Acne Treatments

Acne treatment consists of reducing sebum production, removing dead skin cells, and killing bacteria. Treatment methods differ depending on how serious the acne is. Topical drugs are applied directly to the affected areas of the skin. They are available in the form of creams, gels, lotions, or pads. They are used primarily to treat mild forms of acne in which there is little or no inflammation.

One group of topical drugs used for acne includes antibiotics. These drugs kill the bacteria that contribute to the disease. Another group of drugs is called comedolytics (pronounced KO-mee-do-LIE-tiks). These drugs loosen hard plugs and open pores. Still another group of drugs works by increasing the rate at which new skin cells form. These drugs prevent the formation of new comedos.

Topical drugs are applied once or twice a day after washing with mild soap. Treatment may have to continue anywhere from a few weeks to a few months to a few years. Side effects such as mild redness, peeling, irritation, dryness, and an increased sensitivity to sunlight may occur.

Oral Drugs

Oral drugs are taken by mouth. Doctors sometimes prescribe oral antibiotics for moderate cases of acne. These antibiotics prevent the formation of new comedos and reduce inflammation. They are usually taken once a day
for two to four months. Side effects may include allergic reactions, stomach upset, vaginal yeast infections, dizziness, and tooth discoloration.

A drug that is used for severe cases of acne is isotretinoin (pronounced i-so-TRET-uh-no-un, trade name Accutane). This drug reduces the production of sebum and the stickiness of skin cells. It is used when cysts and nodules are present. The drug may be used alone or with other topical or oral antibiotics.
Isotretinoin treatment usually lasts for four or five months. It is effective in about 60 percent of all patients. If the acne reappears, another course of treatments may be necessary. Some side effects that may accompany the use of isotretinoin include nosebleeds, dry skin, a temporary worsening of the acne, vision disorders, and increased production of liver enzymes, blood fats, and cholesterol. It may also cause birth defects and cannot, therefore, be used by pregnant women.

Women who do not respond to any of these treatments may be given another type of oral drug, an anti-androgen. Anti-androgens reduce the production of androgen and therefore reduce the formation of comedos. Certain types of oral contraceptives are also effective as anti-androgens.

The most serious forms of acne require other types of drugs, including oral corticosteroids, or anti-inflammatory drugs. These drugs are often used for the treatment of a form of acne known as acne fulminans, which occurs mostly among adolescent males. They are also used with acne that produces numerous deep, inflamed nodules that heal with scarring.

FAQ on Sunscreens and Sunburns

1. “How Much Sunscreen Should I Apply?”

The average user of sunscreen tends to use significantly less sunscreen than the amount required to achieve the SPF listed on the container.

2. “How Often Should I Apply Sunscreen When I’m Out In The Sun?’”

Many experts recommend that frequent application during sun exposure is required. However, a group of children were tested by spreading on 1 application of sunscreen to one side of their bodies, and four applications to the other.

They then spent 6 hours in the sun. One application provided the same level of protection as four applications, confirming the adequacy of a single daily application of a sunscreen in that situation.

3. “How Long Before Sun Exposure Should I Apply Sunscreen To My Skin?”

As molecules of sunscreen are present in their active state in the sunscreen, sunscreens work immediately upon application. The only reason for application early is to allow absorption into the skin so that the sunscreen is less likely to be washed off, should the person be entering the water. Even so, modern sunscreens are quite resistant to removal from the skin.

4. “Sun Protection Factor (SPF) - What Is It?”

SPF is the ratio of the minimal ultraviolet dose required to produce redness with and without a sunscreen. For example, if it took ½ hour for your skin to become sunburned without any sunscreen, then for a sunscreen that has a 15 SPF rating, you could stay in the sun for 15 times longer (or 7.5 hours) before you get sunburned. This is provided, of course, that you’ve applied the sunscreen properly so that you’re getting the prescribed protection.

5. “Reactions To Sunscreens?”

Sunscreens can be both an irritant and an allergen, though allergic reactions are rare. Irritant reactions, however, abound. One classic error in sunscreen application is to put a large amount of sunscreen on the forehead. Perspiration and gravity can cause the sunscreen to migrate down your forehead into your eyes, causing a stinging sensation. Some people attribute this to an allergic reaction and discontinue use. It’s also important to wash your hands after applying sunscreen, since rubbing your sunscreen covered finger near your eyes can induce an irritant reaction.

6. “Why Is It Important To Use Sunscreens During Childhood?”

It appears that a great deal of time can elapse between actual sun damage and the development of skin cancer or other skin problems like photoaging. Therefore, it is important to protect your skin from an early age when you are out in the sun.

7. “Sunscreens And The Elderly?”

Many elderly people can become quite obsessed by sun avoidance, and their quality of life can suffer. Sometimes, if they are diagnosed with an actinic keratosis or basal cell carcinoma, they can become anxious and almost leap from shadow to shadow. However, few of them are likely to develop new skin cancers from present sun exposure. As long as they are prudent about avoiding excessive sun exposure and protecting their skin to prevent sunburn, they can continue to enjoy time outdoors.

8. “Can Sunscreens Prevent Cancer?”

There is clear evidence that sunscreens are helpful in preventing actinic keratoses, which are warty lesions that can occur on sun-exposed skin of the face or hands. Research has shown that these lesions can develop into a cancer called squamous cell carcinoma, and that this is linked to a cumulative exposure to the sun.

However, there is surprisingly little evidence that sunscreens have much effect in preventing another kind of skin cancer called basal cell carcinoma, or for malignant melanoma. For malignant melanoma and for basal cell carcinoma, the character and timing, that is, the type of sunlight and your age at the time of the exposure to the sun appears to be more important than the cumulative dose.

Adapted from an article by David I. McLean, MD, and Richard Gallagher, MA.