Acne & Rosacea


Acne can occur at any age or persist through our lifetime. Acne is not just a teenage disease. Acne occurs in at least 25% of women in their 40’s and acne can persist past age 50.


The cause of acne is multifactorial and includes the following:


  • Genetic predisposition
  • Environmental factors
  • Hormonal changes
  • Clogged pores
  • Medications


At Pure Dermatology, Dr. Holcomb evaluates and treats acne patients every day. As a long-time acne patient herself, Dr. Holcomb understands how distressful acne can be. Dr. Holcomb is a board-certified dermatologist who lectures on acne treatments. She helps each patient choose the treatment that is right for them to include prescription and non-prescription options and dietary modification.


Since many acne patients are also concerned about scarring, Dr. Holcomb offers many treatments to improve acne scars. At Pure Dermatology, we offer treatments for depressed acne scars, red scars, or discoloration and hyperpigmentation. Dr. Holcomb has experience treating both old and new acne scars in all skin types and ethnicities.


Dr. Holcomb believes that customized medical grade skincare is important in treating acne and offers many topical products safe for acne prone skin. Pure Dermatology also offers laser and light treatments with no downtime to treat acne as well as chemical peels. Because combination therapy for acne and acne scarring is best, Dr. Holcomb’s patients have excellent success in clearing their acne due to all of the options available at Pure Dermatology.


Treatment Options for Acne and Acne Scarring


Laser Genesis: This pain-free treatment reduces the inflammation from acne as well and helps reduce the appearance of superficial and deep scars and red acne scars. It is safe for teenagers and pregnant women. This restorative treatment is often administered as 5 treatments done every 2 weeks.


ExcelV: This is a cousin of laser genesis and can treat acne but is very effective for red acne scars as well as other skin conditions like rosacea, broken blood vessels, aging skin, pigmentary problems and redness. This procedure does not disrupt the skin barrier but can cause swelling for a few days, depending on the treatment. Treatments vary from 2-5 treatments spaced 2-4 weeks apart.


Eclipse MicroPen percutaneous collagen induction therapy: Also known as microneedling, this treatment is an option for acne scarring. Dr. Holcomb has great results treating acne scars with this modality. Acne scars are softened due to the production of collagen in this procedure. Most patients experience pink skin for 24 hours and mild flaking for 3-5 days. Treatments for acne scars are done monthly and 3-6 treatments are recommended.


BLU-U light therapy: This treatment involves a 16-minute painless procedure that is repeated 2 times per week for 4-8 weeks. It is safe for teenagers and pregnant women. Patients also report a reduction in oil production with this procedure.


Chemical peels: These gentle procedures help to unclog pores and reduce oil production. They help with active breakouts, prevention of new acne, and treatment of scars. Peels also help rejuvenate and refresh the appearance of the skin. A series of 5-6 is recommended spaced 4-6 weeks apart.


Scar subcision: This long-proven procedure involves breaking up scar tissue to help soften deep acne scars. This very safe procedure involves injecting saline under the skin to stimulate production of new collagen. Most patients need 2-3 treatments spaced 6 weeks apart.


TCA Cross: This procedure is best for deep pores or ice-pick acne scars. Basically, this is a micro-spot chemical peel which makes acne scars less deep. There is slight downtime but only over a small area. Treatments are performed every 4-6 weeks for 3-6 treatments.


Rosacea is a troubling skin disease that affects more than 16 million Americans. The largest population afflicted with rosacea is Caucasian women in their 20’s-50’s. However, rosacea can affect skin of color and men as well. As a board-certified dermatologist and member of the American Acne and Rosacea Society, Dr. Kate Holcomb is passionate about diagnosing and treating rosacea in all skin types and races.  “We now know that treating rosacea improves patientsquality of life.” Studies demonstrate that people miss work and cancel social engagements due to their rosacea. Dr. Holcomb is both a speaker on rosacea treatments and was involved in the ANSWER clinical trial for combination therapy of FDA approved treatments for rosacea.


Doctors used to classify rosacea into types but we now understand that patients often have varying presentations and that a patient’s rosacea may change over time. Some patients will have pimples and pustules, with or without dryness. Other patients may have no bumps, but they will have broken blood vessels or complain of a red face. Patients often complain of very sensitive skin with stinging and burning or red flushing of the face due to certain foods, heat, alcohol, or out of the blue which can be very socially troubling. Other long-term complaints of rosacea are prominent pores and thickened skin. Patients may have a combination of these features.


Perioral dermatitis is another complaint that often responds to rosacea treatment.  It can have bumps and dryness around the mouth or eyes, occurs in children and adults, and is socially troubling.


The eyes can also be affected by rosacea with irritation, dryness, redness or that patients describe a feeling of having something in the eye.


In the last 5 years, the number of treatments for rosacea has increased with multiple very effective prescription medications, great professional grade skincare as well as over the counter options, and effective and safe in-office peels and procedures.


Dr. Holcomb recommends that all patients with rosacea use very gentle products that have no fragrance and always wear sunscreen daily. There are new theories on how heat, in addition to sun, plays a role in worsening rosacea; therefore, Dr. Holcomb recommends that rosacea patients only wear sunscreens that contain physical blockers, titanium dioxide and zinc oxide, which reflect light away from the skin.


Aside from prescribing medications for rosacea, Dr. Holcomb performs chemical peels and lasers tailored for each patients’ skin needs.  We used to think that rosacea patients could not tolerate chemical peels, but now there are options which perform well and give beautiful results.  Dr. Holcomb suggests doing your research to make sure that you are seeing a board-certified dermatologist capable of using combination therapy on sensitive rosacea skin.


The exact cause of rosacea is unknown and there is no cure. New theories include the following: neurovascular dysregulation,meaning the nervous system and blood vessels are involved, overactivity of the innate immune system and its messaging (cathelicidins), or reaction to the demodex mite found on all skin but more irritating in rosacea.  The good news is that treatment can control many of the signs and symptoms of rosacea and improve patients’ quality of life.

Before & After

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