Acne Part II: How to Treat Acne
Find out the available medical options to treat acne.
Acne is not a very physically dangerous health condition. However, its deep psychological impact is what makes acne an important issue to address. It can lead to anxiety and depression, social isolation, and low self-esteem. Last week I wrote about acne myths and its underlying causes, today I will discuss the available treatments of it.
How Do Doctors Decide on Acne Treatments?
There are numerous choices when it comes to anti-acne medicines. Your doctor will need to see you and examine your skin in order to determine the first steps. Make sure that you are makeup-free at your appointment so that the doctor can make an accurate assessment. Your doctor will be looking for the following signs:
How severe is the acne?
Is your skin dry, oily, or both? Gels tend to be more drying, and lotions and creams are more moisturizing.
Are there whiteheads or blackheads?
Are there larger, deeper cysts?
Is there a component of “inflammation,” or redness, surrounding the acne?
Is there significant scarring?
Your Doctor Will Take a “History”
It’s also important to share the following with your doctor:
Make a list of the medicines you’ve already tried in the past, both prescription and over-the-counter, and take it with you to your visit.
Are your menstrual cycles regular? The presence of irregular periods and acne can indicate certain health conditions that can predispose to acne, like Polycystic Ovarian Syndrome (read about PCOS here).
Do you have a history of excessive hair on your body, referred to as “hirsutism” (which you can read about in a previous episode)? Like irregular periods, hirsutism can also be a reflection of other health conditions that cause acne.
Are you on any medications that may possibly cause acne? Reveal all over-the-counter and prescription medications you are taking.
Once your doctor has performed an examination and taken a thorough history, she can decide the right medication for you and individualize your treatment plan accordingly.
Most Common Acne Treatments
There are numerous ways that doctors can treat acne.
Remember: No matter what treatments are selected, it can take a minimum of eight weeks to even start seeing a difference. There are no miracles. Acne treatments are slow to respond and take daily effort and patience.
Non-Prescription Treatments and Tips
First, let’s discuss what you can do on your own before you even see your doctor:
Benzoyl Peroxide: This is a common ingredient in over-the-counter cleansers, but can also be found solo. It acts as an anti-bacterial and also breaks apart the components of a zit. Be careful when applying it on the body, as it can bleach your clothing and sheets.
Salicylic Acid: This is an ingredient found in many over-the-counter acne treatments. You can use it in conjunction with benzoyl peroxide. If the combined regimen does not improve your acne after three months of use, it may be time to consider prescription treatments.
Cleansers: When being treated for acne, it’s important to choose a gentle cleanser since many acne treatments can make the skin irritated. A gentle massage with Dove soap, Cetaphil, or a similar cleanser twice a day is recommended.
Makeup: As I mentioned in Acne Part I, it’s important to choose makeup that will not clog your pores. Look for the words “non-comedogenic” on the product labels.
Don’t be a picker: Try to refrain from picking at your zits as this can exacerbate scarring. In addition, it can spread the pus and bacteria contained within the zits and cause further acne.
Keep it off your face: Hair and phones harbor their own set of bacteria that can trigger a zit fest, so try to keep them away from your skin.
Now for the prescription options:
[[AdMiddle]Retinoids are derivatives of vitamin A that help the skin to regenerate and slough off faster, thereby making zits more difficult to form. Tretinoin and adapalene are two of the most commonly prescribed retinoids. These are once a day topical creams applied at night prior to bedtime. An oral form of this medication, called isotretinoin, is reserved as a last resort for those with very severe cystic/nodular acne. Side effects of this oral form are much riskier, and include birth defects in pregnant women.
Retinoids tend to dry out the skin, and some people with very sensitive skin can even experience irritation and flaking. Therefore it’s very important to use it sparingly and thinly over the areas that are affected. And when treated with retinoids, it’s important to avoid other harsh acne treatments. Only a very mild cleanser/soap should be used, followed by a non-comedogenic moisturizer to battle the flaking and dryness, if needed.
Since retinoids are contraindicated in pregnancy, all sexually active females using it should use a birth control method or defer from using this group of acne treatment.
Acne can have a bacterial component. The bacteria gets into the pores, plugs them up, and causes zits. Therefore, as part of your acne regimen, your doctor may prescribe an anti-bacterial to battle the main acne-producing bacteria called P. Acnes. Examples include clindamycin and erythromycin. Combination treatment with retinoids or benzoyl peroxide is commonly used by doctors for anything worse than mild acne.
Oral rather than topical antibiotics are also an option. The most commonly prescribed are tetracycline, doxycycline, and minocyline. However, these medications are reserved for people with moderate or severe acne, as they can have significant consequences. The greatest risk is developing something called “resistance.” That’s when killing off a lot of the body’s bacteria sometimes causes it to grow stronger, and as a result and the antibiotic will no longer work. For this reason, antibiotics are typically only recommended for six months or less of use and are not a long term solution to acne. Treatment with an acne medication in one of the other groups should be started at the same time.
Taking hormonal contraception has also been shown to improve acne, and for those needing contraception who suffer from mild to moderate acne, this kills two birds with one stone. It can take up to several months to see a difference, however. And even though some hormonal contraceptives are marketed more towards acne, all have the potential to treat acne.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.