Acne management

How is acne treated?

Acne treatment depends on its severity: mild, moderate, or severe.

General principles of treatment.

• Acne can be treated effectively, although the response can sometimes be slow.
• Where possible, avoid excessively damp conditions such as sauna, working in a kitchen without ventilation or tropical vacations.
• Consider a low glycemic, low protein, and low dairy diet (note that the evidence that this helps is weak). Avoid protein or amino acids supplements, particularly if they contain leucine. Eat plenty of fresh fruits and vegetables.
• If you smoke, quit. Nicotine increases tallow retention and increase scale within folliclesforming comedones (pimples and pimples).
• Minimize the application of oils and cosmetics to the affected skin.
• Abrasive skin treatments can aggravate both comedones and inflammatory Injuries
• Try not to scratch or pick spots.
• Exposure to sunlight filtered through the window glass can help: View information on lasers, lights, and acne. To prevent sunburn, protect your skin outdoors with sunscreen and protective clothing.

Treatment of mild acne.

Most patients with mild acne can be treated with current treatment (gels, solutions and lotions) that can be obtained on the counter in New Zealand without a prescription. Most people only use topical agents for facial skin, as they can be difficult to apply to the back. Additional vitamins and minerals have not been shown to help.

• Wash affected areas twice daily with a mild cleanser and water or an antiseptic wash.
• Acne products should be applied to all acne-affected areas, rather than simply being placed on individual spots.
• A thin stain should only be applied to clean, dry skin overnight.
• Acne products may work best if applied in the morning as well.
• They often cause dryness, particularly in the first 2 to 4 weeks of use. This is partly how they work. The skin generally conforms to this.
• Apply an oil-free moisturizer only if the affected skin is obviously peeling.
• Avoid applying oily cosmetics as a base or sunscreen.
• It can take several weeks or even months to see a compelling improvement.
• Stop using a product if severe irritation occurs. Consult your doctor for advice.

Suitable topical agents for mild acne that can be obtained over the counter include:

• Antiseptic washes with triclosan or benzoyl peroxide (Acnederm wash ™, Benzac ™ AC Wash, Dalacin ™ T Prewash, Oxy ™ Daily Skin Wash)
• Gentle salicylic acid preparations to exfoliate and unplug follicles (Neutrogena® Oil-Free Acne Wash and many others)

• Benzoyl peroxide cream/ /lotion/ /gel (PanOxyl ™ Acne Gel, Brevoxyl ™ Cream, Oxy-10 ™, Clearasil ™ Ultra Acne Cream, Benzac AC Gel)

• Azelaic Acid (Skinoren ™ Cream, Acnederm ™ Medicated Lotion, Azclear ™ Action Lotion)

• Stabilized Cream Hydrogen Peroxide (Crystacide®, Crystaderm ™)

• Immune defense proteins (Epiology®)
• Tea tree oil, bee venom, polyphenols, and other products for which there is evidence of effectiveness It is limited.

Prescription topical agents for mild acne include:

• Antibiotics, such as clindamycin. solution (Topicil ™, ClindaTech ™) or erythromycin solution (Stiemycin ™) and gel (Eryacne ™), which are best used with benzoyl peroxide or azelaic acid to reduce the chance of antibiotic resistance

• Retinoids ie, tretinoin (ReTrieve ™, Retin-A ™), isotretinoin (Isotrex ™), adapalene (Differin ™); In some countries, adapalene is available without a prescription.

Combined prescription topics include clindamycin / benzoyl peroxide (Duac ™) and adapalene / benzoyl peroxide gel (Epiduo ™).

Lights and lasers, including blue light, have been found to be safe and helpful for mild to moderate acne when oral medications are not helpful or not helpful.

Consult your doctor or dermatologist For advice if your pimples don't clear up in six weeks or if you have severe acne.

Moderately severe acne treatment

Treatment for moderately severe acne generally includes the topical agents described above. Also, oral medications can be prescribed, usually for at least 3 to 6 months.

Suitable oral medications include:

• Antibiotics such as tetracycline, minocycline, doxycycline, or trimethoprim.

• The combined oral contraceptive pill, in women.
• Oral antiandrogens, such as low-dose cyproterone (in combination with estrogen) and / or spironolactone, especially if there are signs of hyperandrogenism
• Short-term use of non-steroids anti-inflammatory agents like ibuprofen or naproxen
• Oral isotretinoin for resistant or persistent acne.

When oral antibiotics are discontinued, control it should be maintained for the long term by continuing topical therapy.

Treatment of severe acne

Treatment for severe acne requires oral treatment. Patients must be under the care of a dermatologist.

Many patients will be treated with oral isotretinoin.

The following may also be prescribed:

• High doses of oral antibiotics for six months or more.
• In women, especially those with polycystic ovary. syndromeOral antiandrogens such as estrogen / cyproterone or spironolactone may be suitable in the long term
• Systemic corticosteroids are sometimes used

Physical treatments for acne.

• Sunlight is anti-inflammatory and may help briefly. However, exposure to Ultraviolet radiation results in skin aging and can eventually lead to skin Cancer.

• Lasers and other light systems that use wavelengths of visible light appear safe and useful for acne. The treatment is often administered twice a week for four weeks. The effect can be enhanced by using a photosensitizing agent (photodynamic therapy).

• Cryotherapy (freezing treatment) can be useful to control new nodules.

• Intralesional steroid injections can be used to shrink older nodules and pseudocysts.

• Comedones can be expressed or removed by cauterization or diathermy (electrosurgery).

• Microdermabrasion can help with mild acne.

• Note: X-ray treatment is no longer recommended for acne, as it can cause skin cancer.