Acne is more than just a teenage concern—it can be an ongoing challenge that affects your skin and self-esteem at any stage of life. While breakouts are common during adolescence, they can also persist into adulthood or appear for the first time in your 30s, 40s, and beyond. In fact, acne remains one of the most widespread skin conditions, impacting millions of men and women well past their teenage years.

At Midlothian Dermatology, Dr. Erin Adams and our experienced team recognize how frustrating and emotionally draining acne can be—not to mention the lingering scars it may leave behind. That’s why we take a thoughtful, customized approach to acne care, combining clinical expertise with the latest dermatologic treatments to target the root causes of acne and promote long-term skin health.

Whether you're managing active flare-ups or seeking solutions for post-acne marks, we're here to help you regain control of your skin—and your confidence—with treatments that are as individualized as you are.

Causes of Acne

Acne forms when pores become blocked by a buildup of oil, dead skin cells, bacteria, or debris. These blockages can result in different types of blemishes. Non-inflammatory acne includes whiteheads and blackheads, while inflammatory acne—such as papules, pustules, nodules, and cysts—leads to redness, swelling, and more severe breakouts.

Several factors can contribute to the development or worsening of acne, including:

• Hormonal changes – Common during puberty, menstruation, pregnancy, or menopause, hormonal shifts can trigger excess oil production and breakouts.

• Overactive oil glands – When the skin produces too much sebum, it can clog pores and lead to acne.

• Bacterial overgrowth – The presence of Cutibacterium acnes (formerly P. acnes) on the skin can worsen inflammation and contribute to deeper acne lesions.

• Stress – Increased stress levels can stimulate oil production and lead to more frequent or intense flare-ups.

• Diet – Some studies suggest that high-glycemic foods and dairy may influence acne in certain individuals.

• Medications or skincare products – Ingredients in some prescriptions or cosmetics can be comedogenic, meaning they clog pores and contribute to acne.

Common Types of Acne

Acne doesn’t look the same for everyone. Recognizing the specific type of acne you’re experiencing is key to choosing the most effective treatment. At Midlothian Dermatology, we evaluate the underlying cause and presentation of your acne to develop a plan tailored to your skin.

Common types include:

• Comedonal Acne – Characterized by clogged pores that lead to blackheads and whiteheads without significant inflammation.

• Inflammatory Acne – Includes red, tender papules and pustules caused by bacteria and inflammation.

• Cystic Acne – Severe breakouts that form deep under the skin, often painful and prone to scarring.

• Hormonal Acne – Typically shows up around the chin and jawline, often linked to menstrual cycles or other hormonal changes.

• Acne Rosacea – Though not true acne, this condition mimics breakouts and is marked by persistent redness, flushing, and sensitivity—usually in adults.

Acne Treatment Options at Midlothian Dermatology

At Midlothian Dermatology, we don’t believe in one-size-fits-all acne care. Dr. Erin Adams and our experienced team take a personalized approach—carefully evaluating your skin, acne type, and contributing factors to design a treatment plan that works for you.

We combine proven medical therapies with advanced in-office procedures to treat acne at the root and help prevent future breakouts. Your plan will be tailored to your skin’s unique needs, whether you’re dealing with mild congestion or more severe, persistent acne.

Medical Therapy for Acne

At Midlothian Dermatology, Dr. Erin Adams PA Stacy Romero take a comprehensive, evidence-based approach to acne treatment—starting with prescription medications that target acne at its source. Each plan is personalized to your skin type, acne severity, and any underlying factors such as hormones, inflammation, or sensitivity.

Treatment options may include:

• Topical Medications – Prescription-strength retinoids, antibiotics, or anti-inflammatory creams that help unclog pores, reduce bacteria, and prevent new breakouts from forming. Topical treatments are often the first step in managing mild to moderate acne and can be combined with in-office procedures for enhanced results.

• Oral Medications – For more persistent or inflammatory acne, oral medications may be recommended. These may include antibiotics to decrease bacteria and inflammation, hormonal therapies like spironolactone for women with hormonal acne, or isotretinoin (Accutane) for severe or treatment-resistant cases.

• Personalized Skincare Regimens – Dr. Adams and Stacy also help patients select medical-grade cleansers, exfoliants, and serums that complement prescription therapy, support healing, and maintain long-term skin health.

Prescription treatments can be highly effective on their own—or serve as the foundation for a broader acne management plan that includes chemical peels, microneedling, or other in-office solutions.

In-Office Treatments for Active Acne

At Midlothian Dermatology, we understand how deeply acne can impact both your skin and your self-confidence. As a board-certified dermatologist with decades of experience, Dr. Erin Adams offers compassionate, results-driven care using the latest medical advancements. PA Stacy has been practicing Dermatology for over two decades, treating thousands of acne patients along the way. Whether you're facing ongoing breakouts or looking to improve the appearance of acne scars, we’re here to help.

Our goal is to treat acne at its root—reducing oil production, clearing clogged pores, calming inflammation, and restoring smoother, healthier-looking skin. With personalized solutions and proven in-office treatments, we help you regain clear skin and renewed confidence.

 Chemical Peels

Chemical peels are a proven, non-invasive way to refresh and improve the appearance of your skin. By removing the outermost layers of dead skin cells, chemical peels help unclog pores, reduce oil production, and stimulate healthy cell turnover—leaving your skin looking clearer, smoother, and more radiant.

• How It Works: Our chemical peels use a carefully selected blend of medical-grade ingredients to exfoliate the skin, target acne-causing bacteria, and reduce inflammation. Peels can also help fade discoloration and soften the appearance of fine lines and acne scars.

• Why Choose a Peel: In just one week, many patients see noticeable improvements in skin clarity, tone, and texture. Chemical peels are suitable for a variety of skin types and can be customized to address concerns like acne, sun damage, melasma, and early signs of aging.

Whether you're looking for a gentle refresh or a deeper resurfacing treatment, Dr. Erin Adams and her team will recommend the right peel for your skin's unique needs.  Our RN, Lisa Banton, has been instrumental in using chemical peels to help our acne patients for over two decades.

Professional Extractions

Expertly performed extractions are a safe and effective way to clear clogged pores and treat non-inflammatory acne such as blackheads, whiteheads, and small cysts—without damaging your skin.

• How It Works: Our trained professionals use sterile tools and gentle technique to extract buildup from pores with precision. Extractions are often performed over a series of visits and may be combined with other treatments to help keep your skin clear and balanced.

• Why Choose Extractions: Enjoy immediate relief from congestion and visible improvement in your skin’s texture. Unlike at-home attempts, professional extractions reduce the risk of scarring and support long-term skin health—especially when combined with a customized skincare plan.

If you're dealing with stubborn clogged pores or recurring breakouts, Dr. Erin Adams and our team are here to help your skin look and feel its best.

Steroid Injections for Cystic Acne

When deep, painful breakouts occur, steroid injections offer fast relief and help prevent long-term scarring. This in-office procedure is ideal for inflamed acne cysts and nodules that don’t respond to topical treatments.

• How It Works: Our team administers a small, targeted injection of corticosteroid directly into the lesion to quickly reduce swelling, redness, and discomfort. For larger cysts, an optional incision and drainage may be performed to accelerate healing.

• Why Choose Steroid Injections: This treatment delivers rapid results—often within 24 to 48 hours—making it a trusted solution for flare-ups before events or during hormonal breakouts. It’s safe, precise, and performed by an experienced team.

If you’re experiencing a stubborn or painful breakout, we’re here to help you feel more comfortable in your skin—fast.

BelaMD for Acne-Prone Skin

BelaMD is a next-generation, medical-grade facial that combines multiple advanced technologies in one treatment to deeply cleanse, exfoliate, and calm acne-prone skin—while improving overall skin health.

• How It Works:
  BelaMD uses a unique combination of exfoliation, pore extraction, and targeted serum infusion to treat breakouts and inflammation at the surface and below.
  

  • Key features include:
    • Microdermabrasion – Gently removes dead skin cells and smooths texture
    • Serum Infusion – Delivers acne-fighting and skin-soothing ingredients deep into the skin
    • Electroporation – Uses gentle electrical pulses to enhance serum absorption
    • Muscle Stimulation – Firms and tones with low-level microcurrent therapy
    • Hydrogen Water Infusion – Hydrates and reduces inflammation while neutralizing free radicals

• Why Choose BelaMD:
  This all-in-one treatment is ideal for active acne, congestion, and dull or inflamed skin. BelaMD offers both immediate glow and long-term improvement—with no downtime and full customization based on your skin’s specific needs.

Acne Scar Treatment

 Understanding Atrophic Acne Scars

Atrophic acne scars are the most common type of scarring that develops after moderate to severe acne. These scars appear as visible depressions or indentations in the skin, often forming when the skin doesn’t produce enough collagen during the healing process. They can vary in shape, depth, and severity—and the type of scar helps determine the best treatment approach.

Common Types of Atrophic Scars:

• Ice-pick scars – Narrow, deep scars that resemble small holes or enlarged pores

• Boxcar scars – Broad, round or oval depressions with well-defined edges

• Rolling scars – Shallow, uneven scars with a wave-like appearance across the skin

At Midlothian Dermatology, Dr. Erin Adams and PA Stacy Romero will carefully evaluate your scar type and skin texture to recommend the most effective treatment plan for smoother, more even-looking skin.