• 17Feb

    What are the best medicines for acne?

    Acne is a skin disease affecting the sebaceous glands. It typically presents with characteristic lesions like blackheads or comedones, papules, pustules, nodules and cysts. The parts of the body commonly affected are the face, chest, and upper back. Severe cases develop discoloration and scarring. This condition commonly affects the adolescents and is a leading cause for visit to the dermatologist. The exact cause of acne is not known though multiple factors are linked to its occurrence, which include abnormal keratinization of skin, excess sebum production and infection with Propionibacterium acnes. 


    Treatment

    There are many treatment options for acne. Many of these depend on skin colour as darker skin is at a higher risk of scarring due to acne. Inappropriate selection of treatment method may also lead to worsening of inflammation and increased pigmentation of skin.

    Topical therapy or skin applications

    Retinoids: This is the first line of treatment in mild to moderate cases. Retinoids are derived from vitamin A. They dissolve the blackheads and prevent excessive keratinization of skin due to their anti-inflammatory properties. Treatment is started with lower doses. Water based formulations are better tolerated. They are applied at night as they increase the sensitivity of skin to light.

    Antimicrobials: They reduce the inflammation caused by bacterial infection due to Propionibacterium acnes. Erythromycin and clindamycin are commonly used as lotions, creams, gels and masks. Benzoyl peroxide is added to these preparations as it prevents the development of bacterial resistance to the antimicrobials.

    acneDapsone: Topical dapsone 5% gel is both safe and effective for the treatment of acne It carries anti-inflammatory and antimicrobial properties.

    Azelaic Acid: This compound is effective for both inflammatory and non-inflammatory acne. It also helps in reducing the hyperpigmentation due to acne.Its antimicrobial properties against P. acnes and Staphylococcus epidermidis increase its effectiveness. It is available as 20% cream.

    Systemic medicines for Acne

    Antimicrobials: They are used in moderate to severe cases of acne. These medicines are prescribed along with topical therapy in these patients. Some of the commonly used antibiotics include tetracycline, doxycycline, minocycline and erythromycin. These antibiotics are effective against the associated bacterial infection. They help in reducing the inflammation as well as post-inflammatory scarring and pigmentation of skin.

    Retinoids: Systemic retinoids are the treatment of choice for severe type of acne. They act by regulating the growth of epithelial cells. Isotretinoin is very effective in the treatment of acne but it should be taken with care. The patients may develop adverse effects like teratogenicity, psychiatric disorders, liver toxicity and abnormal increase in blood lipid levels. Hence, careful patient selection and close monitoring is required.

    Hormonal Therapy: Acne is associated with increased androgen levels in many patients. Hormonal therapy is useful in these patients though scientific studies have shown that this therapy is effective even in patients with normal androgen levels. Many anti-androgenic medicines are effective like oral contraceptives, spironolactone, flutamide, cyproterone acetate, finasteride, and corticosteroids. Oral contraceptives should be used carefully as they have many side effects including development of skin pigmentation on the face.

    Local Corticosteroid injection: In the presence of severe inflammation in nodular form of acne, injection of steroids into the acne has been found to be extremely effective in reducing inflammation. The response is very rapid and is seen in 48 to 72 hours. The injection of triamcinolone mixed with local anaesthetic lidocaine is commonly used. The injections are repeated at two to four week intervals so as to flatten out the lesions.

    Acne is a common condition which affects the cosmetic appearance of face. It may even lead to depression due to more concern about physical appearance in this age group. A thorough assessment by a dermatologist is required to initiate a management based on the type of skin. There are a multiple of treatment modalities available and this condition usually subsides in majority of the patients.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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