Tuesday, January 17, 2006
Acne Treatment
These are the 4 IMPORTANT FACTORS in the formation of ACNE:- Increased Sebum or Oil Production
- Abnormal keratinization (sloughing off of dead skin cells) causing comedones (whiteheads and blackheads)
- Proliferation of Propionebacterium acne bacteria
- Inflammation
Prescription Medications for Treating Acne
- Isotretinoin (Accutane) - the reserve drug against acne. Usually given for severe cystic acne and those resistant with antibiotics, interlesional steroid, and topicals. Click here to read MY PERSONAL ACCOUNT on the use of ACCUTANE.
- Interlesional Steroid - When an acne cyst becomes severely inflamed, there is a good chance that it will rupture and scarring may result. To treat these severely inflamed cysts and prevent scarring, dermatologists may inject such cysts with a much-diluted corticosteroid. This lessens the inflammation and promotes healing. An interlesional corticosteroid injection works by "melting" the cyst over a period of 3 to 5 days. Kenacort-A (Generic: Triamcinolone acetonide) is the available formulation in the Philippines.
- Oral Antibiotics - given to reduce the population of the bacteria P. acnes which is associated with the inflammatory process of acne formation. Antibiotics include tetracycline, erythromycin, clindamycin, and minocycline. The regimen is usually one dose a day for a week or two. But, the regimen varies on the severity of the acne and the drug to be used.
- Oral Contraceptives - the most popular here in the Philippines is the Diane. Oral contraceptives have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands and can be used as long-term acne therapy.
- Topical antimicrobials - just like the oral antibiotics, its purpose is to control growth of P. acnes. This includes azelaic acid, benzoyl peroxide, clindamycin, erythromycin, and sodium sulfacetamide. The use of these entails religious daily long-time application.
- Topical retinoids - the mechanism of action of this group of drug is to unclog the pores by sloughing off the upper dead cells of the skin, a mechanism called desquamation. These prevent formation of whiteheads and blackheads. Adapalene, tazatorene, and TRETINOIN are examples. TRETINOIN has been referred by dermatologist to be A MAINSTAY IN ACNE TREATMENT.
Physical Procedures for Treating Acne
- Chemical Peels
- Comedo extraction - To extract whiteheads and blackheads, dermatologists use a sterile pen-sized device. This procedure should only be performed by a dermatologist or other medical professional. Patients' attempts to extract comedones and drain cysts by squeezing or picking, can lead to worsening of the acne, scarring and infection.
- Drainage and Surgical Excision - Some large cysts do not respond to medication and may require drainage and extraction. Drainage and extraction, which is also called "acne surgery," reduces the pain associated with these cysts and decreases the likelihood of scarring. It should not be performed by patients. Dermatologists are trained in the proper technique and perform "acne surgery" under sterile conditions.
- Phototherapy (Laser and Light Treatments) - Several laser and light treatments are available to treat acne. Some of these laser and light treatments target only one factor that causes acne - P. acnes. For many patients, this is not a comprehensive treatment for resolving their acne. A dermatologist can determine if laser or light treatment is appropriate for a patient.
