to what your mother may have told you, its not what youre
eating that causes acne. Acne has a strong genetic component, exacerbated
by hormonal changes (most women already know this!); stress associated
with school, jobs and starting families, and sometimes-poor skin care
regimens. Everyone knows that acne affects teenagers, but most people
do not realize that young adults in their 20´s and 30´s
are more likely to develop acne than their teen counterparts.
ALL ACNE IS CREATED EQUAL
different types of acne lesions as well as grades of acne severity.
Treatment is based upon these possible combinations.
of acneiform lesions
Comedone (aka the blackhead).
(aka closed comedone).
Dermatologists perform acne grading to help track improvement (or lack
thereof) to therapy. Grade 1 is the mildest, with very few lesions.
This continues up through grade 4, acne that has the most significant
patient presents in my office, I quickly evaluate the overall severity
of the acne (the grade) and the types of lesions present. Every dermatologist
has their favorite combinations of treatments that have been successful
for their patients, so what I am about to share with you are regimens
that I tend to favor. I allow 6-8 weeks for any therapy regimen to show
significant (I didnt say miraculous) improvement. If a patient
does not demonstrate this, I will often change their medications. If
you have been on the same medicines for a year and you are still breaking
out, discuss this with your doctor!
grade 1 acne, composed of small, superficial lesions, such as blackheads
and pustules often responds well to topical therapy. My favorite topical
that shows consistent resolutions of blackheads continues to be Retin
A .025% cream. Frequently, patients will tell me they have used Retin
A in the past and have experienced quite a bit of irritation. Almost
everyone can use Retin A if used properly. I tell my patients to wait
30 minutes after washing before applying a pea-size amount of Retin
A to the face. I also tell them to apply it only every other night when
starting out. This minimizes the dryness. If the patient experiences
anything more than some mild white flaking, they should back off to
every third, fourth, or fifth nights, etc. until they can tolerate its
use. For patients with incredibly oily skin or for those who have innumerable
stubborn blackheads, I have been very pleased with the Tazorac Gel that
comes in 2 strengths, 0.05 and 0.01%. It is used in the same manner
as Retin A or other similar derivatives.
Therapy For Acne Currently On The U.S. Market*
Used to kill the bacteria P. acnes that causes acne flares as well as
act as anti-inflammatory agents, reducing the size of acne lesions and
helping prevent outbreaks altogether. Spironolactone works for those
women with hormonal influences causing acne. BCPs again work at the
hormonal level. Accutane works to correctly form the oil glands whose
linings are improperly forming, and is the closest to a cure
we have for acne.
Control Pills (Ortho Tricyclen)
Vitamin A Derivatives
Used to remove blackheads, dry up excess oils and smooth out bumpy acne.
(Retin A, Avita)
Used to kill of P. acnes, the bacteria responsible for flaring acne outbreaks.
(a combination of BPO and Erythromycin)
BP (a combination of Clinac O.C. and Benzoyl Peroxide)
(MetroGel/Lotion/Cream & Noritate))
Lotion & Cleanser (Sulfa based)
cyst can always rapidly be resolved with a small shot of steroid solution
known as Kenalog (triamcinolone). The plus side to this is the rapid
resolution for those "little emergency" situations like weddings,
prom, etc. The draw back is that this is simply not the way to treat
widespread recurrent acne. Nor is it pleasant should you experience
the atypical "sink" spot where fat atrophy has taken place
as a side effect from the shot. Fortunately this is unusual and fills
in over several months.
agents help reduce oils and often contain ingredients to help unplug
pores otherwise known as keratolytic activity. Many OTC products contain
these 2 activities in addition to some antibacterial properties thanks
to Benzoyl Peroxide.
on Adult Acne: Acne Treatment