There’s a new spot for treating acne with last month’s opening of the Acne Treatment Research Center in Morristown, NJ. According to ATRC’s medical director Hilary Baldwin, MD, the center’s focus on acne will give patients more options and better outcomes when it comes to treating the skin disorder. It all starts with a one-hour consultation at the first visit and full 30-minute follow-up visits.


“I want patients to say, ‘Wow! I never had such an in-depth visit with a doctor,’” Baldwin told Happi. “I want to make a difference.”


The typical doctor visit has become rushed, she explained, with the average dermatologist seeing 6-10 patients an hour. More often than not, these appointments get turned over to physician assistants and medical assistants.


“I started in academia, where we took a long time to teach residents about dermatology,” Baldwin recalled. “I have been unhappy with the speed of office visits.”


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. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center. Upon graduation and board certification in dermatology, she joined the faculty of the dermatology department at The State University of New York, ultimately becoming associate professor and vice chair of the department. Over 20 years at SUNY, she cared for patients, taught countless students, and conducted numerous clinical studies. Dr. Baldwin has lectured extensively both nationally and internationally and published prolifically in journals. She served as a founding board member and second president of the American Acne and Rosacea Society.


There’s No Rush


Throughout her career, Baldwin saw too many dermatologists and other physicians following a set plan when it came to examination and patient interactions, with no room for flexibility. But patient care suffers when doctors are merely following a recipe, insists Baldwin.


“For some patients, the recipe doesn’t work and their needs aren’t being addressed,” she explained.


At its most serious, a rushed examination can have deadly consequences, as Baldwin noted teens that are depressed about their acne have a 2- to 3-fold increase in suicide. Obviously, acne isn’t a minor issue and its impact can be devastating well beyond the formative teen years.


“What happens to you in middle school and high school impacts you as an adult; it can stay with you forever,” explained Baldwin. “It is crucial for teens to get the right care so they are not introverted. That issue is never addressed,” she added


Not Just for Kids


Fifty million Americans have acne and practically all of them are teenagers. While the number of teens with acne has remained rather static over the years, there has been an increase in the number of adult females with acne; Baldwin estimates that the number of cases of women with adult acne is increasing 20% a year, but that increase may be due to dermatologists’ success rate, she added.
“We see a lot of moms with happy teens,” Baldwin explained. “The teens get better and the mother wants to look into it.”


Besides utilizing topical and oral medications, ATRC also offers laser and light therapy and physical modalities such as injections and medical facials.


But not all treatments are alike or appropriate for every patient. Baldwin noted that antibiotics work extremely well, but they must be used correctly.


“You need a long-term treatment plan,” she explained. “Accutane doesn’t cure acne, it controls it. So giving a patient a prescription and saying ‘have at it,’ isn’t an answer.”


ATRC notes that antibiotics work exceedingly well in the treatment of acne; however, in the past decade, medical professionals have come to realize that perhaps antibiotics work so well at treating acne because of their anti-inflammatory properties, not because they are acting as true antibiotics.


An Integrated Approach


That’s one reason why ATRC takes an integrated approach to treatment. Baldwin said she is open to more Eastern techniques that incorporate supplements, meditation and yoga; a regimen that’s designed to relieve stress throughout the body. Working with the Chambers Wellness Center, the ATRC will offer classes in meditation and other stress reducing techniques as well as dietary and supplement education.


“There is no data that stress is a big cause of acne,” she cautioned. “I suspect, as do others, that acne is exacerbated by stress not caused by it.”


The Missing Link(s)


Once the appointment is over, after care kicks in. ATRC offers makeup classes to teach cover-up techniques and improve self-perception. Cooking classes will teach low glycemic index, low dairy recipes as well. Baldwin and her team will provide advice on personal care product use as well.


“Often that is the step that is skipped (at a dermatologist’s office),” she said. “You have to talk about cleansers, moisturizers, sunscreens and cosmeceuticals.”


What she won’t do, however, is recommend specific products.


“For some patients who prefer purchasing products in the office, I do stock products that they could find at Walgreens and I charge them the Walgreens’ price.”


Years ago, Baldwin sold a specific brand out of her office, but when patients asked what brands they should use, “the shelf in my office was calling ‘Use me! Use me!’ I was afraid I was recommending products for the wrong reason. I couldn’t do that ethically.”
So, what does Baldwin look for in a personal care product? Two things: tolerability with enough efficacy to do the job well enough so that the patient keeps using it. “Then the medication can do the heavy lifting,” she added.


Ingredients that get the doctor’s approval include ceramides and hyaluronic acid, which plumps the skin and moisturizes and repairs the barrier. At the same time, Baldwin told Happi that salicylic acid can dry skin, while topical oils such as cocoa butter and shea butter can clog pores.


Research & More Research


Patients are clearly the focus at the Acne Treatment Research Center, but ATRC also conducts research on new topical agents, and the roles that diet and stress play in skin care diseases. The ATRC has four staff members and is currently conducting six studies. In addition to all the research, ATRC is committed to educating consumers and medical students about acne.


According to Baldwin, in the not too distant future a cure for acne may even be discovered.


“It’s not as outlandish as it sounds,” she insisted. “My goal is to put myself out of business.”