The most common topical prescription medications for acne are as Nodular and cystic lesions can be treated by injecting a steroid drug.  The most studied topical retinoids for acne treatment worldwide are tretinoin and adapalene. There is no consensus about relative efficacy of currently. Current treatments for acne are effective but regimens are complex and side effects are common. Better understanding of the pathology of acne.
Treatments for Acne Current
Blackheads are just dirt. You can wash acne away. Too much scrubbing of your skin can further irritate the skin and trigger inflammation. You can't wash acne away! Pregnancy will help acne. Hormonal changes related to pregnancy or with stopping or starting oral contraceptives can cause acne in some people. Masturbation causes acne or makes acne worse. Using lots of over-the-counter acne medication containing active ingredients such as benzoyl peroxide and salicylic acid will improve acne.
Eating too much junk food or drinking too much soft drink can cause acne. Although a balanced diet high in fruit and vegetables will provide the vitamins and minerals necessary for good health, having a balanced diet will not in itself clear your skin and 'cure' your acne.
Acne cannot be 'caught' or transmitted from one person to another. Touching a pimple and then touching someone else on the skin will not increase their chances of forming a pimple.
Make-up and moisturisers won't make acne worse. Some particular face moisturisers or make-up can make acne worse. Oil-based foundation can make acne worse.
A silicone-based foundation is better for people with acne prone skin. Acne is caused by allergies. There is no evidence that acne has any connection with any allergic reactions you may have. Steroids won't cause acne. Anabolic steroids illicitly used for bodybuilding often cause acne and are linked to more severe forms of acne seen in some men. Some prescribed medications won't make acne worse. Some prescribed medications may aggravate or trigger acne. A doctor or pharmacist can advice you on this.
Acne is caused by poor hygiene. Acne happens when the oil glands pores in the skin become blocked. Hormones make the oil glands produce more oil sebum and if the pores are blocked, a build-up occurs and you've got acne.
It is not caused by poor hygiene, however keeping your skin clean will help acne. Types of treatments Treating acne starts with good skin care. Treatments using retinoids can be very effective at unblocking pores of acne spots and preventing new blockages from developing. They are available as topical or oral treatments.
Both types reduce the acne-causing bacteria in the skin and have an anti-inflammatory effect. Oral antibiotics are generally used when acne is moderate to severe.
They can be used on their own or with a topical treatment. Isotretinoin tablets are the most effective treatment for severe acne as they address all known causes of severe cystic acne.
They work by unblocking and preventing further blockage of pores, reducing sebum or oil production and soothing the redness and inflammation of acne. Light therapy may be used to treat mild to moderate acne with biophotonic therapy working best on inflammatory acne. Some low dose, very low dose oestrogen and anti-androgen contraceptive pills can help some women to manage their acne by regulating their hormones. It may cause hyperkalemia when higher doses are prescribed or when there is cardiac or renal compromise , menstrual irregularities.
It is the first androgen receptor blocking agent to be well studied and found to effective in acne in females. It is useful in acne when given in females with hirsuitism. Oral retinoid is indicated in severe, moderate-to-severe acne or lesser degree of acne producing physical or psychological scarring, unresponsive to adequate conventional therapy.
Although there are many studies, but very large evidence-based study is lacking to confirm the dosing schedule. The approved dose is 0. Side effects include those of musculoskeletal, mucocutaneous, and ophthalmic systems, as well as headache, and central nervous system effects.
Oral isotretinoin is a potent teratogen. Therefore women of child-bearing age require negative pregnancy test before treatment, strict contraceptive measures essential before, during and even 6 weeks posttherapy. Both open and closed comedones can be removed mechanically with comedone extractor and a fine needle or a pointed blade.
Gentle cautery and laser puncture of macrocomedones are also useful procedure. Aspiration of deep inflamed lesion may be needed in few cases which are followed by IL steroid injection in cysts and sinus tract. They are indicated for mild-to-moderate inflammatory acne. In vitro and in vivo exposure of acne bacteria to — nm of ultraviolet free blue light results in the photo-destruction through the effect on the porphyrin produced naturally by P.
Acne scar can be broadly divided into two groups, those involving tissue losses Ice pick scar, Box scar, Rolling scar, and Follicular macular atrophy and those involving tissue excess hypertrophic scars or keloids. Currently available treatment for scars include simple excision, and suturing, either alone or combined with punch grafting and laser resurfacing, dermabrasion, various type of lasers, chemical peels, and fillers.
For hypertrophic scars, treatment includes pressure therapy, IL corticosteroid, 5-fluorouracil and bleomycin injections, surgical excision, radiotherapy, laser therapy and cryotherapy. All the procedures have their own merits and demerits; to be chosen carefully seeing the merit.
Dietary restriction has not been demonstrated to be benefit in the treatment of acne. Of late, various authors again claiming that there is the definite role of diet in acne but to conclude that further controlled trials are needed. The benefit of dietary management in the treatment of acne has been neither demonstrated nor disproved. Various topical and systemic drugs are available to treat acne, which may sometimes confuse the treating dermatologist. Similar alliance has also been formed in India recently with their recommendations.
It is an excellent choice in women requiring oral contraceptive estrogen containing for other reason and having moderate-to-severe acne with SAHA symptoms. Oral antiandrogen like spironolactone and cyproterone acetate can be useful in the treatment of acne. It is approved in severe recalcitrant nodulocystic acne. It can also be used in moderate-to-severe acne vulgaris resistant to conventional therapy, frequently relapsing, with severe psychological and physical scarring due to acne.
Pre-treatment counselling, patient selection, and monitoring are critical due to its side effects like teratogenicity, and adverse psychiatric events. Sincere thanks to Dr. Rajesh Kumar, Mumbai for providing few of the reference articles. National Center for Biotechnology Information , U.
Journal List Indian J Dermatol v. Find articles by Sanjay K Rathi. Author information Article notes Copyright and License information Disclaimer. Received Aug; Accepted Dec. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC.
Abstract Acne Vulgaris is one of the most common skin disorders which dermatologists have to treat. Acne , treatment , consensus recommendation. Introduction Acne vulgaris is one of the commonest skin disorders which dermatologists have to treat, mainly affect adolescents, though it may present at any age.
Topical therapy Topical therapy is useful in mild and moderate acne, as monotherapy, in combination and also as maintenance therapy. Benzoyl peroxide It is an effective topical agent since many years and is available in different formulations washes, lotions, creams, and gels and concentrations 2.
Topical retinoids Retinoids have been in use for more than 30 years. Topical antibiotics Many topical antibiotics formulations are available, either alone or in combination. Systemic Therapy Systemic antibiotics 0Oral antibiotics are indicated in mainly moderate-to-severe inflammatory acne. Antibiotic monotherapy is to be avoided and it can be combined with topical retinoid or benzoyl peroxide as per need.
Wherever possible the duration of therapy should be limited. The usual minimum duration of therapy is 6—8 weeks but can be given up to 12—18 weeks and more. It is advisable to use the same antibiotic if retreatment is necessary and use benzoyl peroxide for a minimum of 5—7 days between antibiotic courses to reduce resistant organism.
Concomitant use of oral and topical therapy with chemically dissimilar antibiotics is to be avoided. Oral isotretinoin Oral retinoid is indicated in severe, moderate-to-severe acne or lesser degree of acne producing physical or psychological scarring, unresponsive to adequate conventional therapy. Physical treatment of scars Acne scar can be broadly divided into two groups, those involving tissue losses Ice pick scar, Box scar, Rolling scar, and Follicular macular atrophy and those involving tissue excess hypertrophic scars or keloids.
Acne and diet Dietary restriction has not been demonstrated to be benefit in the treatment of acne. Conclusion Various topical and systemic drugs are available to treat acne, which may sometimes confuse the treating dermatologist.
Combination therapy It works better and clearing of lesion is faster. Antibiotics Oral and topical antibiotics not to be used as monotherapy to prevent bacterial resistance. Generally oral antibiotics are well tolerated, sometimes associated with severe adverse events.
Hormonal therapy It is an excellent choice in women requiring oral contraceptive estrogen containing for other reason and having moderate-to-severe acne with SAHA symptoms. Oral isotretinoin It is approved in severe recalcitrant nodulocystic acne. Acknowledgments Sincere thanks to Dr.
Footnotes Source of Support: Nil Conflict of Interest: Disorders of the sebaceous glands. Rook's Text book of Dermatology. Pathogenesis and pathognesis-related treatment of acne. New understanding of the pathogenesis of acne. J Am Acad Dermatol. Plewig G, Kligman AM. Martin Dunitz Ltd; Treatment of acne vulgaris: Fyrand O, Jakobsen HB.
Water-based versus alcohol-based benzoyl peroxide preparations in the treatment of acne vulgaris. The short term treatment of acne vulgaris with benzoyl peroxide: Effects on the surface and follicular cutaneous microflora. Topical antibiotics for the treatment of acne vulgaris: A critical evaluation of the literature on their clinical benefit and comparative efficacy.
Comparison of two concentrations of tretinoin solution in the topical treatment of acne vulgaris. A comparison of the efficacy and safety of adapalene gel 0. Topical tretinoin in inflammatory acne: A retrospective, investigator-blinded, vehicle-controlled, photographic assessment.
The mechanism of topical retinoids. Krautheim A, Gollnick H. Topical tretinoin or adapalene in acne vulgaris: Comparative tolerance of adapalene 0. A comparison of the efficacy and safety of adapalene 0. Safety and efficacy of adapalene gel 0. Results of post-marketing surveillance study. Indian J Dermatol Venereol Leprol. An update of recent clinical trials examining adapalene and acne. J Eur Acad Venereol. Topical therapy for acne vulgaris.
How do you choose the best drug for each patient? Topical erythromycin solution in acne. Results of multicentric trial.
Antimicrobial susceptibility of Propionibacterium acne isolated from acne vulgaris. Inhibition of erythromycin- resistant propionibacteria on the skin of acne patients of topical erythromycin with and without zinc. Topical zinc therapy for acne vulgaris. Comparison of efficacy of topical clindamycin and nicotinamide combination with plain clindamycin for the treatment of acne vulgaris and acne resistant to topical antibiotics. Pseudomembranous colitis caused by topical clindamycin phosphate.
Comparative effectiveness of benzoyl peroxide and tretinoin in acne vulgaris. Comparison of the efficacy and safety of a combination topical gel formulation of benzoyl peroxide and clindamycin with benzoyl peroxide, clindamycin and vehicle gel in the treatment of acne vulgaris. Am J Clin Dermatol. Combination topical therapy in the treatment of acne. The combined use of topical benzoyl peroxide and tretinoin in the treatment of acne vulgaris. Katsamba A, Dessinioti C. New and emerging treatments in dermatology: Treatment of mild and moderate acne vulgaris with salicylic acid in an alcohol-detergent vehicle.
Acta Derm Venereol Suppl Stockh ; Efficacy of topical azelaic acid gel in the treatment of mild-moderate acne vulgaris. A randomized, double-blind placebo controlled study. A pilot study of the safety and efficacy of picolinic acid gel in the treatment of acne vulgaris.
New topical therapies for the treatment of acne vulgaris.
ACNE VULGARIS TREATMENT : THE CURRENT SCENARIO
Experts compare the latest acne treatments to time-tested remedies. used ProActiv, or is currently using it, and is dissatisfied with results. Current consensus recommends a combination of topical retinoid and antimicrobial therapy as first-line therapy for almost all patients with acne. But even that, as promising as it is, may fall prey to many of the same pitfalls as current treatments. The vaccine, which if put into use would be.