For moderate to severe acne, you may need oral antibiotics to reduce bacteria. Usually, the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin). A macrolide may be an option for people who can't take tetracyclines, including pregnant women and children younger than 8 years old. This ingredient kills acne-causing bacteria, helps remove excess oil from the skin, and removes dead skin cells, which can clog pores.
Benzoyl peroxide products that you can buy without a prescription are available in concentrations of 2.5% to 10%. Studies show that products with a lower concentration are as effective as preparations with a higher concentration. Consider starting with a lower concentration (2.5%) water-based product to reduce the risk of side effects. Possible side effects include dry skin, peeling, irritation, burning, and stinging, especially if you have sensitive skin.
Use caution when applying benzoyl peroxide, as it can discolor hair and clothing. It has no whitening effect on dark spots that may remain after acne has disappeared (post-inflammatory hyperpigmentation). Topical therapy is the standard treatment for mild to moderate acne. 3 Retinoids and antimicrobials, such as benzoyl peroxide and antibiotics, are the basis of topical acne treatment.
These treatments are active at the application sites and can prevent new injuries. 4 The main side effect is local irritation. Gels, compresses (pads soaked with medication), soaps, and solutions tend to dry out and are useful for oily skin. Lotions, creams and ointments are beneficial for dry and easily irritated skin.
Most topical preparations require at least six to eight weeks before improvement is seen; they can be used for years as needed. In addition, “retinoid creams are best for “comedonal acne”, which appear as small bumps or pores filled with dead skin cells. Effective acne treatment reduces the risk of leaving scars and damaging the self-esteem in a lasting way. Systemic antibiotics should not be used to treat mild acne because of the risk of increasing resistance.
The common differential diagnosis of acne includes folliculitis, keratosis pilaris, perioral dermatitis, seborrheic dermatitis, and rosacea. If you have acne that doesn't respond to personal care and over-the-counter treatments, make an appointment with your doctor. In addition, “some over-the-counter acne preparations are chemical exfoliants, such as salicylic acid or glycolic acid, and they work by destroying dead skin cells, but they must be used with care to prevent excessive exfoliation., skin irritation and worsening acne. There are different variants of acne, such as acne conglobata, fulminant acne, mechanical acne, excoriated acne, chloracne, and drug-induced acne (e.g., when you have a lot of inflammation, the treatment you can buy without a prescription is usually not effective in treating acne).
Williams says, “If you're pregnant or trying to get pregnant, consult a dermatologist before treating acne on your own. Over-the-counter acne medications can cause initial side effects, such as redness, dryness, and peeling, which usually improve after the first month of use. So, if you're predisposed to acne and if you have a diet that's very high in dairy and junk food, yes, that could make acne worse, he said. In this installment, two doctors took time to discuss what patients should know about treating acne.
The approach depends on the severity of the acne, treatment preferences and the patient's age, as well as on adherence and response to previous treatment (table).
