Acne – What is it?
Acne is a frequent skin problem caused by clogged hair follicles beneath the skin. Excess oil production, dead skin accumulation, bacterial infection, and inflammation can contribute to this blockage. Acne usually shows as small to large, reddish bumps on the skin, which can be painful or contain pus in certain instances. Acne is most common on the face, chest, upper back, and shoulders. Age, hormonal fluctuations, medications, diet, stress, and contact with oily or greasy substances all have an impact on the development of acne. If left untreated for an extended period of time, acne can cause issues such as skin scarring and emotional difficulties.
Acne Treatment
If home remedies have failed to improve your acne after several weeks, consider consulting a dermatologist. They can prescribe stronger medications to effectively combat your skin condition.
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Prevent acne breakouts to avoid skin damage
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Minimize the appearance of existing scars
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Reduce the visibility of scars over time
Acne treatments aim to control oil production, reduce inflammation, or combat bacterial growth. Most prescription acne medications require four to eight weeks to show noticeable effects. However, clearing acne entirely can be a gradual process that may take several months to years.
Your acne treatment will vary based on your age, acne characteristics, and treatment preferences. Typically, it involves using topical medications or oral drugs twice daily for extended periods. Both topical and oral medications may be used together for optimal results. However, treatment options for pregnant individuals are restricted due to potential side effects.
Consult your doctor to discuss the potential benefits and risks associated with any medication or treatment you’re contemplating. Additionally, schedule regular follow-up appointments with your doctor every 3-6 months to monitor your skin’s progress and ensure it’s responding to treatment as expected.
Topical Acne medications
The most common topical prescription medications for acne are:
- Retinoids and retinoid-like drugs: These drugs are used for moderate acne and come in various forms (creams, gels, lotions). They include tretinoin, adapalene, and tazarotene. Applied in the evening, starting with 3 times a week and increasing to nightly. They prevent the clogging of hair follicles. Avoid using tretinoin with benzoyl peroxide. Retinoids make skin more sun-sensitive and can cause dryness and redness, especially in those with darker skin tones. Adapalene is generally better tolerated in this regard
- Antibiotics. They are used to treat acne by killing skin bacteria and reducing inflammation. Initially, you may use a retinoid and an antibiotic together, applying the antibiotic in the morning and the retinoid at night. To prevent antibiotic resistance, antibiotics are often combined with benzoyl peroxide. Examples include clindamycin and erythromycin, both combined with benzoyl peroxide. However, it’s not recommended to use topical antibiotics on their own for acne treatment.
- Azelaic acid and salicylic acid. Azelaic acid, naturally created by yeast, fights bacteria. A 20% cream or gel is comparable to traditional acne treatments applied twice daily. During pregnancy and breastfeeding, prescription azelaic acid (Azelex, Finacea) is an alternative. It also helps with skin discoloration caused by certain acne types. Mild skin irritation and redness are potential side effects.
Salicylic acid can help keep hair follicles clear and is available in products that can be washed off or left on the skin. There is limited scientific evidence to support its effectiveness. Possible side effects include changes in skin color and mild skin irritation.
- Dapsone. For women with acne, Aczone gel (5%) is recommended to be applied twice a day to treat inflammatory acne. Redness and dryness are potential side effects. There is limited evidence to suggest the effectiveness of topical treatments containing zinc, sulfur, nicotinamide, resorcinol, sulfacetamide sodium, or aluminum chloride for acne.
Oral Acne medications
- Antibiotics. If your acne is moderate to severe, oral antibiotics may be necessary to fight bacteria. Initially, doctors often prescribe either a tetracycline (like minocycline or doxycycline) or a macrolide (such as erythromycin or azithromycin). Macrolides are an alternative for individuals who cannot take tetracyclines, like pregnant women and children under eight years old.
It’s crucial to take oral antibiotics for acne for the shortest duration to minimize the chances of developing resistance to these drugs. Combining antibiotics with other treatments, like benzoyl peroxide, can also help reduce the risk of resistance. While antibiotics for acne are generally well-tolerated, they can make your skin more sensitive to sunlight.
- Combined oral contraceptives. The U.S. Food and Drug Administration (FDA) has approved four birth control pills that also treat acne in women who need contraception. These pills contain both progestin and estrogen (brands include Ortho Tri-Cyclen 21 and Yaz). It can take a few months to see results from these pills, so adding other acne treatments may help in the beginning. Common side effects of these pills include weight gain, sore breasts, and nausea. Taking these pills may also increase the risk of heart problems, breast cancer, and cervical cancer.
- Anti-androgen agents. Spironolactone (Aldactone) may be used for females if antibiotics don’t work. – It blocks androgen hormones, reducing oil production. – Potential side effects include breast pain and heavier periods.
- Isotretinoin. Isotretinoin (Amnesteem, others) A vitamin A derivative prescribed for severe acne that hasn’t responded to other treatments.Potential side effects include digestive problems, depression, and serious birth defects. – Patients taking isotretinoin must enroll in a special safety program and have regular doctor checkups.
Therapies
For some people, the following therapies might be helpful, either alone or in combination with medications.
- Light therapy. Different light-based treatments have shown promising results. Multiple doctor’s office visits are typically required. Further research is needed to determine the optimal technique, light source, and dosage.
- Chemical peel. This procedure involves repeated applications of a chemical solution (e.g., salicylic, glycolic, or retinoic acids). It is suitable for mild acne and may enhance skin appearance. However, results are temporary, and repeated treatments are often necessary.
- Drainage and extraction. Your doctor can use specialized tools to carefully extract whiteheads, blackheads, and cysts from the skin.
- Steroid injection. Injections of steroid medication can be used to treat lumps and cysts. This treatment can quickly reduce pain and improve symptoms. However, it’s important to note that it can also cause side effects such as thinning and discoloration of the skin in the area where the injection was given.
Treating children
Research on acne treatments has traditionally focused on individuals aged 12 and above. However, acne has become more prevalent in younger children, leading to the approval of more topical products for their use. The American Academy of Dermatology recommends that topical treatments such as benzoyl peroxide, adapalene, and tretinoin have been found to be effective and safe for preadolescents, posing no increased risk of adverse effects.
For children with acne, consult a pediatric dermatologist for guidance. Discuss medications that should be avoided in children, including appropriate dosages, potential interactions, side effects, and the impact of treatment on your child’s physical and emotional well-being.
Alternative Acne medications:
Some complementary treatments may aid in reducing acne:
- Tea tree oil. Gels with at least 5% tea tree oil may be equally effective as lotions containing 5% benzoyl peroxide, but tea tree oil may act more gradually. However, potential side effects include mild irritation (itching, burning, redness, and dryness), making it unsuitable for individuals with rosacea.
- Brewer’s yeast. A specific strain of brewer’s yeast (Hansen CBS) has shown promise in reducing acne when taken orally. One potential side effect is gas (flatulence).
Further studies are necessary to confirm the efficacy and long-term safety of integrative approaches like biofeedback and ayurvedic products. Consult your doctor to discuss the potential benefits and risks of specific therapies before incorporating them into your healthcare plan.
Acne: Lifestyle and home remedies
To manage mild or moderate acne, consider the following self-care tips:
- Wash problem areas with a gentle cleanser. Use gentle cleansers such as Cetaphil or Vanicream to wash problem areas twice daily, being mindful when shaving.Steer clear of harsh products like scrubs, astringents, and masks, as they can worsen acne by irritating the skin. Avoid excessive washing and scrubbing, as this too can aggravate the skin’s condition.
- To combat acne, consider using over-the-counter products with ingredients like benzoyl peroxide and adapalene. These products aim to reduce oil production and encourage peeling. Other options include products containing salicylic acid, glycolic acid, or alpha hydroxy acids. It can take time to notice results, so consistency is key.Gels and ointments can be more irritating than creams. Be aware that initial side effects, such as redness or dryness, are common with nonprescription acne medications, but they usually subside within the first month of use.
- Avoid irritants. Avoid skin products that can worsen acne, such as heavy makeup, sunscreens, hair products, or acne cover-ups. Instead, choose products that are oil-free or noncomedogenic, which are less likely to clog pores.
- Protect your skin from the sun. For some people, sunlight can darken areas of skin that were previously affected by acne. Some acne medications can also increase your risk of sunburn. Ask your doctor if your medication is one of these. If so, limit your time in the sun and use a non-oily moisturizer that contains sunscreen regularly.
- Minimize contact with objects that can irritate skin: Keep your acne-prone areas away from things like phones, helmets, tight clothing, and backpacks to prevent friction and pressure.
- Resist the urge to touch or pick acne-prone areas. void touching or manipulating acne blemishes, as this can worsen breakouts and potentially cause infections or scarring.
- Rinse off after exercising: After activities that produce sweat and oil, such as workouts, take a shower to remove impurities that can contribute to acne.
The Psychological Impact of Acne and the Power of Support Networks
Acne and its scarring can trigger anxiety, impair social interactions, and damage self-esteem. Seeking support from loved ones, joining a support network, or consulting a counselor can be beneficial.
Stress can exacerbate acne, so it’s essential to prioritize stress management by ensuring adequate sleep and utilizing relaxation methods.
Acne : Preparing for your appointment
If you have acne that doesn’t improve with home treatments or over-the-counter products, it’s important to see a doctor. Treating acne early and effectively helps prevent scarring and protect your confidence. After checking your skin, your doctor might recommend you to a specialist who focuses on skin conditions (dermatologist) for further evaluation and treatment.
Here’s some information to help you with your appointment.
What you can do?
- Key medical information: Note down any current medical conditions, medications, vitamins, and supplements you’re using
- Key personal information: Record any significant stresses or life events you’ve recently experienced.
- Questions for your doctor: Prepare a list of questions you want to ask to optimize the time spent with your physician.
Here are some fundamental queries you can direct to your medical practitioner regarding acne. If you have any further inquiries during your appointment, please feel at ease to voice them.
- Which treatment would you suggest based on my condition?
- What are alternative treatments if the initial one proves ineffective?
- What are the potential side effects of the prescribed medications?
- How long is it appropriate to take these medications?
- How long might it take for my symptoms to improve after starting treatment?
- When should I return for a follow-up appointment to assess progress?
- Is it safe to discontinue the medications if they don’t provide relief?
- What lifestyle changes can I make to mitigate my symptoms?
- Are there specific dietary adjustments you recommend?
- Should I make any changes to the over-the-counter skin care products I currently use, such as soaps, lotions, sunscreens, and cosmetics?
Before your doctor’s appointment, prepare to answer several questions. This will save time during the visit, allowing you to focus on discussing specific topics of interest. Your doctor may ask:
- When did your acne first appear??
- Are there specific factors that seem to make your acne worse, such as stress or (for females) your menstrual cycle?
- What medications or supplements do you take? This includes both prescription and over-the-counter medications, vitamins, and supplements.
- For females: Do you use birth control pills?
- For females:: Do you have regular menstrual cycles?
- For females: Are you currently pregnant or planning to become pregnant?
- What daily care products do you use for your skin, hair, and appearance?
- How does acne impact your feelings about yourself and your confidence in social situations?
- Have any of your family members experienced acne before you?
- What remedies or lifestyle changes have you implemented to address your acne? Which have worked best for you?
- Have any of your relatives undergone treatments like Isotretinoin or hormone therapy for their acne? Were these treatments successful?
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