Man With White Powder on Face
Man With White Powder on Face

We’re going to be talking about acne, people always have all sorts of questions about acne, the biggest thing really about acne is how you approach it, there are a lot of different types of acne and knowing which types of acne you are talking about is really important, so for people who have mild acne, the nice thing is they’re really good over-the-counter products that you can use, there’s over the counter benzoyl peroxide, there’s over-the-counter salicylic acid and now within the last couple of years there’s over-the-counter retinoid products which are really helpful as well for some people who have say moderate to severe acne, over-the-counter products alone aren’t going to be as helpful as you probably want them to be so in those situations that’s when you would come see a board-certified dermatologist and they can talk about different ways to manage acne, now one of the things that’s really important to realize about acne is that it’s hormonalIy driven and the people who tend to have acne are people whose hormones are all up and down, that tends to be people who are teenagers and you know unfortunately those of us in our 20s, 30s, 40s also can can get acne and can get blemishes at times.

Where does acne most commonly occur?

The most common spots where you might have acne are your face, forehead, chest, shoulders and upper back. Oil glands are all over your body, but those are the places where there are the most. The best way to treat acne depends on how severe it is. Acne can be mild (a few occasional pimples) moderate (inflammatory papules) or severe (nodules and cysts).

How is acne treated?

Your healthcare provider may suggest some non-prescription medications for your condition. Depending on the condition’s severity, your age, the type of acne you have and how effective the over-the-counter remedies have been, you may need stronger prescription medications.
The use of certain contraceptives can sometimes help a woman’s acne go away. The Food and Drug Administration has approved three types of birth control pills for treating acne. All four contain a combination of estrogen (the primary female sex hormone) and progesterone (a natural form of steroid that helps regulate menstruation).
Various medications and therapies have proven to be effective. They target the underlying factors that contribute to acne. You might require at least one or multiple, depending on the severity of your condition.

Medications applied topically:

Benzoyl peroxide is available as an over-the-counter product (such as Clearasil®, Stridex®, PanOxyl®) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin. Irritation (dryness) is a common side effect.

Salicylic acid is available over-the-counter for acne, as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.

Azelaic acid is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.

Retinoids (vitamin A derivatives) such as Retin-A®, Tazorac®, and Differin® (which is now available without a prescription) break up blackheads and whiteheads and help to prevent clogged pores, the first signs of acne. Most patients are candidates for retinoid therapy. These medications are not spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. The most common side effect is irritation, which usually improves with moisturization and time on the medication.

Antibiotics (topical types include clindamycin and erythromycin) control surface bacteria that aggravate and often encourage the swelling of acne. Antibiotics are more effective when combined with benzoyl peroxide.

Dapzone (Aczone®) is a topical gel, which also has antibacterial properties, can be used for inflamed acne. It’s applied to the skin twice a day.

Medications taken orally (by mouth):

Antibiotics, especially tetracycline antibiotics such as minocycline and doxycycline, are commonly used to treat moderate to severe acne.

Oral contraceptives can help with breakouts associated with menstrual cycles. Three classes of medications have been approved by the FDA for acne patients. Some brand names include Estrostep®, Beyaz®, Ortho Tri-Cyclen® and Yaz ®.

Isotretinoin (Amnesteem®, Claravis®, Sotret®), an oral retinoid, is an especially effective drug used only for the most severe cases of acne. Isotretinoin shrinks the size of oil glands, which contributes to acne formation. The most common side effect is dryness, but can also cause birth defects. Some evidence suggests a possible increased risk of ulcerative colitis and depression. Because of these risks, anyone using the drug must take part in a Food and Drug Administration-approved risk management program known as iPledge.

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