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Today, virtually every case of acne can be resolved. Typically acne is treated with the simplest topical and/or oral treatments which are deemed effective. Dr. Sikorski will assess your acne severity and recommend the appropriate and most quickly effective regimen.
Depending on the grade of acne you are dealing with, you'll be given one of several programs to follow initially. Regardless of the severity of your acne, you want to unclog the pores and kill the p. acne bacteria which causes inflammation. The following is a brief list of the most common ingredients in over-the-counter and prescription acne products:
* Salicylic Acid dissolves and removes the dead cells inside the hair follicles. This allows the pores to become unclogged and the sebum to pass through unimpeded.
* Benzoyl Peroxide is considered the most active ingredient in acne treatments. It is an anti-bacterial that helps remove the p. acne bacteria in the follicle. The lower concentrations can be obtained over-the-counter, while higher strengths require a prescription.
* Retinoids, such as Retin-A work by increasing skin cell turnover and promote the extrusion of the clogged follicle. They are very effective for unblocking the pores of oil glands.
* Facials and Peels are helpful treatments for removing pore blockage. The facial will help remove the surface layer of dead skin and wash away the bacteria.
* Blue light therapy, such as Blu-U or Omnilux, uses a special blue light that kills the p. acnes bacteria in your skin. It is a safe alternative if you are sensitive to antibiotics or the active ingredients in topical treatments.
Medically acne is a follicular eruption with plugged pores called comedones ("blackheads and whiteheads"), red papules, pustules and nodules, generally found on the face and upper body to include the shoulders, upper back and chest. The disease peaks at adolescence but can be seen in children as young as 8 and is not uncommon in adulthood.
Almost Clear (Grade I) - Very few clogged pores and no real inflammation or pustules. Generally easily controlled with proper cleansing and exfoliation.
Mild Acne (Grade II) – Consists primarily of superficial lesions (lesion -, a physical change in body tissue caused by disease or injury) mostly comedones, and some inflamed papules and pustules, no evidence of scarring and no nodules.
Moderate Acne (Grade III)- Lesions may involve the face and trunk, mild superficial scarring may be seen, with papules, pustules, comedones, and a few nodules. Nodules are not the dominant lesion.
Severe Acne (Grade IV) - Acne is causing persistent painful nodules, comedones, papules, and may have deep scars. In addition, acne has not responded to conservative optimal treatment.
General - Acne is a chronic disease and must be managed for best outcomes.
There is no cure though acne usually improves with time in most cases and there are many methods of care available which can provide a great amount of control.
Patients need to understand the importance of non-comedogenic skin care products.
Mild Acne - Potential control with topical non-RX products such as Benzoyl Peroxide or Salicylic Acid.
If needed, topical Tretinoin cream (Retin-A) nightly (or at less frequent intervals if too much irritation).
Most patients should begin with 0.025% or 0.05% cream. Retin-A frequently causes some redness and scaling which improves with time and can be minimized by closely following prescribing advice.
Tretinoin may cause an initial worsening of acne at 3-4 weeks and has maximum benefit after 4-5 months.
In addition, topical antibiotics such as erythromycin or clindamycin-type solutions applied twice daily (best) are used to help reduce the P. Acnes population in the follicles.
Follow up at 8 -12 weeks helps to reinforce correct use and adjust product selection if required.
Moderate Acne - Topical Retin-A and antibiotic as above.
Oral antibiotics address inflammatory acne and should be used for a minimum of 2-3 months before declaring a treatment failure. Follow up at 8-12 weeks.
Severe Acne - Referral to upper level therapies if there is not a marked improvement at 12-week follow-up to full regimen for moderate acne.
Potential use of oral Isotretinoin (Accutane for many years was the drug of choice for severe acne which did not respond to other therapies -
now generic versions of this powerful medication is still available but not under the same brand name.)
*Low progestin - type oral contraceptives: For women who have acne that comes and goes with their menstrual cycle, birth control pills can help reduce the flareups.
Two BCPs are labeled for acne: Ortho-Tricyclen, and Estra Step. Yasmin, while not labeled to treat acne is, nevertheless, commonly recommended by dermatologists for acne treatment.
Gentle skin cleansing is encouraged: Mild soaps (ie Dove, Oil of Olay for Sensitive Skin, Cetaphil, Phisoderm, Purpose, Neutrogena) may be used to cleanse the skin. Scrubbing with washcloths, Buff-Puffs, and any cleanser that contains abrasives of any type as these can worsen acne, and contribute to scarring. Avoid soaps with deodorant and anti-bacterial claims such as Dial, Zest, Coast, Irish Spring, Safeguard - and Noxzema and Ivory – these seem to contribute to worsening of acne.
If your skin gets clogged easily then you are at more risk from using those ingredients. Here are the main ones to look out for:
Not sure where to start? Give us a call and chat with our patient coordinator Michelle. Call the office at (949) 448-0487 or Request a callback through this online form.