Acne Treatment

There are several acne treatment options for the person with acne.

The best way to prevent post-inflammatory changes caused by acne is to prevent spots from occurring in the first place. If spots are already present, then careful management can minimise and prevent further inflammation, tenderness and spots. This involves:

• Washing twice daily with mild soap and lukewarm water. Avoid exfoliating substances or abrasive soaps. Scrubbing can produce more inflammation, so be gentle.
  
• Preventing the hair from falling onto the face
  
• Avoiding oil-rich face creams which may clog pores. Instead, use a water-based moisturiser.
  
• Avoiding any foods that you think may trigger your acne.
  
• Treating mild acne with over-the-counter preparations. It is important to follow instructions for use carefully in order to get the best results. Consult a doctor if these do not work within two months.
  
• Avoiding thick, greasy make up. Instead, choose brands that are oil-free and water-based so that pores do not become clogged. Choose products labelled 'non-comedogenic'. This means that they do not specifically cause blackheads or whiteheads.
  
  Some skin care products, practices and medications can improve mild to moderate acne.
  
  Wearing a good sunscreen is a good habit to keep. Unprotected exposure to the sun causes additional skin damage and can interfere with healing.

Specific treatment for acne includes:

• Topical treatments. These are applied directly to the skin.
  
• Antibiotics (taken by mouth).
  
• Oral contraceptive pills
  
• Isotretinoin capsules.

Topical treatments involve the use of gels, lotions and creams. These should be applied to the entire affected area, and not just to individual spots.

Benzoyl peroxide
This kills bacteria, reduces inflammation and aids the unblocking of pores. So this may be successful in the treatment of blackheads, whiteheads and inflamed spots. This can be bought at a pharmacy, under different brand names and strengths. Use the lowest strength (2.5%) first. It may have the best effects with the least irritation.

If you need to increase the strength, do it in gradual steps. Apply daily at first, remembering to wash it off after a few hours. Then increase the amount of time that this is left on the skin before removal. Once you are used to this preparation, try using it twice daily.

To apply it, wash your skin about half an hour beforehand. Be aware that it has a bleaching effect on bed-linen, towels or clothes that it comes into contact with.

RetinoidsThese include tretinoin, isotretinoin, and adapalene -- under various brand names. They can help to unblock pores and treat blackheads and whiteheads and minor inflamed spots. You will need a doctor's prescription to get a topical retinoid.

Using retinoids may cause some reddening of the skin and even peeling. There also may be some irritation and dryness. The spots may even get slightly worse before the improvement can be seen. This usually settles after a certain amount of time.

Also the skin may be more sensitive to sunlight; therefore night-time application is probably better, or the additional use of sun protection cream.

Pregnant females should not use retinoids, nor should those intending to become pregnant, as there is a slight risk of harm to unborn babies. Reliable contraception should be discussed with the doctor, when applicable.

Azelaic acid
This unplugs blocked pores, so this is useful for clearing blackheads and whiteheads. It can also help to reduce inflamed acne, but is less successful than benzoyl peroxide in this respect. Nevertheless, it usually causes less skin irritation than benzoyl peroxide.

Topical antibiotics
These require a prescription from a doctor. They reduce the number of bacteria present on the skin, and therefore lessen inflammation. They do not work on blocked pores, however. Although they produce fewer side-effects than other topical preparations, they may cause mild irritation.

Combinations
Many preparations include a mixture of substances; benzoyl peroxide plus an antibiotic is a common combination, as is a retinoid plus an antibiotic. Skin specialists consider that the combination can work better than the sole use of one ingredient.

Tablets to treat acne

Tablets containing antibiotics work by killing the bacteria that contribute to the presence of acne. They also reduce inflammation of the spots and also the surrounding skin. It is essential to read the instructions that come with these antibiotics, as there are varying side effects and precautions to consider, according to the specific antibiotic used.

Tetracycline based antibiotics are very commonly used for acne treatment. These are: oxytetracycline, tetracycline, doxycycline, lymecycline and minocycline.

Women who are taking the contraceptive pill should use additional contraceptive precautions for the first three weeks of taking antibiotics.
Tetracycline based antibiotics should not be taken by women who are pregnant, breastfeeding, or intending to become pregnant; contraception should be considered as necessary.

Tetracycline should be taken between meals with a glass of water. This is because food and especially milk-based foods affects the absorption of oxytetracycline or tetracycline. Doxycycline, minocycline and lymecycline can be taken at the same time as food.

Erythromycin and trimethiprim are antibiotics that occasionally prescribed for people who have found the other antibiotic treatments unsuccessful.

The contraceptive pill
The combined oral contraceptive pill can be helpful for some women whose acne relates to hormonal changes. It is the oestrogen part of the pill that is considered to be the significant factor in its helpfulness.

Isotretioin
These highly-effective tablets affect the amount of sebum that the sebaceous glands produce. However, this is only prescribed after all other options have been tried, as there are potentially serious side effects associated with this medication.

It is important to remember that any treatment will take up to four weeks in order to show visible improvement. It can even take up to four months for maximum response to show. Failure to eradicate acne is often due to people giving up their treatment if they do not see improvement in the first couple of weeks.

Once spots have disappeared, acne can suddenly return at a future date. Therefore, maintenance treatment is recommended; this involves the use of benzoyl peroxide or a topical retinoid.

These can be used indefinitely, and the dosage required to prevent the recurrence of acne is relatively small, compared with the original acne treatment.

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