Acne is a common, chronic inflammatory skin
disease that mainly affects the face, neck, chest, and back.
It is caused by the overactivity of the sebaceous glands. Treating
acne correctly involves a thorough examination of the patient’s
medical and family history. A family history of severe acne
most often necessitates a more protracted course of treatment.
The patient must be informed of any misconceptions about acne’s
links to diet or uncleanness, and be prepared for several months
of acne therapy.
Treatment of Acne
Treatments are tailored to the patient’s skin type and
acne severity. Acne can be mild, moderate, severe, or a degree
between the three. The treatment regimen must be vigilantly
observed by the patient in order to improve the chances of good
results. The patient must also be warned against picking the
acne lesions, as these may aggravate the condition.
Mild Acne Treatment
Mild comedonal acne usually responds well to topical retinoid
therapy. This drug hampers acne by slowing cell activity in
affected areas, removing mature comedones and hindering the
formation of new ones. Topical retinoids in wide use include
tretinoin, adapalene, and isotretinoin. Azelaic acid or salicylic
acid can also be used in the same manner. At the beginning of
this therapy, the mild comedonal acne sufferer may experience
some irritation.
For mild papulopustular acne, topical treatment is extended
to a twice-daily regimen. In these cases, retinoids may also
be used in combination with other treatments. The retinoids
can complement the activity of the other topical agents as well
as treating the acne directly. Antibacterial agents used in
this treatment include azelaic acid, benzoyl peroxide, and topical
antibiotics. When irritation occurs, it can generally be controlled
by lowering the dosages.
In all cases, it is important to apply the topical treatment
to the entire affected area and not on the lesions only.
Moderate Acne Treatment
Moderate acne is widespread and sometimes tends towards physical
scarring, bringing systemic drug therapy into consideration.
Treatment of moderate acne may include hormonal therapy, oral
antibiotics, and/or oral retinoids. Oral antibiotics hamper
the development of the P. acnes bacterium. Patients are advised
to take the medicine before meals and without any milk.
Oral antibiotics treatment must always be accompanied with
topical treatment. They may also be used in tandem with hormonal
therapy as an effective option for female patients suffering
from moderate papulopustular acne. Hormonal therapy is recommended
for women whos uffer from excess sebum secretion, pre-menstrual
flare-ups, and attacks centered in the beard area. Antibiotic
intake may be discontinued with papules and pustules begin to
clear, but other treatments must be maintained. Dermatologists
must be aware of the possible interactions of all drugs and
antibiotics in a patient’s treatment regimen. Also, studies
have shown a slight increase in the rate of contraceptive failure
during antibiotic therapy.
Severe Acne Treatment
For more severe forms of nodular acne, isotretinoin treatment
is the ideal choice. It is best for patients suffering from
visible scarring and excessive seborrhea, as it targets all
of acne’s pathogenetic mechanisms. Lower doses over a
longer period of time is recommended for patients with attacks
on the back and chest. Isotretinoin treats severe acne with
deep nodules, pustules, and papules, and helps prevent any future
outbreaks.
Isotretinoin treatment, however, has several serious potential
side effects. These include ophthalmologic, gastrointestinal,
neurological, and mucocutaneous problems, as well as depression
and suicidal behavior. It has also been found that one out of
every three patients treated with isotretinoin relapse, necessitating
another round of isotretinoin treatment.
Maintenance Therapy
When acne is brought under control after any successful acne
treatment, maintenance therapy is important. This therapy usually
involves a regimen of vigilant application of topical retinoids
and benzoyl peroxide.
Treatment for Pregnant Women
The safest treatments for pregnant acne sufferers are limited
to oral and topical erythromycin and benzoyl peroxide, since
the other treatments pose a potential risk to the embryo.
Cosmetics
Acne sufferers must choose their cosmetics carefully. Cosmetics
must be noncomedogenic and able to mask lesions effectively.
Cosmetics with moisturizing properties may also be used for
patients undergoing isotretinoin therapy, as it tends to dry
the skin.
Other Treatments
Modern treatment of acne includes lasers, phototherapy, and
photodynamic therapy, although use is generally expensive and
requires frequent visits to a clinic. As with all other kinds
of acne treatment, consultation with a dermatologist is often
in order prior to undergoing these kinds of treatments. Regardless,
most dermatologists still believe that combination therapies
work best. Future acne treatments may involve new agents such
as leukotriene inhibitors.
Acne, despite being common, must not be ignored. Acne that
is not treated appropriately and immediately can worsen and
leave permanent scars.
