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Acne Treatment

Acne is a disorder that affects the skin’s oil glands and hair follicles. The small  pores in your skin connect to oil glands under the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin. Sometimes, the hair, sebum, and skin cells clump together into a plug. The bacteria in the plug cause swelling. Then when the plug starts to break down, a pimple grows.

Most pimples are found on the face, neck, back, chest, and shoulders. Acne is usually not a serious health threat, but it can cause scars.

Many people think that acne is just pimples. But a person who has acne can have any of these blemishes: Blackheads , whiteheads , papules , pustules , cysts and nodules.

Acne can cause more than blemishes. Many people who have acne say that their acne makes them feel bad about themselves. Because of their acne, they do not want to be with friends. They miss school and work. People who have acne suffer from more than low self-esteem. Acne can lead to a medical condition called depression. The depression can be so bad that people think about what it would be like to commit suicide. Acne can cause  Scars .

Treatment

Topical medications

The most common topical prescription medications for acne are as follows:

Retinoids and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A . You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.

Antibiotics. These work by killing excess skin bacteria and reducing redness. For the first few months of treatment, you may use both a retinoid and an antibiotic, with the antibiotic applied in the morning and the retinoid in the evening.

Azelaic acid. A 20 percent azelaic acid cream seems to be as effective as many conventional acne treatments when used twice a day for at least four weeks. It’s even more effective when used in combination with erythromycin .

Dapsone. Dapsone 5 percent gel twice daily is recommended for inflammatory acne, especially in adult females with acne .

Oral medications

Antibiotics. For moderate to severe acne, you may need oral antibiotics to reduce bacteria and fight inflammation. Usually the first choice for treating acne is tetracycline  such as minocycline or doxycycline .

Oral antibiotics should be used for the shortest time possible to prevent antibiotic resistance. Antibiotics may cause side effects, such as an upset stomach and dizziness. These drugs also increase your skin’s sun sensitivity.

Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.The most common side effects of these drugs are weight gain, breast tenderness and nausea.

Anti-androgen agents. The drug spironolactone may be considered for women and adolescent girls if oral antibiotics aren’t helping. It works by blocking the effect of androgen hormones on the sebaceous glands.

Isotretinoin. Isotretinoin is a powerful drug for people whose severe acne doesn’t respond to other treatments. Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects

Therapies

A variety of light-based therapies and lasers have been tried with some success .

The Chemical peel uses repeated applications of a chemical solution, such as salicylic acid, glycolic acid or retinoic acid. Any improvement in acne is not long lasting, so repeat treatments are usually needed.

FAQ  :

Who are more prone to adult acne?

Regardless of gender and age, the same factors that cause acne in adult apply. However, women tend to be more prone to adult acne due to fluctuations in hormones, probably also because of the use or application of cosmetic products and some other factors too. Women too also experience the onset of acne during adult years compared to men.

What Causes Acne in Adults?

Acne in adult is believed to be caused by a number of factors. Genetics play a role as a contributing factor to acne in adult. People with a genetic predisposition for acne are more probable in getting acne  .Fluctuating hormones and other chemical imbalances especially in women during menstrual period can cause acne breakouts. These imbalances may trigger sebaceous glands, leading to excess production of sebum. Stress was also found to have a link with acne breakouts .

 In between treatments, how do I maintain or improve my skin at home?

Your doctor will advise you on the proper skin care regime necessary to balance your skin and eventually control acne. Detailed home care instructions will be given to you during an initial consultation and treatment.

After my acne clears what can I do about scarring?

There are several treatment options depending on your situation and severity of skin damage. The most popular treatments are:

Microdermabrasion: A series of Microdermabrasion treatments removes the upper most layer of skin to minimize the appearance of scars with no downtime.

Non-ablative Fractional lasers are more popular due to quick recovery time, easier downtime, and evident clinical improvement within a few sessions. Fractional lasers help resurface the skin by creating microscopic wounds that reveal smoother skin in as little as two or three treatments

Dermal fillers: Can be used alone or in conjunction with other scar treatments .They are  injected to elevate depressed acne scars. The result of the treatment is temporary, and depending on the filler used it will need to be repeated every 6 to 9 months.

What is the best treatment for mild acne on the chest, back or shoulders?

The treatment for these areas is the same as for facial acne. For mild acne on these areas, we use  often an alcohol-based lotion containing salicylic acid made up for the upper body, which proves more economical for treating larger areas. Sometimes we may may prescribe a topical antibiotic.