Medications for Acne

Nonprescription products

Cleansers. There are many cleansers, soaps, washes and so on advertised for acne. Most special cleansers are unnecessary if the acne is being treated properly otherwise. Some may even aggravate acne. Be careful that vigorous scrubbing and washing does not irritate the skin.

Benzoyl peroxide. Benzoyl peroxide works by destroying the bacteria associated with acne, P. acnes. It usually takes about 2 weeks to work and it must be used continuously to keep acne at bay until you outgrow getting acne. This is because it does not affect sebum production or the way the skin follicle cells are shed, and when you stop using it, the acne comes back. It is available in a wide range of vehicles: creams, lotions, gels. It often works quite well for milder cases of acne.

Salicylic acid. On the skin, salicylic acid helps to correct the abnormal shedding of cells. For milder acne, salicylic acid helps unclog pores to resolve and prevent lesions. It does not have any effect on sebum production or P. acnes, It must be used continuously, just like benzoyl peroxide, since its effects stop when you stop using it--pores clog up again and the acne returns. Salicylic acid is available in many acne products, including lotions, creams and pads.

Prescription products

Because prescription drugs must be ordered by a dermatologist, your own dermatologist is the best source of information about specific products and the treatment of your acne.

Antibiotics. Antibiotics may be used on top of the skin (topical) or taken orally (systemic). Antibiotics work by clearing the skin of P. acnes, There are several topical products available in creams, gels, pads and lotions. Topical antibiotics are limited in their ability to penetrate the skin and clear more deep-seated P. acnes, whereas systemic antibiotics circulate throughout the body and into sebaceous glands. Systemic antibiotics, therefore, often cause more side effects than topicals, but they can be used for more severe kinds of acne.

Antibiotics do not address the other causative factors in acne and may take several weeks or months to clear up acne. Antibiotics are usually used in combination with other drugs that "unclog" follicles. Orally taken (systemic) antibiotics for acne should not be used during pregnancy, and some may reduce the effectiveness of oral contraception pills, risking a pregnancy during treatment. Be sure you get all the facts about any antibiotic your dermatologist prescribes.

Vitamin A derivatives. Vitamin A derivatives, called "retinoids," have numerous effects on the skin. Other drugs that work like vitamin A have similar effects. Topical retinoid preparations help unclog pores to clear up moderate-to-severe acne by normalizing the way the skin grows and sheds. They can be used in combination with other acne products, such as benzoyl peroxide, and oral antibiotics. However, the dermatologist's instructions should be carefully followed.

An oral retinoid is available that reduces sebum output, improves the shedding of skin and reduces the P. acnes population of the skin--the only medication that intervenes in all the causes of acne. It will often clear severe nodular acne, even if the acne has not responded to other treatments. This product can have long lasting results, but it can also cause significant side effects in some people. In addition, it has been shown to cause birth defects if taken during pregnancy. A course of treatment completed in the past has no effect on future pregnancies, but the drug should not be used by a women who believes she may become pregnant during treatment. A person taking this drug should carefully follow the dermatologist's direction.

Oral contraceptives. Oral contraceptives, being female hormones, help to counteract the effect of male hormones (androgens) on acne. Because they are female hormones, however, their use is limited to female patients. It should be pointed out that the use of some systemic antibiotics, which should not be used during pregnancy, may reduce the effectiveness of oral contraceptives as birth control. Oral contraceptives contain combinations of hormones, and some combinations are more effective than others in clearing acne. The maximum benefit of oral contraceptives on acne occurs in 3 to 4 months.

Other medications. Anti-inflammatory medications called corticosteroids may be injected by a dermatologist directly into severe inflamed acne lesions to help heal the lesions.

A dermatologist is the best source of information as to which one is right for an individual case of acne.

 

Dr. Kiran Godse
Skin Specialist
Laksh-Deep Hospital