11 best remedies for acne

Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

Acne or acne is a long-known inflammatory disease of the skin appendages. It was probably first described by Byzantine court doctors back in the middle of the first millennium AD. Neglected cases lead to the formation of a cosmetic defect, serve as a source of chronic skin inflammation and scarring. Severe acne is a constant source of stress, development of dysmorphophobia, feelings of inadequacy and significantly worsens the quality of life, in extreme cases leading to suicide.

The essence of acne is in the inflammation of the glands that produce sebum and bring it out, in the blockage of the excretory duct of the sebaceous gland and the concomitant inflammation of the hair follicle. Acne almost never occurs as a single formation. In the event that there are no more than 10 acne (no inflammation symptoms) on the face, shoulders, neck or chest, then such a rash is considered mild. And if there are more than 40 acne, and almost all of them are surrounded by a halo of inflammation with the phenomenon of pain and edema, merge (conglobates) and proceed with symptoms of general intoxication, then this is a serious condition in which serious and long-term treatment is necessary.

Dermatologists count many causes of acne, among which the most common is hormonal changes in the body during puberty. Low immunity, pregnancy, improper diet and constipation, the use of low-quality cosmetic products often lead to the appearance of inflammatory changes in the sebaceous glands.

This review includes drugs that are intended both for topical application by application to the skin and drugs for systemic action in the form of tablets. The second group of medicines can be prescribed only by a doctor, according to indications and in the absence of contraindications. Any self-medication is dangerous and categorically contraindicated. The rating will not list traditional medicine, as well as numerous physiotherapeutic procedures that are widely used in beauty salons in order to eliminate the effects of long-term, chronic acne in the formation of scar tissue. These include a variety of masks, peels, cryotherapy and ozone therapy, darsonvalization, various types of cleansing, phototherapy, dermabrasion and many more. Their consideration is not the purpose of this rating.

First, we will look at topical medications that are good for treating mild acne, using creams, gels, and ointments. But local remedies for acne treatment include antibacterial agents and antibiotics, so even in this case, a specialist consultation is necessary before use. All prices listed in the ranking are relevant for large cities of the Russian Federation for the beginning of 2019, and for pharmacies of all forms of ownership.

Rating of the best drugs for the treatment of acne

Nomination	a place	Name of product	price
The best antibiotics and antiseptics	1	Zenerite (erythromycin + zinc acetate)	628 RUB
	2	Dalacin Gel (Clindamycin)	767 RUB
	3	Klenzit C (clindamycin + adapalene).	562 r
	4	Baziron AC (benzoyl peroxide)	583 r
	5	Skinoren (azelaic acid)	RUB 1,100
Best Remedies for Reducing Inflammation and Reparants	1	Curiosin – gel	RUB 600
	2	Delex – acne, acne gel	231 r
	3	Bioderma sebium AKN	882 r
The best drugs of systemic effect: contraceptives, retinoids, antiandrogens.	1	Jess (Yarina, Janine)	995 RUB
	2	Systemic retinoids (Roaccutane, Acnecutane, Erase)	RUB 1,660
	3	Cyproterone (Androkur)	RUB 1,395

The best local remedies

The purpose of using local remedies is to reduce the secretion of sebum, reduce the number of populations of bacteria that are on the surface of the skin, and are involved in the formation of secondary inflammation, and fight follicular hyperkeratosis. Hyperkeratosis leads to a delayed removal of dead epidermal scales from the skin surface. Hyperkeratosis provides food for bacteria and pathogenic fungi, the epidermis clogs the ducts of the sebaceous glands, creating plugs. All topical drugs are used in the treatment of acne for a long time, they are applied to the affected skin, with the exception of the eyelids and the area around the eyes.

The best antibiotics and antiseptics

Antibacterial drugs and antibiotics will be discussed first. They largely inhibit the growth of bacteria and suppress the very cause of inflammation. However, antibiotics should not be abused, since resorption and systemic effects are possible if applied to large areas. It is also recommended to regularly change the regimens for the use of antibacterial drugs in order to avoid the development of microflora resistance to the drugs used. For this, it is recommended to periodically take the discharge from the surface of the foci and conduct a bacteriological study with the isolation of a pure culture and determination of the sensitivity of microbes to antibiotics.

Zenerite (erythromycin + zinc acetate)

Rating: 4.9

Erythromycin, which is part of Zinerit, is a dermatotropic antibiotic. It does not kill microorganisms, but suppresses their reproduction. Zinc acetic acid has an astringent and drying effect, reduces sebum secretion and is suitable mainly for oily skin. Erythromycin is especially good at inhibiting the growth of epidermal streptococci and propionic bacteria, which are most often the main consumers of sebum, which are responsible for the appearance of acne.

Zinerit is produced in the form of a liquid, in a bottle with an applicator. You need to apply Zinerit on acne twice a day, morning and evening. By pressing the applicator, you can dose the amount of liquid. The average daily dose is 1 ml of solution. The average course duration is 3 months. As a rule, visible improvement in mild to moderate acne can be seen as early as 2 weeks. Zinerit is produced by the pharmaceutical company Astellas, the Netherlands, and the average cost of one bottle, which is enough for a month's use, is 735 rubles.

Advantages and disadvantages

Zinerit's advantage is its high safety. Erythromycin can even be used in pregnant and breastfeeding women, and occasional burning and dryness can occur from local side effects. These symptoms are mild and soon disappear without requiring discontinuation of the medication. A big plus will be the fact that after drying on the skin, the solution becomes invisible, and the patient can safely apply Zinerit on the face, it will not be covered with any white spots of zinc ointment, as many think. The relative disadvantage of the product is the high price and small volume of the bottle, but the effectiveness makes up for this small disadvantage.

Dalacin Gel (Clindamycin)

Rating: 4.8

This local agent in the form refers to antibiotics from the group of lincosamides, and is a monocomponent drug. It is this antibiotic that quickly acts in the ducts of the sebaceous glands, as it is activated by skin enzymes. Almost all known strains of propionic bacteria are sensitive to its action. The second positive effect of clindamycin will be to reduce the oiliness of the skin by reducing the amount of fatty acids. It is necessary to apply the gel in the same way as Zenerit, 2 times a day, applying it with a thin layer on the surface of the acne. The course of treatment is long. The first results will be noticeable in at least a month and a half, and the duration of the course of treatment can be up to 6 months. This highly effective gel is produced by the American company Upjohn, and a tube weighing 30 grams costs 925 rubles.

Attention! When buying Dalacin, do not confuse it, since it is also available in the form of a cream, but the cream is intended only for intravaginal use. This is all the more important because the cost of gel and cream is almost the same, and it is very easy to get confused.

Advantages and disadvantages

The advantage of Dalatsin is its high activity and the ability to dry the skin without clogging the pores, simply by reducing the secretion of fatty acids. When treating, it is imperative to take into account the fact that Clindamycin and Erythromycin should not be used together, since the phenomenon of antagonism is observed between them. Clindamycin can often cause dryness and irritation when applied to the skin. During treatment, it is necessary to carefully avoid applying the agent to the conjunctiva of the eyes and the oral mucosa. If this happens often enough, and Clindamycin will systematically enter the mouth, then severe and prolonged diarrhea may develop.

Klenzit C (clindamycin + adapalene).

Rating: 4.8

This is a combined preparation, which, in addition to the already mentioned clindamycin, contains adapalene. This substance belongs to retinoids, relatives of vitamin A. It is known that they are highly effective in the treatment of acne, and have a pronounced anti-inflammatory effect, eliminate the so-called comedones. Comedones are cystic enlargement of the sebaceous gland orifices, which turned out to be clogged by the poorly exfoliated superficial epidermis, and hyperkeratosis is to blame for their formation.

Comedones for acne are a risk factor that leads to the chronicity of the process and the retention of inflammation in the depths of the skin. It is adapalene that improves the cellular composition of hair follicles, which reduces the likelihood of clogging. In addition, adapalene reduces the severity of cellular inflammatory reactions. The second component is again clindamycin, which was mentioned above. Together, these two components produce a more pronounced effect than alone.

The drug is applied to dry and clean acne once a night. You can notice the effect of the use on average in two weeks, the course usually lasts no longer than a month under the supervision of a dermatologist. Persistent improvement develops after several courses, for a total duration of about 3 months.

The Klenzit C gel is produced by the pharmaceutical company Glenmark from India, and the average cost of a tube weighing 30 g is 830 rubles.

Advantages and disadvantages

The advantages of Klenzit C are the combination of two highly active components in one relatively inexpensive product. The medicine is highly effective because it only needs to be applied once a day, which results in significant savings. However, the drug can cause side effects, mainly due to clindamycin. Klenzit C is contraindicated during pregnancy and lactation, and is prohibited for use in patients with Crohn's disease who have not reached the age of 12 years, due to the lack of necessary research.

Baziron AC (benzoyl peroxide)

Rating: 4.7

This drug with a pronounced antimicrobial effect is a gel, but not colorless, but white. It is produced in a tube weighing 40 g, both in a concentration of 2.5% and 5%. The cost of these two varieties is approximately the same: 900 rubles per package. The famous French company Galderma produces a medicine for acne. Baziron has not only antimicrobial, but also keratolytic effect, removing excessive keratinized skin. This allows you to eliminate the formation of cysts, or comedones, improve the blood supply to tissues and reduce the synthesis of sebum. Baziron AC should be applied once to 2 times a day on dry and clean skin, the effect will be visible in a month. Persistent clinical remission usually occurs three months after treatment.

Advantages and disadvantages

Plus Baziron AS is a double action: a keratolytic and an antiseptic in one. Benzoyl peroxide has a very low coefficient of resorption, and even if it gets through the skin, it is quickly excreted by the kidneys and does not accumulate in tissues. The medicine has no harmful effect on the fetus, and can be used during pregnancy and lactation. Adverse reactions include mild redness, dryness, or burning of the skin, which usually do not require withdrawal. As in other cases, Baziron should not be applied to the conjunctiva of the eyes, the mucous membrane of the mouth and nose, and due to accidental ingestion, they should be rinsed with plenty of water. The price range of this medicine is average (among the remedies for the treatment of acne), the quality is European. Baziron can be combined with other topical preparations as it does not contain antibiotics.

Skinoren (azelaic acid)

Rating: 4.6

Skinoren is a highly effective dermatoprotective agent that protects the skin from microbial aggression and is used as a gel and cream. At the same time, the cost of cream and gel (30 g) is approximately the same: about 1400 rubles. The actions of azelaic acid are to improve the function of keratinization in the sebaceous glands, reduce the fat content of the skin and antimicrobial activity. However, Skinoren is not considered an antibiotic. Also, the agent has an anti-inflammatory effect, regulates cellular immunity.

It is necessary to apply the cream on previously cleansed and dried skin, rubbing in slightly, 2 times a day, preferably in the morning and in the evening. An economical remedy: a strip about 2 cm long is enough to apply to the entire face area. With acne vulgaris, clinical improvement is usually noticeable after a month, but the course should be longer, usually two or three months. Skinoren is produced by the well-known pharmaceutical company Bayer.

Advantages and disadvantages

The advantage of Skinoren is the possibility of its wide use in cosmetology, it is not only an anti-acne agent. It has been used successfully for rosacea. Skinoren has antimicrobial effect and does not have the side effects of antibiotics. Skinoren does not require skin protection from ultraviolet radiation during treatment, and is successfully used in the complex therapy of various types of acne, ranging from vulgar to severe.

Best Remedies for Reducing Inflammation and Reparants

Some of the funds considered in the previous section of the rating already have anti-inflammatory components in their composition. But there are also special recipes that have an anti-inflammatory effect, and at the same time do not contain antibacterial components and antibiotics. Nevertheless, in this case, there will be an antiseptic effect, but at the expense of other ingredients. They can be sulfur preparations, boric acid. Antifungal drugs are also widely used, which are used prophylactically.

Curiosin – gel

Rating: 4.9

This gel, produced by the famous Hungarian company Gedeon Richter, belongs to reparants, that is, it restores tissue and stimulates its healing. Curiosin contains hyaluronic acid in combination with zinc. The use of Curiosin contributes, in addition to improving tissue regeneration, reducing inflammation, the agent has an antiseptic and bacteriostatic effect.

The use of Curiosin improves local cellular immunity, promotes the correct differentiation of fibroblasts in the inflammation focus. The introduction of zinc in combination with hyaluronic acid made it possible to obtain activity against pathogenic microorganisms, which is not observed with the use of other hyaluronic acid compounds (for example, sodium hyaluronate). First of all, Curiosin is indicated if the patient has a large number of comedones, pustular acne, that is, in the presence of a blistering rash containing pustules, or pustules.

It is recommended to prescribe this remedy for an uncomplicated course of acne immediately after reducing inflammation, and after the manifestation of the action of antibacterial drugs. The presence of hyaluronic acid allows the formation of minimal, cosmetic and subtle scars, since the connective tissue with regular use of Curiosin fills the entire skin defect. You need to apply Curiosin in the morning and evening, 2 times a day on clean affected skin. It dries up quickly enough, and the duration of the course of treatment is determined by the shape and severity of the acne. The cost of one package of gel weighing 15 g is, on average, 570 rubles.

Advantages and disadvantages

Plus Curiosin is the ability to ennoble young scars, but for this it is necessary to use it after the first fight against inflammation. Curiosin does not stain the skin, does not leave prints on linen. The safety of Curiosin is high, when applied topically, it is practically not absorbed into the bloodstream, and it is contraindicated only in case of individual intolerance, in pregnant and lactating women, but due to lack of data.

Delex – acne, acne gel

Rating: 4.8

Finally, we present a domestic drug in the ranking. Manufacturer LLC Helsey – gel produces a whole line of cosmetics. These are gels and lotions for acne, which include plant extracts, menthol, and sulfur. The manufacturer does not describe in detail which herbal formula is contained, therefore this tool and the entire line can be considered not medicinal, but parapharmaceutical. This gel and lotion for acne is used not so much for treatment, but as a preventive measure, and especially for patients with oily skin. As a result of the care, the secretion of sebum decreases, and in some cases Delex – acne gel is able to cope with acne, but only if it is mild.

This gel should be applied to the skin of the face one to two times a day, usually in the morning and evening. You should not rub in the gel, but you can only apply it. In the event that the gel is used for treatment, then it should be applied only to areas with acne, but not to healthy skin. The manufacturer does not limit the duration of the course of use: from a week to the complete disappearance of the symptoms of inflammation. One package of 30 ml costs on average, about 210 rubles.

Advantages and disadvantages

The disadvantage of this drug is the fact that it is a cosmetic product, not a medicine, and according to the strict rules for rating the best products, it should not be in it at all. But nevertheless, for him we will make an exception, since acne has periods of not only exacerbation but also remission, it is at this time that skin care is required with a preventive purpose. Prevention is considered to be the strong point of all parapharmaceuticals, including this line of products. This gel or lotion is not able to cope with a rather pronounced acne on its own. The fact that the manufacturer did not limit the duration of the course of treatment indicates that the agent does not have a particularly strong effect. But on the other hand, it is available in pharmacies, is well tolerated, has no contraindications, except for individual intolerance, has a very low price.

Bioderma sebium AKN

Rating: 4.7

Another example of high quality parapharmaceuticals used for the treatment and prevention of acne. This product is available in two forms: cream and face emulsion. This product contains esters of alpha hydroxy acids, which have the ability to dissolve comedones, and in cosmetics they are used for the so-called acid or glycolic peeling. Natural weak organic acids are considered to be the source of alpha hydroxy acids. These include, for example, malic, citrus and lactic acids. Also, the emulsion contains a beta-hydroxy acid, namely salicylic acid. This agent has long been used in medicine as a keratolytic drug, it normalizes follicular keratinization, preventing hyperkeratosis, improves exfoliation of dead epidermal particles, and has an anti-inflammatory effect.

It is necessary to apply this emulsion on pre-cleansed skin once or twice a day, they should be prescribed to patients with acne within a few weeks after the exacerbation has subsided. It is advisable to carry out the treatment under the guidance of an experienced dermatocosmetologist. The well-known French company Bioderma produces an emulsion, and a 30 ml tube costs an average of 1000 rubles.

Advantages and disadvantages

Bioderma is a very good parapharmaceutical, and it will ideally prevent the formation of new acne and comedones, but only if the inflammation is cured first. Therefore, before purchasing this remedy, you need to consult with a dermatologist or dermatocosmetologist, and find out if you need a comprehensive treatment first. You can get confused on your own, since there are agents that include different concentrations of hydroxy acids. So, funds with a high concentration are used for peeling, medium-concentrated ones are prescribed for a longer period, and drugs with a low concentration of acids are indicated in the inter-relapse period, as well as for the prevention of scarring. In the same case, if after the cure of acne, the so-called 'problem' skin remains, then this care product will be ideal.

The best drugs of systemic effect: contraceptives, retinoids, antiandrogens.

Finally, we proceed to describe 'heavy artillery', or systemic drugs. They are used exclusively as prescribed by a doctor, and almost all are prescription. These are pretty serious tools. Among them there are contraceptives, or contraceptives, agents that affect male sex hormones and suppress their activity (strict antiandrogens), as well as systemic retinoids, of which Roaccutane, the 'gold standard of treatment' for severe acne, will be the most active. Let's consider these tools in more detail. In this section of the rating, we will not list in detail each of the many drugs within the groups, since only a doctor makes a specific selection. Here is one typical and most striking representative.

Jess (Yarina, Janine)

Rating: 4.9

It goes without saying that hormonal contraceptives were originally created for women, and not only to prevent pregnancy, but also to normalize the cycle, and therefore these funds are used only to treat female acne. It is known that the activity of the sebaceous glands, and the associated subsequent blockage of the excretory ducts and inflammation, is regulated by the activity of the male sex hormones, testosterone.

Therefore, the use of some drugs (Jess, Yarina) with a blocking androgenic effect from this group can reduce the severity of acne and the manifestation of secondary inflammation. These funds are quite effective, they are able to treat existing acne, as well as reduce the formation of new elements. Since all of these drugs are initially considered contraceptive, their appointment should not be solely on the part of a dermatologist. The use of contraceptives Jess and its analogue-Yarina should be monitored by a gynecologist.

The drug Jess, in addition to contraception and the treatment of severe forms of premenstrual syndrome, is officially indicated for the treatment of moderate acne. In this case, Jess is applied according to a rather complex scheme, which we will not describe here. For this, there is a special rating of contraceptives, to which we refer the reader. This medicine costs from 1000 rubles per package, which is designed for a month of administration, and is produced by the German company Bayer.

Advantages and disadvantages

Of course, the main disadvantage of all hormonal drugs will be strict indications and the need for medical supervision. Also, these drugs can have serious side effects, for example, associated with the development of thrombosis and vascular complications. But given the evidence, there is a choice. The drugs Jess and Yarin are identical in composition, but the concentration of hormones in the first of them is less than in the second, and the risk of side effects is proportionally reduced, and Jess acts more gently.

On the other hand, Yarin's drug acts more strongly, clearing the skin of acne elements faster, but at the same time its use is associated with a higher risk. Of course, the ideal prescription for the drug is a combination of a direct indication, that is, the need for hormonal contraception and the simultaneous presence of acne. Also, hormonal drugs are great for all patients who have functional disorders of the menstrual cycle and the development of acne, in which case hormonal drugs will help establish a normal cycle and simultaneously get rid of acne.

Systemic retinoids (Roaccutane, Acnecutane, Erase)

Rating: 4.8

Above, we talked a little about retinoids in the description of topical agents. So, the drug Klenzit-s in its composition contains adapalene, which is a mild retinoid. Roaakutan is significantly more powerful. It acts by suppressing the activity of sebum production, with a pronounced anti-inflammatory effect on the skin, effectively combating hyperkeratosis of epithelial cells. Roaccutane improves the differentiation of skin cells.

This remedy is indicated only for severe types of acne, which are absolutely not sensitive to other types of treatment. You need to use Roaccutane with meals once or twice a day, during the treatment, the dose is selected. Quite often, it is possible to achieve very good results in continuous four or six months of treatment, during which the individual dose is gradually selected.

The standard dosage for most patients does not exceed 1 mg per kilogram of body weight per day. The average course dose is 135 mg per kilogram of the patient's body weight during the entire course. One package of 30 capsules, 100 mg each, costs 1,800 rubles on average. Roaccutane is produced by Hoffmann la Roche from Germany. According to calculations, for a patient with an average body weight of 70 kg, 9450 mg of Roaccutane should be taken during the course. Accordingly, these are 94 tablets, or 5640 rubles for the entire course lasting three months, about 1900 rubles per month, which is not very expensive for the successful treatment of severe skin lesions.

Advantages and disadvantages

Perhaps the advantage of Roaccutane is the fact that it is one of the last 'magic wands' for severe forms of acne, disfiguring the skin, and completely refractory to all other methods of treatment. The high cost of the drug, divided by several months of administration, turns out to be not that great. Much more serious are the side effects that it can cause. Roaccutane in this sense is a very serious drug.

So serious that before starting treatment for a woman who is sexually active, she needs to present a certificate from a gynecologist that she is not pregnant. Also, the patient must bring a written consent that she understands the danger of pregnancy, is fully informed about the possible consequences of pregnancy, and bring a certificate that already a month (!) Before the planned intake of Roaccutane, she began to take contraceptives, and preferably two different contraceptives. At least 11 days prior to starting Roaccutane, the test must confirm the absence of pregnancy, and such testing in the case of sexual activity must be performed monthly during treatment. Why are all these conditions unusual for any drug necessary?

The fact is that isotretinoin is not only a highly effective drug for treating severe acne, but also a drug that not only can cause congenital malformations of the fetus, but is almost guaranteed to cause them. In the event that Roaccutane or its analogs are prescribed to men, then the patient should completely exclude the possibility of taking at least one single tablet for use by women. Therefore, with men it is much 'easier'.

It should also be remembered that during the treatment of acne, an exacerbation of the disease usually occurs in 10-15 days, and this is normal. But throughout the entire period of treatment, the entire skin becomes very sensitive, prone to wounds, abrasions, so you cannot carry out planned operations and you need to try not to get injured. While the patient is taking Roaccutane, one cannot sunbathe, take alcohol, quite often such a side effect as dry lips and mucous membranes worries – this is a sign of vitamin A hypervitaminosis. In very simple words, synthetic systemic retinoids are a means of introducing a patient into an artificial hypervitaminosis, which helps to get rid of acne.

Cyproterone (Androkur)

Rating: 4.7

Finally, in conclusion of the rating of effective drugs for the treatment of acne, or acne, it is necessary to highlight the infrequently used individual antiandrogenic drugs. Oral contraceptives have already been described above, with a certain blocking effect on androgenic activity. But antiandrogens are specifically formulated to block the action of testosterone. Initially, drugs are used to treat malignant neoplasms of the prostate gland, since the prostate is an organ that is extremely responsive to changes in the concentration of male sex hormones. The most famous of the group of these funds is Androkur.

Officially, the indication for the use of the drug Androkur or its analogues in women is hirsutism, androgenic alopecia, as well as severe forms of acne. It should be noted that acne treatment is possible only with a minimum dosage – this is 10 mg. The fact is that tablets of 50 and 100 mg are on sale, they are created specifically for the treatment of prostate cancer, to reduce libido in sexual dysfunction, as well as for other special purposes not related to acne.

In women, the drug is used in conjunction with hormonal contraceptives, such as Diane-35. The purpose of this combination is to prevent bleeding in women while taking antiandrogens. It goes without saying that the control of treatment in conjunction with a dermatologist should be carried out by a gynecologist, since women take Androkur on certain days of the cycle, and according to special rules.

Androkur is produced by the well-known company Schering, and the cost of 15 tablets, calculated for monthly intake in an appropriate dosage of 10 mg, is, on average, 1,500 rubles. They are used daily in the first 15 days of the cycle, and then the contraceptive Diana – 35 is connected.

Advantages and disadvantages

Perhaps Androkur is an alternative to Roaccutane for severe acne, but only in women. If you take men, then almost all of them will prefer to use Roaccutane. It is better to take care of the skin, and to have the risk of developing any systemic effects, than to lose male sexual characteristics during the treatment, acquire impotence and suppress sexual desire for a long time. After all, usually antiandrogenic drugs for men are indicated only for a very serious reason, for example, the purpose of prolonging life in severe, inoperable forms of prostate cancer.

In conclusion, it should be recalled that it is better from the very beginning to correctly deal with the first manifestations of acne in adolescence, and not to bring the matter to severe forms. For this purpose, regular hygiene procedures are recommended, it is important to follow the principles of proper nutrition. Avoiding bad habits is essential for maintaining healthy skin.

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Attention! This rating is subjective and does not constitute an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.