Acne Treatment

Virtually everyone has experienced some form of acne at some point in their life. Acne results from one or more of the following: secretion of too much sebum (a fatty lubricating substance that coats hair and helps protect skin when secreted in normal amounts), over-production of the bacterium p. acnes (normally a skin-dwelling organism), skin cells that shed too rapidly and/or release inflammatory substances. Effective acne treatments must interfere with the underlying cause in order to successfully treat acne.

 

 

Whether for an occasional small pimple, blackhead, or whitehead or a more severe case involving cysts and nodules, most teenagers and many adults seek at least some level of acne treatment. Fortunately, most cases of acne can be successfully treated today. Treatments vary from cleansers, creams, and other products sold over the counter to prescription oral and topical medications and physical procedures performed by physicians. For many cases of occasional or mild acne, treatments available without a prescription can be effective. But for more persistent cases and for moderate to severe acne, treatment by a physician will undoubtedly be necessary for effective resolution.

 

Acne treatments provided by physicians may involve one or more of a variety of physical treatments, prescription of oral medications, or some combination of treatments.   Physical treatments include:

 

·       Phototherapy: A variety of laser and light treatments can reduce acne breakouts, often by targeting p. acnes, and stimulate skin repair. Photofacials reduce breakouts, tighten pores, and help revitalize and mend damaged skin reducing the frequency of breakouts. Over time, these treatments can produce skin that is more robust and resilient, and thus less vulnerable to acne breakouts. Laser resurfacing, in addition to being used as an acne treatment, has also become an important tool in treating acne scars. Though it is an intensive procedure, it can produce extraordinary results.

·       Chemical Peels: Chemical peels employ chemical agents to loosen blackheads and decrease breakouts. They work by sinking into skin layers causing controlled tissue injury that triggers the skin’s natural reaction of regeneration and repair.

·       Extraction and Drainage:   It is sometimes beneficial to remove blackheads and whiteheads. Extraction by a physician of other qualified medical professional using a small, sterile device is essential. Do-it-yourself squeezing or picking can result in a worse case of acne, scarring, and infection of injured tissues by staph, strep, or other bacteria. Drainage and surgical extraction, or ‘acne surgery’ may be required for large cysts to reduce pain and decrease the likelihood of scarring. This procedure should only be performed by physicians.

·       Microdermabrasion: Often used in conjunction with a chemical peel, microdermabrasion is a deep exfoliating treatment that helps remove dead skin cells on the skin’s surface. This allows healthy skin cells to grow more readily which decreases acne breakouts and improve the appearance of scars.

·       Oral Antibiotics:   Oral antibiotics including doxycline, erythromycin, minocycline and tetracycline, work by reducing the growth of p. acnes and have been a foundation of acne treatment for years. Treatment typically starts at a high dosage with reduction as the acne resolves. The bacteria can become resistant to a particular antibiotic over time requiring treatment with a different antibiotic.

·       Oral Contraceptives: Oral contraceptives can be effective in helping to clear acne in women. They work by reducing increased production of sebum by sebaceous glands. Since oral contraceptives can cause serious side effects in certain populations of women, physicians will evaluate the efficacy of their use for each individual. A synthetic steroid may be used in with oral contraceptives to treat acne in some adult women.

·       Interlesional Corticosteroid Injection: Severely inflamed acne cysts can rupture and produce scarring. To avoid this, physicians may inject the cyst with a much-diluted corticosteroid to lessen inflammation and promote healing.

·       Isotretinoin: Isotretinoin is the most effective acne treatment today as it targets all the causes of acne noted previously. However, it is a potent drug with the potential for a number of significant side effects. As a result, it is only used to treat severe acne in certain patients and under close physician monitoring.

 

Successful acne treatment in some cases will require a combination or succession of more than one approach. Examination by and consultation with an experienced, qualified physician is necessary to determine the acne treatment most suitable for individual patients. Regardless of the severity of acne and the treatment used, starting treatment early is essential to achieve the best results and avoid scarring.