Acne Treatment Options

Acne vulgaris (commonly called acne) is a common skin condition affecting the face, the upper part of the chest, and the back. Acne is most common during adolescence, affecting more than 89% of teenagers, and frequently continues into adulthood.

Causes of Acne

Acne develops as a result of blockages in follicles. Dead skin cells accumulate on the inside of the follicles, forming a plug. Whiteheads are the direct result of skin pores becoming plugged with sebum, a naturally-occurring oil, and dead skin cells. The root causes of why some people get acne and some do not are not fully known. It is known to be partly hereditary. Several factors are known to be linked to acne:

• Family/ Genetic History – The tendency to develop acne runs in families. A family history of acne is associated with an earlier occurrence of acne.
• Hormonal Activity – This includes menstrual cycle and puberty. During puberty, an increase in male sex hormones, called androgens, cause the follicular glands to get larger and make more sebum.
• Stress – Causes increased output of hormones from the adrenal (stress) glands.
• Bacteria – Propionibacterium acnes (P. acnes) is an anaerobic bacterium that causes acne.

Acne Treatment Options

There are many products available for the treatment of acne. General treatments are believed to work in at least four different ways:

• Normalizing shedding into the pore to prevent blockage
• Killing Propionibacterium acnes (P. acnes)
• Anti-inflammatory effects
• Hormonal manipulation

A combination of treatments can greatly reduce the amount and severity of acne in many cases. Many people consult with doctors when deciding which treatments to use, especially when considering using any treatments in combination. There are a number of treatments that have been proven effective:

• Topical Bactericidals – Widely available over-the-counter bactericidal products containing benzoyl peroxide may be used in mild to moderate acne. In addition to its therapeutic effect as a keratolytic (a chemical that dissolves the keratin plugging the pores), benzoyl peroxide also prevents new flare ups by killing P. acnes. However, it routinely causes dryness, local irritation, and redness.
• Topical Antibiotics – Externally applied antibiotics such as erythromycin, clindamycin, azelaic acid or tetracycline kill the bacteria that are harbored in the blocked follicles.
• Oral antibiotics – Reduces the P. acnes bacteria but will not, in itself, do anything to reduce the oil secretion and abnormal cell behavior that is the initial cause of the blocked follicles.
• Hormonal treatments – The antiandrogen, Cyproterone, in combination with an estrogen is particularly effective at reducing androgenic hormone levels. If a pimple is large and does not seem to be affected by other treatments, a dermatologist may administer an injection of cortisone directly into it, which will usually reduce redness and inflammation almost immediately.
• Topical Retinoids - appear to influence the cell creation and death lifecycle of cells in the follicle lining. This helps prevent these cells from accumulating and creating a blockage.