Acen Treatment | Sheperd Integrative Dermatology in Mount Pleasant, SC

Most people are no stranger to acne. It’s the most common skin condition in the United States. According to the Academy of Dermatology , mild to moderate acne affects between 40 and 50 million Americans annually. While acne usually begins in puberty and affects about 90% of teenagers, it is not restricted to any age group. In fact, clinical studies indicate that between 40 and 55% of the adult population age 20 to 40 years old are diagnosed with low grade, persistent acne and oily skin. The good news is this: Acne is not incurable and there are many great treatments for it.

Here at Sheperd Integrative Dermatology , we’ve helped hundreds of patients in their fight to control breakouts, and our providers understand just how frustrating acne can be for a patient. I know firsthand how much breakouts can impact a person’s life, leading to heightened self-consciousness and minimal self-confidence. Unfortunately, many individuals don’t realize that they are treating their acne at home incorrectly and simply prolonging, and sometimes feeding, the vicious cycle of breakouts. To help you better understand the main causes of acne, how it can present, and how to fight it, we’ve put together this informative guide with the help of our very own, Dr. McLean Sheperd.

What’s Causing Your Acne?

Acne is most commonly linked to the effects of male hormones or androgens in the body, which control excretion from the oil-producing sebaceous glands in the skin. This is one of the reasons why acne is often associated with teenage years; the hormonal shifts in early adulthood often cause significant changes in the production of oil or sebum resulting in blocked skin follicles. However, acne can become an issue at any point of your life. In women, progesterone levels spike before menstruation, which can stimulate increased production of sebum and result in breakouts. Acne may also flare up in women during menopause due to low levels of estrogen.

It’s important to note that the root cause of your acne doesn’t have to be hormone related. There’s a possibility it can stem from food sensitivities, most commonly to dairy or wheat. Food sensitivities can develop at any stage of your life, particularly during high psychological stress. The stress response can disturb gut microbiota and break down the intestinal barrier, allowing substances to leak into the bloodstream. This promotes an inflammatory response throughout the body, which has direct effects on the skin. Make sure to check out my two blogs, “The Brain-Skin Connection: A Holistic View of Skin Health” and “How a Healthy Gut Microbiome is Essential for Healthy Skin” if you’re interested in learning more!

Acne can be broken down into six different categories:

Blackheads and Whiteheads:  Also called comedonal acne, this is the mildest form of acne that presents in small pimples with either black or white tips (comedones). A common misconception with blackheads is that the dark coloration is due to dirt, when the real culprit is oxidation of the upper layers of the pore plug. This can be difficult for some patients, because they feel even more self-conscious as they mistakenly associate the blackheads with dirty skin.

Papules: This type of acne is associated with red, inflamed bumps. The inflammation can lead to acne scarring, which makes it important to treat if the acne is present on a large portion of the skin.

Pustules, Nodules and Cysts:  These are the most severe types of acne, and can result in deep scarring if left untreated. Cystic acne is perhaps the most difficult to treat, as the cysts and the bacteria are located deep under the skin, where topical medication often cannot penetrate.

How to Treat Your Acne

Treatment must be carefully planned, based on the patient’s unique situation. People suffering from acne often don’t understand that it doesn’t have much to do with hygiene or how often they wash their skin. The hormonal fluctuations are the real culprit. This leads many to exacerbate the problem by washing with harsh ingredients and scrubbing the skin too much, which leads to inflammation, skin irritation and damage. For best outcomes, it’s vital to design a treatment plan that focuses on the root cause of the problem. The goal of Sheperd Integrative Dermatology providers is to help each patient achieve clear skin and reduce chances of future breakouts. Our objective is to get the patient clear, as opposed to some percentage of clear.

Oral Antibiotics for Acne: In some cases, topical antibiotics are just not enough, and oral antibiotics may be required to kill bacteria and reduce inflammation. Acne-causing bacteria flourish on the oil produced by the sebaceous glands. The bacteria break down the oil into irritating substances, which lead to inflammation. Therefore, by killing the bacteria, antibiotics also reduce inflammation and the probability of scarring.

Light and Laser Acne Therapies: In some situations, light-based therapy can also be used to cure acne. The goal is to focus on targeting acne-causing bacteria with different types of light. One of the benefits of such treatments is that they can be performed in addition to using topical medication, but are also a great alternative for individuals whose skin is too sensitive for retinoids or antibiotics.

It’s Time to Clear Acne for Good

If you’re struggling with acne, there’s no need to go it alone. The highly trained providers at Sheperd Integrative Dermatology in Mt. Pleasant, SC will take the time to understand your unique situation and create a customized treatment plan just for you. Stop by our office or give us a call at 843-216-3530 to take the first step towards clear, healthy skin.

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Rebecca Repaire


Becky is a board- certified Physician Assistant and has practiced Dermatology for over 18 years. She graduated magna cum laude from her undergraduate degree at the University of Georgia, then completed her Physician Assistant studies at the Medical University of South Carolina. She now practices medical, surgical and cosmetic dermatology. She has done extensive training in the use of a dermatoscope and equally extensive training in surgical techniques for the removal of skin cancers. As her practice and skill have continued to grow, cosmetic dermatology has become a passion of hers and she devotes herself enthusiastically to continuing training to ensure she remains at the forefront of innovations with Botox, fillers, threads, and other techniques. She believes that our skin is a reflection of our overall emotional and physical well-being, and she delights in helping patients find their inner beauty.

Amy Jetter


Amy brings her whole heart to her role on the Sheperd cosmetic team.  A graduate of Elon College and the Medical College of Virginia, Amy has been a board-certified nurse for over 30 years.  Bringing her skills as an ICU nurse into her role in cosmetic patient care, Amy provides a warm, reassuring presence to all her clients, listening to their concerns and collaborating with them in a plan to bring forth and enhance their natural beauty.  A standing member of the American Association of Plastic Surgery Nurses and a past RN trainer in cosmetic and aesthetic procedures, Amy offers all types of laser treatments, botox and dermal filler injections, and chemical peels.

Melissa Mancuso

Body Contouring Specialist

Melissa has six years of experience in body contouring, beginning with her role as the CoolSculpting representative for Maryland, Virginia, and the District of Columbia. Since joining the Sheperd team, she has received additional training and now offers chemical peels, Vivace micro-needling, and Diamond Glow dermal infusion. She loves helping patients feel good about their bodies and teaching them about how the various cosmetic procedures can help them achieve the results they are seeking.

Margaret Gierhart


Margaret, a South Carolina native, is a Licensed Esthetician and makeup artist with over 20 years of experience in the beauty industry. She earned a BA in Psychology from the University of South Carolina. She began her career in beauty as the resident makeup artist for Bobbie Brown cosmetics at Saks Fifth Avenue in Charleston. In order to expand her knowledge, she earned her degree in esthetics from Trident Technical College, graduating with honors. She joined the Sheperd Integrative Dermatology staff in 2014 and is certified in a wide array of cosmetic procedures and skin care products. Her offerings include laser skin resurfacing, IPL, micro-needling, chemical peels, radio frequency, laser hair removal, and body contouring. Her background in both psychology and artistry gives her a deep capacity to care for patients and understand what makes them feel beautiful. A mother of two daughters, Margaret understands beauty as not only external appearance, but also as a manifestation of the inner qualities of kindness, generosity, and well-being.

Madeline Anderson


Maddie is a board-certified Physician Assistant and a Lowcountry native. She obtained her undergraduate degree from Clemson University and then went on to earn a Master of Science in Physician Assistant Studies from the Medical University of South Carolina, graduating with highest honors. While in PA school, Maddie served as a Student Representative for the SC Society of Dermatology Physician Assistants. After graduation, she completed a six-month advanced dermatology internship here at Sheperd Integrative Dermatology. She also completed the Diplomate Fellowship with the Society of Dermatology Physician Assistants. Maddie has a heart for medical missions and is passionate about patient education. Her free time is shared with her family, her friends, and her two fur babies!

AnnaKathryn Keiper


AnnaKathryn completed her Doctorate degree at the Medical University of South Carolina and has seven years of experience in dermatology. She has completed additional training in medical dermatology, cosmetic dermatology, and functional medicine. She provides skin cancer screenings, surgical removal of skin cancers, treatment of precancerous lesions, extractions of cysts, and the treatment of acne. In the cosmetic domain, she provides laser, filler, and neurotoxin treatments. Certified through the Institute of Functional Medicine, AnnaKathryn has a special focus on wellness, including weight loss and diet consulting. She uses her expertise in this field to create an individualized program to help each of her patients achieve optimal wellness supporting them in maintaining vibrancy and vitality throughout their lifespan.

Allyson Harrell-Garrison


Ally is a board-certified Physician Assistant and a Diplomate of the Society of Dermatology Physician Assistants, their highest rating. She is a graduate of Clemson University and earned her Master’s degree in Physicians Assistant studies at the University of Alabama; additionally, she completed a dermatology fellowship at Charlotte Dermatology in North Carolina. For more than ten years, her focus on both medical and surgical dermatology has included identifying and treating skin cancers as well as managing biologic medications for psoriasis and atopic dermatitis. Ally has a strong love of surgical dermatology and she performs surgeries every day in the clinic, including excisions of cysts and skin cancers. She also loves the challenge of a difficult case! On the cosmetic side, Ally is a skilled injector of both Botox and Dysport. She sees compassion and empathy as vital qualities that she brings to all her patient interactions. She is mindful that skin cancer screenings can be frightening or overwhelming; her warm, calm manner and her focus on patient education throughout each appointment make her an outstanding clinician.
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