The goals of acne treatments are to repair existing wounds, prevent
new lesions from developing, prevent scarring, and reduce as much
as possible the psychological stress, awkwardness and humiliation
Drug treatment of acne is intended to lessen several aspects
that contribute with acne: the anomalous clumping of cells in
the follicles, improved oil creation, growth of bacteria and
inflammation associated with acne.
Depending on the severity of the patient's acne, the physician
will prescribe one of several over-the-counter (OTC) medicines
or topical (administered on the skin) or systemic (oral) medicines.
The doctor may recommend using more than one topical medicine
or combining oral and topical treatments.
In order to handle mild inflammatory acne, physicians generally
advise OTC or topical prescription. Topical therapy must be rubbed
directly onto the acne lesions and on to the whole area of affected
The most widespread topical OTC medicines used for the treatment
of acne are benzoyl peroxide, resorcinol, salicylic acid, and
sulfur. Benzoyl peroxide works best at eliminating the bacteria
P. acnes and in reducing oil production. Resorcinol, salicylic
help break down blackheads and whiteheads. In addition, salicylic
acid makes it easier to reduce the shedding of cells lining the
follicles of sebaceous glands. Topical OTC medications are available
in various presentations, such as gels, lotions, creams, soaps,
Some OTC acne medicines may cause side effects such as skin irritation,
burning, or redness. Although side effects lessen or disappear
after persistent use of the treatments for some people; severe
or lasting side effects should be reported to the doctor.
Topical or systemic medicines, alone or in combination, may be
prescribed for the treatment of moderate to severe
inflammatory acne cases.
As regards to prescription of topical medicines, treatment of
acne most commonly includes antibiotics, benzoyl peroxide, tretinoin,
adapalene, and azelaic acid. Antibiotics and azelaic acid help
or slow the development of bacteria and lessen inflammation. Tretinoin,
a retinoid, unplugs existing comedones, allowing other topical
medicines to enter the follicles. Other retinoids, like tazarotene
or adapalene, help reduce comedo formation.
Prescription topical medicines are available as creams, lotions,
solutions, or gels, which the physician will prescribe considering
the patient’s skin type. Since creams and lotions offer
moisture, they are likely to be good for people with a sensitive
type of skin. Gels and solutions are usually alcohol based, and
therefore, tend to dry the skin.
In the beginning, the skin may look worse before improving. Some
of the most usual side effects of the treatment of acne include
stinging, burning, redness, peeling, scaling, or discoloration.
As regards prescription of oral medicines, physicians frequently
prescribe oral antibiotics for patients with moderate to severe
acne. Oral antibiotics help control acne by restraining the development
of bacteria and reducing inflammation. In many cases, oral and
topical medicines may be combined; most commonly, benzoyl peroxide
can be prescribed together with clindamycin, erythromycin, or
sulfur. Tetracycline, minocycline, and doxycycline are other common
antibiotics used for the treatment of acne.
Common side effects include increased tendency to sunburn, upset
stomach, faintness or light-headedness, and changes in skin color.
Tetracycline is not given to pregnant women as there is significant
side effect risks for the unborn child.
For treatment of severe inflammatory acne cases, isotretinoin,
a retinoid, may be prescribed for use. Isotretinoin is
an oral drug that reduces the size and activity of the sebaceous
glands in order
oil production, and therefore, the growth of bacteria.
Isotretinoin is very effective in preventing scarring. However,
it can provoke birth defects. That is why it is mandatory that
women are not pregnant and avoid pregnancy during treatment of
acne with this drug.
Other kinds of treatment of acne in women include hormonal therapy.
Hormonal therapy is useful to treat acne in women that is due
to an excess of androgen hormones. The doctor may prescribe an
reduces excessive oil production. Antiadnrogen drugs include spironolactone,
cyproterone acetate, and flutamide. Possible side effects of antiandrogen
drugs include irregular menstruation,
and fatigue. Women using anti androgens must also use birth control
to avoid pregnancy. Birth control pills can themselve help to
treat acne when the condition is mild.
A treatment of acne alternative to drug therapy may include removal
of the patient’s comedones or injection of cortisone directly
into lesions in order to reduce the size and pain of inflamed
cysts and nodules.
In case of scarring, surgical treatment of acne may be suggested.
Irregular scars may be corrected by a superficial
laser. Laser treatment may also be used deeper into the skin to
tighten underlying tissue and to "plump out" scars. Dermabrasion
kind of treatment of acne usually used in combination with a subsurface
laser. Another option for treating deep scars is the transfer
of fat taken from other parts of the body.