An approach to skin breakouts and treatment

Treatment: Considerations and how to approach

There is no single best mode for treatment of all lesions . Different treatments for different forms of acne is determined by many factors, including the type of lesions present, duration of disease, past and present response to treatment, tendency for scarring and development of acne spots. Knowing the symptoms and treating acne early and adequately are the keys to a successful acne management. Current medical condition and medications especially oral contraceptives, corticosteroids and topical antibiotics may affect its treatment . Psychological factors may have great impact on removal of lesions. Also adult patient's overall hygiene, facial care, hair grooming and use of cosmetics must be considered. There are two important points that acne patients should be aware of. First, six to eight weeks of treatment may be required before improvement is noted. Second, body lesions including back, chest, shoulder lesions respond more slowly to a topical applications than do those on the face.

A rational approach to treat acne could be to selectively target the treatment to factors involved in development of acne and its pathogenesis. These approaches provide a guideline prevention for and medical intervention for acne. First, prevention of comedones (whiteheads and blackheads). Second, sebum production reduction. Third, preventing rupture of comedones. Fourth, resolution of inflammation concurrent with treating acne. Fifth, preventing and correcting acne scars. Treating these sequeles of acne could become even more cumbersome.

When should I see a doctor?

It is important to note that severe acne must be consulted with a physician. Best treatments for mild forms of acne such as comedones (whiteheads and blackheads), small pustules and scattered papules are treatment products with desquamating agents such as benzoyl peroxide. Among leading over-the-counter drugs it could be counted. Its antibacterial efficacy is noteworthy in rapid destruction of Propionibacterium acnes. This suppressive effect is much faster compare with that of antibiotics. In contrast to antibiotics, resident organisms do not become resistant to this agent. This anti acne agent also demonstrates anti-inflammatory effect due to a reduction of oxygen free radicals. Its comedolytic effect is comparatively slight in contrast to other topical agents used for treatment of acne. Contact allergy is quite rare with it.

Treatment would be based on severity of acne lesions. Mild, moderate and severe acne are to be treated with different treatment protocols. Mild form (grade I) is treated with topical retinoid plus benzyold peroxide. For moderate acne (grade II-III) oral antibiotics and hormone therapy for females may be added. Treatment of severe acne is either isotretinoid or combination of what is indicated for mild to moderate forms. Here you can find more information on acne maintenance treatment and its algorithm based on acne grade. Evidently, isotretinoin and antibiotic therapy is not included in acne maintenance treatment, which targets comedogenesis, for their potential side effects and toxicity. Maintenance treatment is necessary to prevent development of microcomedones.

Topical Acne Treatments:

Among comedolytic agents salicylic acid, which could be used as alternative or adjunct to benzoyl peroxide, is considerably being used. This combination treatment may be used among modalities for moderate acne forms. Salicylic acid comedolytic activity justifies its therapeutic value in acne. Keratolytic activity of this BHA causes peeling and removal of top layer of the skin. This can result in preventing the follicles from getting plugged. Salicylic acid is also moderately effective in destructing Porpionibacterium acnes and shows moderate antibacterial efficacy. pH control is another means to treat acne as propionobacterium acne alters skin's pH and its modification may have a role in treatment. Application of alpha hydroxy acids may resolve the comedones and prevent more severe acne. Use of AHA's alone is not indicated for acne. However, a positive effect through control of sebum production and ductal hypercornification is likely.

Topical acne treatments containing azelaic acid is indicated in mild forms like acne comedonica. No sebum production reduction is seen using this agent. At high concentration, this acid is bactericidal. However, the degree of bacterial suppression is considerably less than that with benzoyl peroxide. Azelaic preparations have also an anti-inflammatory effect to some degree by decreasing production of reactive oxygen species. It also normalizes keratinization, which accounts for its anticomedogenic effect. Mild sides effects such as redness and scaling is associated with use of the drug.

One of the oldest drugs in history of acne is sulfur. For a long time sulfur was the most common ingredient in acne clearing treatment products. Sulfur while banishes inflammatory acne, simultaneously it incites formation of the comedones from which new acne starts.

Tretinoin is another topical modality that could be used to treat acne vulgaris. This derivative of Vit A is keratolytic and may cause a form of dermatitis called retinoid dermatitis. It could be combined with antibiotic to address other etiologies involved in formation of acne lesions. One of these combinations is tretinoin-clindamycin that one study indicates its increased efficacy. New retinoids(adapalene) have shown to have anti-inflmmatory effects which aims to another mechanism in develpoment of acne, inflammation (increase in IL-1 and TNF). This reserves use of retinoids in inflammatory as well as non inflammatory acne treatment.

Antioxidants are another category among treatments for acne. Superoxide and other free radicals production appear to be involved in aggravation of acne vulgaris. Propionobacterium acne may be accounted for superoxide's radicals generation. This may explain role of alpha lipoic acid and bioflavanoids in treatment of acne vulgaris.

Oral Treatments:

Isotretinoin is among oral treatments used in severe cases of acne. Retin-A tretinoin (topical form of isotretinoin) is among acne modalities to get rid of breakouts especially when other forms of treatment has failed. Tretinoin is a prescribed drug and an skin irritant particularly in liquid form. Cold climates and exposure to sunlight may cause marked irritation. Retin-A (tretinoin) has an antikeratinization effect and prevents formation of the comedones. Retin-A differs from benzoyl peroxide and topical antibiotics in having no or a controversial effect on Porpionibacterium.acnes and causing no reduction in surface free fatty acids. Tretinoin effectiveness against microcomedones (a blackhead) compare with other removal modalities provides a rationale for its use in most forms of acne. This agent is particularly helpful in reducing non-inflammed lesions and comedones thereby indirectly reduces the number of inflammed blemishes by correcting the follicular hyperkeratosis. This drug is a powerful exfoliant and can cause tenderness, redness and scaling.

Go to next page

>> Homepage

>> Causes and pathogenesis

>> Role of Hormones

>> Stress Effect

>> Fatty Acids & oil-forming skin

>> Acne treatment kit

>> regulating Cream

>> Product features

>> Body skin breakouts

>> Acne spots, Scar & damaged skin

>> guide to clear complexion

>> prevention, maintenance treatment

Hippocrates serums, " skin purifying acne treatment serum ", a multifunctional cure to purify the skin inside out:

This potent serum battles sebaceous hyperconification, one of the major mechanisms in acne development. Simultaneously it renews retexturizes the skin, smooth away acne scars. Maintains skin's normal pH and prevents bacterial colonization.

Hippocrates acne clearing treatment serum minimizes pores and smooth away scars. Control breakouts. Read also skin purifying treatment benefits and purification regimen for tips on how to clear acne including back, chest, shoulder lesions

Acne kit eliminates freckles and acne spots and refine the skin by revealing a brighter, more even-toned complexion

Hippocrates acne kit purify the skin, tightens the pores, reactivates the natural defenses of the skin and reduces the inflammation

Contains: Bioflavanoids, Green tea extract, alpha lipoic acid, powerful anti oxidants to prevent the oxidation of lipids in the skin which results in aggravation of black heads and white heads, helps to activate skin's own natural defenses to clear the epidermis.

By daily application of Hippocrates acne serum you maintain a regular use of appropriate therapeutic agents which ensure that acne remains in remission. Topical agents are the mainstay of Hippocrates acne maintenance treatment. A number of topical therapeutic options have been selected to ensure the maximum efficacy. This serum is an element of Hippocrates kit to treat acne and is accompanied by two other products, a treatment cream and a pore refining cleanser. Treatment cream, Day Effect is to regulate sebum and skin secretions and is developed in synergism with the acne treatment serum.

1 | 2 | 3