Guest: Dr. Hilary Baldwin
Presenter: Neal Howard
Guest Bio: Dr. Baldwin, the Medical Director of the ATRC, is a board certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Dr. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine.
Segment overview: Dr. Hilary Baldwin, Medical Director of the Atlantic Health System’s Acne Treatment and Research Center in Morristown, NJ, and Galderma Laboratories consultant, discusses acne and the psychosocial impact of the disease.
Health Professional Radio – Acne and its Effects
Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, glad that you could join us on the program today. Our guest is Dr. Hilary Baldwin, Medical Director of the Atlantic Health Systems Acne Treatment and Research Center. She’s with us today to discuss acne and the psychosocial impact of this disease, welcome to Health Professional Radio Dr. Baldwin.
Dr. Hilary Baldwin: Thank you, pleasure to be here.
N: Thank you for coming by. You know, we talked about acne, the word, the first thing I think of is the Medical School and as a freshmen, high school I had a little bit of it. It affects many, many people talk about how you became a dermatologist and just how many people are we talking about when we say a lot of people.
B: Well I became a dermatologist because I myself was a sufferer as for my siblings and I recognized the toll that it takes teenagers especially having to live with something during their formative years that makes them the front of joke and makes them feel less significant and less in control of their own bodies, and we’re talking about a huge number of people, 40 – 50 million Americans are estimated to have acne. And of course it depends on how many pimples it takes before you call it the entity acne, but if you call all pimples, acne, and then virtually 100% of teenagers experience this to some extent, and 85% of them bad enough to look for treatment. But there’s another patient segment which is been largely nor over the years and that’s adult women, we have about half of women in their 20’s and a third and their 30’s and a quarter in their 40’s who have facial acne and that group, they’re very, very psychologically impacted enough that the teenager’s aren’t but imagine it, as a teenager you look like everybody else, as an adult woman you stand out in the crowd. You might be the only one of your friends, you’re the only one of your coworkers who have acne so it’s a completely different type of psychological difficulty.
N: Is there a specific focus on acne during healthy skin month with happens to be well November right now or is it just a healthy skin overall what exactly is acne? You mentioned all pimples not being acne. What exactly is the acne that we’re talking about when we want a raise awareness and do something about it?
B: Certainly, well in Healthy Skin Month we’re talking about everything in certainly acne is the most common disorder that presents to dermatologists but we can’t forget the sun exposure, and sunburns and the resulting problem in skin cancer is probably overarching a more crucial issue to think about during Healthy Skin Month. But acne certainly a part of it. And what is acne? Well that’s an extraordinarily good question of you, what acne is has changed dramatically over the last couple of years literally. Now we consider it to be a chronic inflammatory disorder and you get pimples and blackheads and nodules and more importantly perhaps ultimately scars on the face, the neck, in chest, in back in also on the upper arms and it’s mostly a problem of teenagers as we said before and some of them will just have a pimple or two. I call that acne, if you have pimples, if you get pimples, you have the condition referred to as acne. But many people come in and say “That’s not acne, that’s just a pimple.” But then it is perceived as a disease entity as the patient comes in often in their younger teenage years so have a couple of pimples here and there, but as they get older reaching a peak at usually about age 16 their acne will get more significant, perhaps more inflammatory, more red bumps and then gradually decline over the next two or three years, so this is a long haul process, not a short term issue.
N: Is there a clear cut cause of acne for it to affect so many people, and to be well basically a common thing that you know we all talked about when I was a kid and we see it on television? Still it’s been 50 (cough) anyway, we still see nothing but acne, clear skin and all of these products at night, what exactly causes it and is it preventable?
B: Well, again a great question, so what is it? It’s caused certainly during teenage years by an increase in hormones which causes an increase in the production of sebum of by the Sebaceous glands that in the pores in acne prone areas, and without the sebaceous glands, without the production of the hormone, acne would not occur. Well obviously we’re not suggesting that people have their reproductive organs removed so that they don’t get acne but indeed that would work. So it is not something that at the present time anyway that is completely preventable. If you were genetically pre- destined to get it, you’re going to get it, and then we react by treating you appropriately but at the present time it is not something that we can prevent.
N: Is this something that can be predicted genetically? You’ve mentioned if you’re genetically pre-disposed then you’re going to get it. Is this something that we can look out for and maybe even prepare for?
B: Well, you know to some extent the answer is ‘Yes.’ There are people in whom the family history is predictive of acne, but that’s usually the people with remarkably severe acne, remarkably severe acne does seem to have a genetic predisposition as does as bad acne in the adult female. Garden Variety Acne however is something that occurs in a hundred percent of people, how can you say that they got it because their brother and sister did, well if everybody gets it then the genetic inheritance pattern is less able to be predicted, so ‘No’ I can’t predict who’s going to develop it unless they got a strong family history of remarkably severe acne. And then you can see it very early on, in my family, my husband had bad acne and I’ve noticed it aged 6 with my twin daughters that they started to have clogged pores and I knew that it was going to be problem in them so I think if you look really carefully, you might be able to predict it.
N: You’re the Medical Director of Atlantic Health Systems Acne Treatment and Research Center. Is the ATRC actively involved in research on an ongoing basis just for acne? Or are there other things that you do research into as well as for instance rosacea or anything else?
B: Well we’re doing acne and rosacea but our focus and of course these are very similar conditions in many ways and certainly in a way that they present in patients. And yes we are actively involved in research both research looking into ways to treat acne with a relatively common topical and oral medication, but also ultimately looking at to see if we can find some way to cure acne. Not in curing it in a way of stomping in out across the world so one will never have a acne again, but cure it in light of if you come in to see me with the bad case of acne I would be able to treat you with a medication and that you would take for sure periodic time then stop and your acne would be gone. Much like treating pneumonia for example with an antibiotic so right now our acne treatments are more of a band aid on a problem. I give it to you, you get better. If you stop it, it comes right back again with the exception of Isotretinoin now and more or commonly known in the general problem as Accutane so indeed I am through my research trying to put myself out of business. So right now am treating everybody and ultimately I hope the cure so that I won’t have to do that anymore.
N: Well it has been great talking with you today, Hilary.
B: Yes, a pleasure.
N: Thank you and I’m hoping you’ll come back for a some more segments and talk with us a little bit more about acne treatment and your research center and as well.
B: I look forward to it. Thank you.
N: Thank you. You’d been listening to Health Professional Radio, I’m your host Neal Howard, in studio with Dr. Hilary Baldwin, Medical Director of the Acne Treatment and Research Center in Moorestown, New Jersey. She’s been with us discussing acne and some of those psychosocial impact of the disease on children and adults as well. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also @ hpr.fm you can also subscribe on this podcasts on ITunes.