Overcoming Acne 2: How to treat acne

In Part 1 of this series, we have learnt that the cause of acne for one person may not necessarily be the same for another person.

Searching for the best acne cure is no easy feat.

With so many products out there, how do you know what will work? No single product will be the miracle cure for all spots. The best product for you depends on the type of acne you have.

Closed and open comedones

Essentially, comedones are pores clogged with skin cells. They are best resolved using a group of ingredients called keratolytics. They remove and/or prevent the build-up of these cells by speeding up the turnover of the top layer of our skin.

Some examples of keratolytics are

• Salicylic acid – A type of beta-hydroxy acid (BHA). Works by clearing out the clogged pore.
• Glycolic / lactic acids – Different types of alpha-hydroxy acids (AHAs). Removes surface skin cells in a controlled and even manner.
• Tretinoin – Also known as Retin-A. Regulates cell regeneration from deeper in the epidermis and is prescribed for both mild to moderate acne.

 

Papules and pastules

Comedones that become infected are papules and pastules.

They are usually associated with bacteria, so the best ingredients to treat them have anti-bacterial properties. They are usually topical (or applied), and some of them require prescription.

Common topical anti-bacterial ingredients are

• Benzoyl peroxide
• Tea tree oil
• Antibiotics (e.g. tetracycline and erythromycin)

Nodules and cysts

The most extreme cases of acne are nodules and cysts. They are severely inflamed so prompt medication is necessary to stop and prevent further infection.

These are typically drugs ingested for a systemic (or whole body) effect. Some examples of medication for moderate to severe acne are

• Antibiotics – E.g. tetracycline and erythromycin
• Contraceptive pill – Regulates hormones (androgens) causing excess oil production.
• Isotretinoin (roaccutane) – Reduces oil production, bacteria and inflammation; regulates cell turnover; prevents excess cell/sebum buildup within the pore.

The best treatment

By now you will have realised that there is no single best acne treatment.

The best one is what’s most appropriate for the type of acne you have. Something that works well against blackheads will not be equally effective against cysts.

After clearing your skin with the right treatment, your work is not finished yet! You do still want to keep your skin looking clear right? That’s coming up in the final part of this series.

 

References

Jo-Ann See, Drug treatment of acne, Aust Prescr 2012;35: pp180–2

John S. Straus et al., Guidelines of care of acne vulgaris management, J Am Acad Dermatol 2007;56:pp 651-63

Andreas D.Katsambas et al., Guidelines for treating acne, Clinics in Dermatology 2004;22:pp 439-444

Thiboutot et al., New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group, J Am Acad Dermatol, May 2009, Vol 60:5 Supplement 1, pp 1-50