Acne Treatment

 Acne

Most people develop acne --the most common skin condition to some degree ,but it primarily affects teenagers undergoing hormonal changes.

Acne may be mild (few occasional pimples), moderate ( inflammatory papules), or severe (nodules and cysts).Treatment depend on the severity of the condition.

What causes Acne.

Acne is primarily a hormonal condition driven by male or 'androgenic' hormones, which typically become active during the teenage years.Sensitivity to such hormones ,combined with bacteria on the skin, and fatty acids within oil glands ,cause acne.Common sites for acne are the face,chest,shoulders,and back the sites of oil glands.

Acne lesions include whiteheads , black heads, small pumps, and nodules and cysts.

Though acne is essentially a normal physiologic occurrence, including :

. Fluctuating hormone level around the time of menses (women)

.Manipulating (picking/prodding) acne lesions

. Clothing (for example ,hats and sports helmets) and headgear

How is Acne Treated

Only three types of drugs have proven to be effective for the treatment of acne--Antibiotics , Benzoyl Peroxide, and Retinoids. Most people require at least one or two agents ,depending on the severity of their acne.

. Benzoyl Peroxide  

is available  as over the counter product (for example,Clearasil, Stridex) and by prescription (for example , Benzoyl, Panoxyl, Persagel), targets surface bacteria ,which often aggravate acne.
Irritation (dryness)is a common Side effect.

.Retinoids

(vitamin A derivatives), for example, Differin, Retin-A, Tazorac,treat blackheads and whiteheads,the first lesions of acne.The most common side effect is irritation.While most are prescription only,there is an over the counter version of Defferin now available.

. Antibiotics

either topically applied to the skin (clindamycin, erythromycin), or taken orally (tetracycline and its derivatives,trimethoprim-sulfamethoxazole)contro surface bacteria and reduce inflammation in the skin. Antibiotics are more effective when combined with benzoyl peroxide or retinoids.The oral retinoid isotretinoin (Absorica, Amnesteem,Claravis,Myorisan and Zenatane) is reserved for people with severe (nodular or cystic )disease.
Isotretinoin shrinks the size of oil glands,the anatomic origin of acne.Without active ,plump oil glands,acne actively diminishes.
Side effect can include dry skin,elevated cholesterol and triglycerides,and birth defects.
Women of childbearing age must practice birth control before ,during and after treatment (about one month ) with isotretinoin.Thye use of isotretinoin requires rigorous testing (cholesterol pregnancy, triglyceride, cholesterol,liver function and bone marrow function)and follow up for the prescribed period (5 more months).It is reserved for the most severe types of acne that do not rtespond to other treatments.

. Hormone therapy

may be helpful for some women with acne ,especially for those with signs and symptoms (irregular periods, thinning hair) of androgen (male hormone) excess. The hormone therapy consists of low dose estrogen and progesterone (birth control pills) or

 anti-androgen medications (spironolactone).

.Herbal,organic, and "natural"medications.

The are many herbal,organic and natural products marketed  to treat or prevent acne.The effectiveness of these agents isn't proven and they are unlikely to have much benefits.

Note. When pus-filled pimples are ready to break,apply to a hot towel for a few minutes to encourage the natural bursting process.Inflamed pimples should be opened only by a nurse or doctor using surgical instruments and following antiseptic practices.Squeezing pimples yourself may lead to further inflammation and perhaps permanent scars.

 

Another common drug your doctor may try is triamcinolone,a type of corticosteriod solution that is injected directly into acne nodules.

.Warning About Acne Treatment  

patients taking acne drugs should be alert to possible side effects and interactions with other drugs and herbal remedies.

The topical retinoids and benzoyl peroxide can leave skin reddened ,dry and sensitive to sunlight.