Acne Facts / Acne Treatment - A Doctor Written Guide
Advances in our understanding of acne and its treatment means people no longer have to suffer for years with acne. This includes all spectrums of the disease from mild to severe.
This doctor written Acne Facts / Acne Treatment Guide is intended to help people discover the facts and debunk the myths about acne. All information is based on the latest medical literature.
Acne Vulgaris, Acne, Pimples, Zits they go by many names but for many they are all too common. Almost 80% of people will have acne in their teenage or young adult life. For some acne can have a strong negative impact on their psychological development, resulting in withdrawl from society and depression. It can also persist for years resulting in permanent disfigurement and scarring. Clearly, acne is a problem which has definite impact on one's overall well being.
It is important to realize that acne results from a combination of factors. Briefly reviewing how acne is caused will help one understand how to treat acne and how to cure acne. Also, it is important to understand what NOT to do so one doesn't make acne worse.
What Causes Acne?
Located primarily on one's face, back and chest are glands known as sebaceous glands. These glands are responsible for the production of sebum, your skin's natural oil. These glands are located in specialized follices known as sebaceous follices. Acne results when these specialized follices become plugged due to excessive amounts of sebum combined with an abnormality in the outer layer of these follices (known as the epithelial cells) to slough off as they normally should. This results in the non-inflammatory lesions of acne "blackheads" and "whiteheads"
The next factor involved is the bacteria P. acnes. The excessive sebum combine with the epithelial cells to create a nice enviroment for P. acnes to grow. One's immune system recognizes this and tries to kill P. acnes. The resulting battle of your immune system against the bacteria results in the red, painful inflammatory lesions known as papules, pustles, and nodules. That's it for the complicated stuff now lets get into acne treatment and ultimately acne cure.
Facts and Myths -
Reducing the production of oil (sebum) - Its a common myth that that frequently and vigorously washing one's face will cure acne. However, while soaps, detergents and astringents may remove sebum from one's face they do NOT alter the production of sebum. Vigorous scrubbing or using harsh soaps / detergents will only lead to inflammation which may make acne WORSE. The best approach to washing is to use a mild gentle cleanser such as cetaphil or a mild neutrogena cleanser. Another common myth is that diet can lead to oily skin (sebum production), however, it does not.
Facts - Reduce the growth of P. Acnes - Reducing the growth of P. Acnes helps prevent the inflammation that results when one's immune system tries to destroy P. Acnes.
Acne Treatment Medications (The Facts)
The vast majority of acne treatment can be broken down into one of two broad categories:
1. Reducing the growth of P. Acnes
2. Allowing the follicular epithelial cells to slough off normally.
P. Acnes can be killed using medications which have anti-bacterial or antibiotic (bacteria killing) properties. The most commonly used of these agents is benzoyl peroxide. Benzoyl peroxide is applied topically (to the skin) and is available over the counter in 1, 2.5, 4, and 10% strengths both as gels and lotions. Benzoyl peroxide can be irritating to the skin which can be a limiting factor in its use. It should not be applied more than once or twice a day.
Topical antibiotic medications such erythromycin, clindamycin, azelaic acid also reduce the growth of P. Acnes and may be prescribed by your doctor. Preparations combining benzoyl peroxide with clindamycin and benzoyl peroxide with erythromycin may also be prescribed by your doctor.
The next type of medications help to correct the abnormal sloughing of the follicular epithelial cells. A commonly used medication is Salicylic acid which is applied topically and available over the counter. It is generally reserved for milder forms of acne. Skin irritation, can be a limiting factor in using salicylic acid.
Other prescription medications which help correct this abnormality in epithelial sluffing include tretinoin (Retin - A) and adapalene (Differin). Retin-A must be applied at bedtime as the sunlight inactivates it. It can be irritating to the skin but most people get used to these side effects especially when used in lower concentrations. Retin-A can cause sun sensitivity so it is important to where sunscreen (oil-free) during the day. These medications are often prescribed in conjunction with with topical benzoyl peroxide or topical or oral antibiotics. Thereby the acne is being targeted at two levels:
1. Reducing P. Acnes.
2. Helping the abnormality in epithelial cell sloughing.
Oral Acne Medications
For moderate to severe acne your doctor may also prescribe a oral antibiotic. Commonly used medications are doxycycline, minocycline and erythromycin.
Sebum production is influenced by male hormones (androgens). Therefore, for females an OCP (oral contraceptive pill) may be helpful in acne by reducing androgen levels.
For severe nodular cystic acne the oral medication isotretinoin (Accutane) may be used. Accutane works by profoundly reducing sebum production. Accutane is the drug of choice in patients who have severe acne with scarring. Accutane can only be prescribed by your dermatologist. Females taking Accutane must NOT get pregant as Accutane causes severe birth defects. Other side effects include joint pains, stiffness, tendonitis, and high triglycerides. Nevertheless, for those with severe acne Accutane can lead to prolonged remissions.
Sincerely, Dr. Rajesh Shoor
**Disclaimer** This site is intended for educational purposes only. It is not intended to diagnose, treat or cure any disease. It in no way replaces consultation with your doctor.
The author of this article has no affiliations with any pharmaceutical companies whatsoever. Medication names when given have been done so for informational purposes only.
The medication links have been directed to the National Library of Medicine - NIH, a government funded website.
This doctor written Acne Facts / Acne Treatment Guide is intended to help people discover the facts and debunk the myths about acne. All information is based on the latest medical literature.
Acne Vulgaris, Acne, Pimples, Zits they go by many names but for many they are all too common. Almost 80% of people will have acne in their teenage or young adult life. For some acne can have a strong negative impact on their psychological development, resulting in withdrawl from society and depression. It can also persist for years resulting in permanent disfigurement and scarring. Clearly, acne is a problem which has definite impact on one's overall well being.
It is important to realize that acne results from a combination of factors. Briefly reviewing how acne is caused will help one understand how to treat acne and how to cure acne. Also, it is important to understand what NOT to do so one doesn't make acne worse.
What Causes Acne?
Located primarily on one's face, back and chest are glands known as sebaceous glands. These glands are responsible for the production of sebum, your skin's natural oil. These glands are located in specialized follices known as sebaceous follices. Acne results when these specialized follices become plugged due to excessive amounts of sebum combined with an abnormality in the outer layer of these follices (known as the epithelial cells) to slough off as they normally should. This results in the non-inflammatory lesions of acne "blackheads" and "whiteheads"
The next factor involved is the bacteria P. acnes. The excessive sebum combine with the epithelial cells to create a nice enviroment for P. acnes to grow. One's immune system recognizes this and tries to kill P. acnes. The resulting battle of your immune system against the bacteria results in the red, painful inflammatory lesions known as papules, pustles, and nodules. That's it for the complicated stuff now lets get into acne treatment and ultimately acne cure.
Facts and Myths -
Reducing the production of oil (sebum) - Its a common myth that that frequently and vigorously washing one's face will cure acne. However, while soaps, detergents and astringents may remove sebum from one's face they do NOT alter the production of sebum. Vigorous scrubbing or using harsh soaps / detergents will only lead to inflammation which may make acne WORSE. The best approach to washing is to use a mild gentle cleanser such as cetaphil or a mild neutrogena cleanser. Another common myth is that diet can lead to oily skin (sebum production), however, it does not.
Facts - Reduce the growth of P. Acnes - Reducing the growth of P. Acnes helps prevent the inflammation that results when one's immune system tries to destroy P. Acnes.
Acne Treatment Medications (The Facts)
The vast majority of acne treatment can be broken down into one of two broad categories:
1. Reducing the growth of P. Acnes
2. Allowing the follicular epithelial cells to slough off normally.
P. Acnes can be killed using medications which have anti-bacterial or antibiotic (bacteria killing) properties. The most commonly used of these agents is benzoyl peroxide. Benzoyl peroxide is applied topically (to the skin) and is available over the counter in 1, 2.5, 4, and 10% strengths both as gels and lotions. Benzoyl peroxide can be irritating to the skin which can be a limiting factor in its use. It should not be applied more than once or twice a day.
Topical antibiotic medications such erythromycin, clindamycin, azelaic acid also reduce the growth of P. Acnes and may be prescribed by your doctor. Preparations combining benzoyl peroxide with clindamycin and benzoyl peroxide with erythromycin may also be prescribed by your doctor.
The next type of medications help to correct the abnormal sloughing of the follicular epithelial cells. A commonly used medication is Salicylic acid which is applied topically and available over the counter. It is generally reserved for milder forms of acne. Skin irritation, can be a limiting factor in using salicylic acid.
Other prescription medications which help correct this abnormality in epithelial sluffing include tretinoin (Retin - A) and adapalene (Differin). Retin-A must be applied at bedtime as the sunlight inactivates it. It can be irritating to the skin but most people get used to these side effects especially when used in lower concentrations. Retin-A can cause sun sensitivity so it is important to where sunscreen (oil-free) during the day. These medications are often prescribed in conjunction with with topical benzoyl peroxide or topical or oral antibiotics. Thereby the acne is being targeted at two levels:
1. Reducing P. Acnes.
2. Helping the abnormality in epithelial cell sloughing.
Oral Acne Medications
For moderate to severe acne your doctor may also prescribe a oral antibiotic. Commonly used medications are doxycycline, minocycline and erythromycin.
Sebum production is influenced by male hormones (androgens). Therefore, for females an OCP (oral contraceptive pill) may be helpful in acne by reducing androgen levels.
For severe nodular cystic acne the oral medication isotretinoin (Accutane) may be used. Accutane works by profoundly reducing sebum production. Accutane is the drug of choice in patients who have severe acne with scarring. Accutane can only be prescribed by your dermatologist. Females taking Accutane must NOT get pregant as Accutane causes severe birth defects. Other side effects include joint pains, stiffness, tendonitis, and high triglycerides. Nevertheless, for those with severe acne Accutane can lead to prolonged remissions.
Sincerely, Dr. Rajesh Shoor
**Disclaimer** This site is intended for educational purposes only. It is not intended to diagnose, treat or cure any disease. It in no way replaces consultation with your doctor.
The author of this article has no affiliations with any pharmaceutical companies whatsoever. Medication names when given have been done so for informational purposes only.
The medication links have been directed to the National Library of Medicine - NIH, a government funded website.
posted by Rajesh Shoor at 7:20 AM
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