Acne Treatment
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- For ordinary, superficial acne, a number of conventional medical products, some available by prescription and others over the counter, may be effective:
- Benzoyl peroxide is a topical nonprescription antibacterial used in many over-the-counter acne preparations. It helps to decrease the growth of bacteria and works to open and clean out clogged pores. Benzoyl peroxide is available in lotion, cream, and gel forms. The gel is considered the most effective, but it can also be the most irritating. Benzoyl peroxide has a drying action and can cause redness and scaling. If it causes irritation, try applying it only every other day.
- Tretinoin is a naturally occurring derivative of vitamin A that acts by thinning the outer layer of the skin and opening up clogged pores. It is available by prescription in gel, cream, and liquid forms. Six to twelve weeks of therapy may be necessary before any improvement is noticed. Like benzoyl peroxide. Tretinoin can be very drying to the skin. Also, it is important to avoid the sun when using this medication, as it makes it much easier to get sunburned.
- Tropical preparations of the antibiotics erythromycin, clindamycin, and tetracycline are available by prescription and may be useful against acne, especially if benzoyl peroxide and tretinion prove ineffective by themselves. As with all antibiotics, an allergic reaction is possible and may be difficult to distinguish from simple contact irritation. Even when applied to the skin, these drugs are absorbed into the bloodstream. In rare cases, these antibiotics can cause a dangerous form of diarrhea or colitis.
- If you develop cysts or pustules in addition to ordinary pimples, it may be time to consult to a doctor. Depending on the severity of the condition, and on your physician's expertise with skin problems, it may be necessary to seek advice from a specialist in dermatology for chronic acne. Dermatologists often prescribe oral antibiotics such as tetracycline, minocycline, and erythromycin for significant inflammatory acne. Antibiotics work to decrease the amount of bacteria on the skin and have an anti-inflammatory action. Usually improvement can be noted in one to three months, but oral antibiotics are often recommended for a six to twelve month period to ensure success. Tetracycline can cause discoloration in developing teeth. It should therefore not be taken by children who do not have all of their permanent teeth, or by pregnant women. Also, be alert for developing signs of abdominal distress. These antibiotics can cause a rare but very dangerous form of diarrhea or colitis.
- Isotretinoin is a synthetic compound that resembles vitamin A. It can be extremely effective against acne, but it can also have such severe side effects as arthritis, elevation of blood fats, liver toxicity, nosebleeds, cracking at the corners of the mouth, and extreme dryness of the eyes. Most significantly, it is known to cause birth defects in a very high percentage of fetuses exposed to it. So serious is this danger that doctors often recommend that any woman of childbearing age who takes this drug use multiple forms of birth control and take pregnancy tests monthly. If despite these measures, pregnancy test monthly. If despite these measures, pregnancy does occur, therapeutic abortion may be recommended. We believe that if pregnancy is even a remote possibility, this drug should be not be used. In general, isotretinoin is a treatment of last resort for disfiguring cystic acne that does not respond to other treatments.
- Steroid injections introduced directly into a cystic acne lesion help decrease the size and inflammation of the lesion. They also help reduce the unsightly scarring and pitting that occurs in severe cases of this type of acne. Steroid injections are painful, however, and have potentially serious side effects, so they are generally recommended only for very severe cases of cystic acne that do not respond to other treatment.
- For severe cases of acne that result in deep scarring, dermabrasion may help to improve the appearance of the skin. This technique can cause a significant amount of discomfort, however. Longer-lasting problems with dermabrasion can include pigmentation problems, with patches of skin ending up either darker or lighter than surrounding areas, and scarring. Darker skinned people seem to encounter these problems more frequently than those with lighter complexions.
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