Acne vulgaris or acne is a chronic inflammatory skin disorder occuring within  acne-infected hair follicles – four processes have been identified as major culprits:

  • disorderly keratin formation which clog the follicles (comedo effect).

  • excessive androgen-controlled excitation of sebaceous gland activity

  • inflammation

  • propionibacterium acnes growth

Factors like genetics, race, sex, diet, immune status, obesity, stress, hormonal imbalance all affect safe acne treatments.

It afflicts over 80% of the population aged 14-30 with 22-24% of this group enduring permanent scarification which eventually can determine the type of acne treatment or acne treatment products.

The Symptoms of Acne

Safe acne treatment or acne topical treatments must consider the fact that acne can present as whiteheads, blackheads, and pimples due to the immuno-stimulating roles which produce active molecules and proteins like lipases, proteases, chemo tactic factors and hyaluronidase

How is Acne Treated?

The production of pro-inflammatory cytokines (proteins) e.g. 1L-1, 1L-8 and
TNF – laid the foundation for the acceptable acne treatment options to reflect genetics, hygiene, hormones,dietary, racial and lifestyle factors. Hence, safe acne treatment options range from topical creams, antibiotics, sebum-reducing agents, anti-androgens and oestrogens depending on acne type,skin sensitivity and severity.Invariably,safe acne treatment is compatible and healthy acne treatment.

Topical And Safe Acne Treatment

There are a variety of topical acne products. Keeping a clear skin is important while avoiding skin products that may clog the pores. Wash your skin once to twice a day. A full medical and family history is usually taken by doctors to optimize safe acne treatment,minimize side effects and broaden healthy treatment options.

Topical Treatment – Retinoids

Safe acne treatment incorporates a deliberate approach at optimizing results by reflecting individualized treatment modalities, viz-a-viz side effects, lifestyle, immunological and hormonal status.

Retinoids are derivatives of Vitamin A and are essentially of 3 types: tazarotene, tretinoin, adapalene.They are available as creams, gels, and liquids. Notable side effects like erythema, peeling and irritation are inconsistent and usually dose-related. They are used alone or in combinations depending on aim of acne treatment which can be comedolytic,anti-inflammatory or to normalize follicular hyperproliferation and hyperkeratinization. They reduce microcomedones, comedones or inflammatory conditions.

Topical Treatment – Antibiotics

Topical antibiotics in acne treatment aim at combating the role of P. acnes – more effective results come from combination therapy especially with Benzoyl peroxide, which also reduces the likelihood of resistance to antibiotics. The commonest antibiotics are Clindomycin, erthromycin, tetracycline and minocycline. A more advocated recommendation is a treatment period of  6-8wks while being cautious  of irritant dermatitis and hair bleaching.

Oral Antibiotics:Systemic Treatment

Doxycycline, minocycline and tetracycline are the most recognised examples. Minocycline is efficacious against mild-moderate acne same is also true for doxycycline. Combination acne treatment has proven to be effective against inflammatory acne and may consist of:

  • topical prescription

  • topical prescription antibiotic,gels, creams or lotions

  • prescription oral antibiotics

  • prescription oral isotretinoin e.g. accutane(has significant side-effects)

5. Oral antibiotics are useful in moderate to severe acne especially if there has been prior resistance to topical acne treatments E.g. tetracycline,doxycycline, minocycline,erythromycin and oral isotretinoin (for moderate to severe nodulo- cystic acne.)

Hormonal Therapy in Acne Treatment

Female patients with acne are the main recipients of hormonal therapy especially in cases of moderate to severe nodulo-cystic acne. This employs the use of oestrogen to suppress ovarian androgen, systemic anti-androgens, and glucocorticoids to suppress adrenal androgens.

Oral contraceptives reduce acne progression by decreasing free active testosterone, having earlier been ascertained that there is a significant consequential link between circulating androgens and acne severity.

Anti-androgen compounds like oral contraceptives and androgen-receptor inhibitors e.g. flutamide, spironolactone are in use. Safe acne treatment will entail adequate consultation with your doctor to ascertain patient peculiarity and the safety window. Most importantly, safety profiles are usually dose related.

Isotretinoin

This drug acts by blocking sebaceous gland proliferation and differentiation,decreases the size of sebaceous glands and suppresses sebum production. It exists as a naturally-occurring metabolite of Vitamin A – adverse effects could range from dry lips, headache, dry eyes.

It is pertinent to note that there is no “one size fits all” with regards to acne treatment.Accutane has been clinically proven to be effective against cystic acne.

Retin A and Renova are tested topical derivatives of vitamin A and are effective in clearing up fine line, wrinkles and skin discolorations,same for salicylic acid and Benzoyl peroxide.Click here to learn more.

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