Acne as Procedural Dermatology

In this episode of Conversations in Aesthetics, Gary Goldenberg, MD, sits down with dermatologist Emmy Graber, MD, for a conversation shaped by acne, rosacea, lasers, cosmetics, and the operational decisions behind a focused clinical niche.  Dr Graber traces how an early interest in acne led her to laser training in Boston, and eventually to a practice built around the patients and conditions she most wanted to treat. The discussion moves into what it means to build that kind of practice with intention, from knowing the local patient population to resisting the pressure to buy every new device that enters the market.  Much of the conversation centers on acne as a procedural condition. Drs Goldenberg and Graber discuss where lasers may fit alongside topicals, oral medications, spironolactone, and isotretinoin, especially for patients who cannot take isotretinoin, will not take it, or want to exhaust other options first. Just as important is the way those options are presented—plainly, honestly, and without pretending any one treatment works for everyone.  The episode also widens into practice management, including virtual front desk support, virtual scribes, AI-assisted HPI capture, online scheduling, and the small efficiencies that help with climbing reimbursement, labor, rent, and device costs.  Throughout, the throughline is practical: choose the patients you want to serve, tools that make sense for them, and build a practice that can actually support both.