from the Fall 1999 issue
Just as photo aging is the most common cause of facial skin problems in the middle age to older population, acne is the most common reason for less than perfect skin in the teen to young adult years. Eighty-five percent of people ages 12 to 25 have some form of acne. The good news is that we now have many excellent treatments to control acne and help prevent scarring.
Acne begins to appear when boys and girls hit puberty, and the sex hormones kick in. Androgens are the hormones that stimulate the oil glands to become active and cause pores to become blocked. Bacteria proliferate down in the plugged pores and cause red bumps and cysts. If the cysts are large and deep, they can cause permanent scarring. Stress can flare acne through its effect on hormone levels.
For mild cases of acne, over-the-counter products may be effective. Here are a few tips for self-treatment:
- Try a salicylic acid or glycolic acid cleanser. These products help exfoliate, thereby clearing plugged pores. Examples include M.D. Forté® Cleanser (with glycolic acid) and SalAc® or Neutrogena Acne Wash (with salicylic acid).
- Apply a 2.5-percent benzoyl peroxide lotion or gel every evening. Benzoyl peroxide is effective in killing the bacteria involved in acne.
- Apply a glycolic acid product (such as M.D. Forté) every morning. Glycolic acid helps to exfoliate and unclog blocked pores.
For more severe cases of acne or cases that aren't responding to over-the-counter treatments, a visit to our office is in order. It Is a good idea to see a dermatologist before the condition produces scarring and/or takes an emotional toll. The earlier we intervene, the better your chances of not progressing to permanent scarring. We now have a large arsenal of prescription medications and procedures at our disposal to help keep your skin clear and looking its best. Some of the options are:
- Retinoic acids. Available as creams, solutions and gels, these vitamin A acids (Retin-A, AvitaTM, Tazorac®) can help unblock pores and reduce skin bacteria. Differin® (adapalene) is a naphthoic acid derivative with retinoid-like activity.
- Topical antibacterial agents. These creams and lotions can reduce acne inflammation and skin bacteria. They include benzoyl peroxide, azelaic acid (Azelex®), clindamycin (Cleocin T®) and erythromycin (T-Stat®). Some products such as Benzamycin® and Triaz® have two active agents combined.
- Oral antibiotics. For acne that is not controlled by topical treatments alone, oral antibiotics are usually the next agent added. Commonly used antibiotics are tetracycline, doxycycline, minocycline and erythromycin.
- Birth control pills. Women who use oral contraceptives may notice that their acne improves significantly. In fact, the FDA has approved one birth control pill, Ortho Tri-Cyclen®, specifically for acne treatment.
- Accutane®. For severe cystic acne or acne that doesn't respond to other treatments, Accutane (isotretinoin) is very effective. It needs to be used with care since it can cause birth defects and may have other side effects.
- Chemical peels. Glycolic acid peels and salicylic acid peels may speed resolution of blackheads, whiteheads and pigmented spots caused by acne.
There is no longer any reason to suffer with the embarrassment of a red, pimply complexion. Start today on the path to clear, smooth skin.
For more information, see:
Acne Remedies
Holiday 2001
Acne Update
Spring 2005
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