Understanding Acne and your Treatment
Acne is a very common condition. It affects about 75% or 3 out 4 people ranging in age from 11-30 years old. It can affect the face, back, chest and arms of people. It is most common to begin in puberty, but can begin at any age. Acne is a condition of the oil glands. As the oil glands begin to produce oil, pores can sometimes get clogged and this causes inflammation. This leads to pimples. There are many different kinds of pimples and ways acne can affect the skin. Fortunately, there are many different medications that help target these different types of acne. Sometimes people have a combination of these different types of pimples and may require a combination of different medications to treat their skin.
- Retinoids: Topical retinoids are a great place to start. These are topical cream or gel medications like Retin-A (tretinoin), Differin (adapalene), Epiduo (adapalene & benzoyl peroxide) or Tazorac (tazarotene). They work in a distinct way to “unclog” your pores. If you are using a retinoid be sure to use only a very small amount. Dryness and flaking are the most common side effect of this type of medication, so caution must be used when applying this medication. I often recommend only one pea sized amount for your entire face. Using too much does not work any faster, it only irritates your skin more. If you get irritated it is acceptable to use an oil free moisturizer and/or skip this medicine for a night or two.
- Benzoyl Peroxide: Another great topical product for acne. Benzoyl Peroxide (or BPO) comes in cleansers and topical gels to apply to the skin. BPO targets the bacteria (p. acnes) that cause acne and help to reduce this bacteria on our skin. The main side effect of BPO is dryness and irritation to the areas where it is applied.
- Dapsone: A newer medication in the last few years is topical dapsone (Aczone). This medication targets the inflammation associated with acne. It is generally well tolerated and does not cause much irritation or dryness to the skin. Be careful using this with benzoyl peroxide products as the two combined sometimes can cause a temporary orange color to the skin.
- Sulfur: One effective medication often found in cleansers and sometimes topical creams is Sulfur. Sulfur is a good tool because it has many benefits. It reduces oily skin without much irritation and it also helps to unclog pores by increasing the turnover of the top skin layer. It also has some anti-microbial benefit, and it too targets the acne bacteria.
- Topical antibiotics: These medications can be helpful at times, but some patients can develop bacterial resistance with them. They are best used in combination with other topical medications such as benzoyl peroxide to prevent resistance to them. Two such antibiotics often used topically are clindamycin and erythromycin.
- Oral antibiotics: Oral medications can be very effective for the right patient. Most commonly used are the Tetracycline class of antibiotics. These are pills named Doxycycline and Minocycline. They are effective drugs at reducing the bacteria on our skin and also helping to reduce inflammation in many cases. It may seem strange that these antibiotics will be prescribed for an unusual length of time, usually a few months. But this is often what is needed to see beneficial results. Side effects of these medications could be upset stomach or sometimes headaches and dizziness. They should be taken as prescribed and with plenty of fluids.
- Isotretinoin (Accutane): There is a whole section dedicated to this medication, so if you are interested please visit that page.
As you can see I have many options to help your skin. Regardless of what medications you are prescribed you need to know that treating acne is a process and results do not come quickly. Make sure you follow all instruction given, and keep using the medications even though you may not see results right away. The only way you stand any chance to see clearer skin is if you stick with the program. And if I see you at your follow up visit and you are not any better I may need to change up some of your medications to find what works best for you. We will work together as a team to get the best results we can!
Oh, and one other thing: Do Not Pick at your skin or try to pop your pimples, especially the deeper ones. It can, and most likely will lead to blemishes and scarring.