effective treatment for either persistent or cystic acne is isotretinoin, previously known as Accutane. Except for Botox, since 1982, it is one of the most studied medications in American history and when the basic rules are followed, for many patients it is very nearly a cure. Consisting of a purified form of vitamin A, isotretinoin is the oral cousin of the well-known Retin-A, the topical cream used for acne, melasma and wrinkling.

One question that often comes up in patient meetings is whether diet plays a role. At this point, the research community offers a cautious “most likely”. Remember when we told you that hormones are a driving force in oil production, which is the foundation of acne development? Human beings are the only mammal in the history of the world that continue to use breast milk – which is full of hormones — as part of their daily diet throughout their lives, and in particular during the teen years. Where does this breast milk come from, you ask? Dairy cows, of course. Remember, the dairy cow lactates and produces milk heavily which through yogurt, cheese, ice cream and milk we enjoy and can drive hormonal activity.

Schedule a consultation with a skin health provider at a location near you to have a thoughtful discussion of your acne concerns.

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About the author


Victor Czerkasij, MSN, NP-C

Victor Czerkasij is an associate lecturer with Fitzgerald Health Education Associates, Inc. (FHEA), an international provider of nurse practitioner certification preparation and continuing education. He holds a Master’s of Science in Nursing from Vanderbilt University and a Bachelor of Arts and Master of Arts from Southern Adventist University.

He is the recipient of Vanderbilt’s Excellence in Writing award for his research paper, The Effects of Moderate to Severe Psoriasis on Human Sexuality. Victor is a certified family nurse practitioner with the American Academy of Nurse Practitioners and the American Nurse Credentialing Center. He is also a registered histotechnologist.

He currently practices as a nurse practitioner at the Skin Cancer & Cosmetic Dermatology’s Cleveland office, where he applies his skills diagnosing and prescribing for many patients on a full-time basis. He has served alongside Dr. John Chung since 2002. Victor is a member of numerous organizations, including the National Society of Histotechnology, the Dermatology Nurse Practitioner’s Association, the Southeast Association of Histotechnologists and Medical Lab Personnel, the Medical Reserve Corps of Southeast Tennessee, the Tennessee Nursing Association, the Georgia Nursing Association, and Sigma Theta Tau (the nursing field’s international honor society). He is a contributing author to the Nurse Practitioner Certification Examination and Practice Preparation textbook (4th ed.). He has been published in and serves as an editorial board member for the Nurse Practitioner Journal and the Journal of Nurse Practitioners. He has additional publications in Men in Nursing, Clinician Reviews and various newspapers throughout Tennessee and Georgia.

In addition to teaching at Southern Adventist University, Dalton State College and Vanderbilt University, Victor is a popular speaker nationally, and has presented at local regional and national medical centers and conferences on the topics Common Malignancies in Dermatology and the Role of Moh’s Surgery, Malignant Tumors of Dermatology and Treatment in the Adult Primary Care Setting and Dermatology in the Adult Primary Care Setting. He has recorded the audio programs, The Golden Years: Understanding and Treating Skin in the Older Adult, A Primer on Dermatology: Increasing Skills to Enhance Clinical Competency, Dermatology Across the Lifespan, Help My Child: Topics, Diagnosis and Treatment of Common Pediatric Dermatologic Conditions, and Is this Skin Cancer? Identifying and Treating Malignant Cutaneous Neoplasms. Victor is currently in his doctoral program at the University of Tennessee at Chattanooga.

Ukrainian born and raised in New York City, he has been married to his Alabama wife for 34 years and they have two adult sons. Victor has a farm in Bradley County, TN, where he keeps a dozen beehives, fishes on his lake and enjoys pizza from his own outdoor wood fired oven he built from scratch.

Victor Czerkasij, MSN, NP-C is now accepting patients in Cleveland & Chattanooga, TN.

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