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Acne Treatment Guidelines

The only danger posed by acne is the psychological and mental torture it gives its host especially if permanent scars are to be noted on the skin, particularly on the face. This drives medical researcher to look for ways to resolve the problem. Today, various techniques offering successful systematic treatments of acne is available as newer treatment methods are being researched and developed.

Treating acne effectively requires that its severity and type must be graded since it varies from one person to the other. The severity can be determined by considering the number and the type and distribution of the lesions. Currently, there are 25 existing methods used in grading the severity of acne and 19 methods for counting lesions.

Acne can be classified into two types:

  • Non inflammatory or purely comedonal
  • Inflammatory (papules, pustules and nodules)

The Treatment

As in any other ailments and diseases, obtaining and thoroughly analyzing the family and medical history of the patient is helpful. The data from the past about responses to treatments will give the therapist an idea how to approach the problem. During the treatment, it is necessary that the severest lesions be treated first, as the treatment will cure the less severe ones in the process.

It is imperative to clarify certain myths about diet and cleanliness in order to facilitate willingness and cooperation of the treatment from patient. It is in the patient’s best interests to be informed that the initial physical reaction towards the treatment might include acne flare-ups, and that the desired result may take a while and require simple, disciplined regimens. It would be good to forewarn the patient about the adverse effects of picking the pimples as well.

Treatment based on severity

Mild comedonal acne

Mild comedonal acne is composed only of non-inflammatory comedones and can be usually treated with topical retinoid therapy (examples of which include treninoin, isotreninoin, adapalene, tazarotine, and retinaldehyde). This treatment eliminates mature comedones and prevents its formation. Some non-retinoids such as salicylic acid and azelaic acid are also used for the same purpose. When comedones become too large, physical treatment like extraction and electrocauterization in a clinic becomes necessary.

Mild papopustular acne

Few comedones and few inflammatory papsules and pustules are the main characteristics of mild papopustular acne. These characteristics are responsive to topical retinoids and antibacterials like benzoyl peroxide, clindamycin, and erythromycin—all of which help eliminate P. acnes bacteria.

Moderate acne

Moderate acne is characterized by moderate amounts of pustules, few small nodules, and many comedones with or without residual scarring of the skin. Treating moderate acne using drug treatments require systematic methods to be effective. Antibiotics, hormonal therapy, and oral retinoids are used to treat moderate acne. Oral antibiotics like erythromycin, tetracycline, and trimethoprin are used to eliminate P. acnes by stopping its growth.

When using oral antibiotics and topical retinoids on women with moderate papopustular acne including small nodules, it is recommended that hormonal therapy be used along with the treatment to produce desired results. Women who suffer from acne due to ovarian or adrenal hyper-androgenism may experience hirsutism, excessive sebum secretion, and acne in adulthood that worsens before menstruation. This therapy consists of antiandrogens like cyproterone actate, spironolactone or flutamide, preventing androgen production from the ovaries or adrenal glands.

Severe acne

Oral isotretinoin is used for treatments of the patients suffering from excessive sebum secretion and gram negative folliculitis (exhibited as innumerable inflammatory nodules and severe scarring). Prior to the administration of the drug isotretinoin, it is imperative to obtain data of blood lipids test, liver function test and complete blood count. Forewarning the patient about the potential side effects of the drug in the form of neurologic, ophthalmologic, mucocutaneous and gastrointestinal discomforts is advisable.

Physical therapy

Physical therapies for acne treatment include phototherapy, photodynamic therapy, and aspiration of deep inflamed lesions that are found in cysts and sinus tracts. The scars can be treated with collagen injection, fat transfer, chemical peeling, laser resurfacing, skin surgery, dermabrasion and steroid injection depending on their size, shape, patient’s skin type, and the number and location of the lesions across the affected area.

Continuous and maintained treatment of acne with topical retinoid even after the initial treatment has taken effect leads to curing acne permanently. Noncomedogenic cosmetics can be used to lessen and hide the erythma making the skin appear better. Patients taking isotretinoin medications require moisturizers to prevent skin dryness.

The present treatment targets one or a combination of known mechanisms. Optimal results can be achieved when treatments used to target several mechanisms were targeted simultaneously ad the patient needs only to adjust with the kind of therapies he is taking based on their level of improvement and tolerance. Patients are expected to overcome physical and mental trauma brought about by acne with all the available treatments present.