What is the treatment of Acne ?

March 12 23:42 2019 Print This Article

There are many options available in the market for the treatment of acne. There results are not proven scientifically. The general successful treatment does not show much improvement in few days. They must be continued for three months. There are many treatments that promise big improvements within 14 days but can be disappointing.

1. The small usage of cortisone can give good results and other treatments can also be helpful by improving the active spots and excluding the all active spots. The general treatment works in different ways. The modes of improvement are not fully known. The different ways could be the anti inflammatory effects, manipulation of the hormones, shedding in the pore to prevent the blockage and killing the P. acnes. So, a combination of treatments must be used to reduce the amount and severity of this disorder. The treatments which are more effective can lead to more side effects. They must be monitored and a step wise approach is needed.

2. The people must consult with the doctors prior to the commencement of treatment. A proper hygiene must be maintained. It involves the use of proper washing and skin care. It removes the bacteria and oils which may lead to the formation of acne. A few studies have shown that the placing of towel on the pillow every night can prevent the contamination of pillow. It affects the bacteria which cause acne. The affected areas must be touched with the clean hands which do not allow the transmission of bacteria from one part of the body to other.

3. There are widely available topical bactericidals which contain benzoyl peroxide. It is used in the treatment of mild and moderate acne. There is a gel available in the market which contains benzoyl peroxide. It must be used twice daily into the pores of affected areas. There are bar soaps and washes available in the market and they must be used depending on their concentration which can be as low as 2 percent and as high as 10 percent. It has the ability to dissolve the keratin and is referred as keratolytic. It also has the ability to kill P. acnes.

The benzoyl peroxide can bleach the hair as well as fabric. It must be handled carefully. In a study almost two third of the participants used a 10 percent benzoyl peroxide which showed a decrease in the acne. The results were seen after 6 weeks. The benzoyl peroxide is a strong oxidizer and do not give rise to bacterial resistance. It may lead to the dryness, irritation and redness. The treatment may include the low dose of benzoyl peroxide preparation. It is combined with the non comedogenic moistures which keep the skin wet.

4. There are other anti bacterial which are used to treat acne but they are not much effective. It includes the triclosan and chloro hexidine gluconate. They cause fewer side effects. The prescription strength of benzoyl peroxide is available in the vehicle form which penetrates deeper into the pores of skin.

5. There are certain topical antibiotics which are used to treat the infections by killing the bacteria. It acts in the blocked follicles and include the erythromycin, clindamycin and tetracycline. It is also effective in the oral use and this method prevents the possible side effects which lead to the upset of stomach and drug interaction. It is not sufficient to apply it over a large area. There are certain oral antibiotics which are used to treat the infections by killing the bacteria. It also acts in the blocked follicles and include the erythromycin, tetracycline and doxy cycline. It may also include the Trimethoprim.

The decrease in the P. acne bacteria does not reduce the oil secretion and abnormal behavior of the cell. This may lead to the blocked follicles. With the increase in resistant forms of P.acnes the antibiotic are becoming less effective with each passing day. The acne may reappear when the treatment is completed. It can be either with the topical application or the use of oral antibiotic.

6. There are many side effects of the tetracycline it can lead to the yellowing of the teeth. It causes the imbalance of gut flora. The systemic products are used as the topical have been ruled out. There are few anti microbial doses of the antibiotic like mino cycline which heals the acne. It also provides anti inflammatory effect.

7. There are certain hormonal treatments available which can improve the condition of acne. The combination of estrogen or progesterone along with the hormonal contraception has been an effective method. The combination of anti androgen with the estrogen is effective only in the reducing the androgen levels. Cyproterone is the anti androgen drug. Oestrogen is also known as the Diane 35. It is not available in the USA and it is replaced by the new contraceptive known as the progestin drospirenone. It has a fewer side effects than Diane 35. They can be used when the blood tests can show high levels of androgens. They are effective when this is not the case.

8. The treatment with the low dose spirono lactone shows anti androgenetic properties. It occurs mainly in the patients with poly cystic ovarian syndrome.

9. If there is a large pimple which is not affected by the other treatment than a dermatologist can give an injection of cortisone which decreases the hardness and redness. It occurs immediately. It makes the pimple flat and makes it easy to cover the pimple when one does the makeup. It also helps in the healing process. Its side effects are minimized. It includes a temporary whitening of the skin. It occurs around the injection point and a small depression forms which if persist can be filled eventually. This method has a small risk and is better than the surgical method.

10. The follicle cell life cycle are normalized by the group of medicines. It includes the tretinoin, adapalene and tazarotene. They all are related to the Vitamin A. They are given as topical and have mild side effects. They may cause irritation to the skin. They also affect the cell creation and the death of the cells present in the lining of follicle. It prevents the hyper keratinization of the cells and may cause the blockage. There is a form of Vitamin A which is known as the retinol which has mild side effects. It is used in the many over the counter moisturizers. The topical retinoids can cause flaring up of acne and the flushing of face. They have been effective in the past three decades and are available on the basis of prescription and are not used as widely as other treatments. There are few oral retinoids which are available in the market.

A daily oral dose of vitamin A derivative iso retinoin for a period of 6 months may lead to the decrease in acne. The oral retinoids work by decreasing the secretion of oil from the glands and it also affects the other factors which affect the acne. The iso retinoin is also effective in reducing the severe form of acne. It can improve or clear around 80 percent of the patients. The effect of the drug is long and is better than the anti bacterial drugs. It requires a close supervision by the dermatologist. It has many side effects. After the treatment is over around one fourth of the patients develop relapse and after the second treatment for 6 months it may be indicated to have a better results.

11. There must be a time gap between the two treatments as the condition can improve after the treatment one. It also gives a chance to the body to recover. Sometimes a third or fourth course is also used. But their benefits are questionable. It may lead to the dry skin and nose bleed. They may also cause the flaring up of acne. It is severe and can occur within the month. It can be severe also. This may damage the liver of patients also. The blood sample of the patients must be taken and examined. It must be done before and after the treatment. The treatment is reduced as the enzymes present in the liver are elevated and cause injury to the liver. The reports of damage to the liver are unreliable.

The relevance of the routine testing is also questionable. There is a need to monitor the blood triglyceride level. In few countries the routine testing is a part of official guideline. A few press reports have suggested that the oral retinoid may cause depression. But this has not been universally accepted. They may also cause the birth defects in the women which are pregnant. So, the female patients can control the birth rate by the abstinence when they use this drug. The usage of this drug in the females must be controlled and they must be provided with the milder treatments.

12. There were some rules placed on the usage of drug in the USA so that it must not be misused. The oldest remedy of acne is the sulfur. Its use has been very ancient. It has been used from the Greek, Roman and Chinese time. There are sulphur formulations which are very effective as an antiseptic and ex foliant. It is hydrophilic and can go inside the sebaceous pores. It can cause local immune response by removing the infection which occurs due to the acne division.

The growth of acne bacteria is limited naturally and due to the acidic nature of skin and the use of alkaline cleansers one has a determental effect on the division of acne. There are few sulphur based cleansers which have a neutral or normal ph. They prevent the acne and prevent the future break out. They maintain the acidity of hydrophilic layer and are not able to control the growth of acne on the surface of skin. The keratin has a lot of sulfur and it helps in the synthesis of collagen. There is an active ingredient which is present in the prescription and in the counter lotions, gels, washes and shampoos. The sulfur also controls the rosacea, eczema, psoriasis, scabies and lice.

13. There is a cosmetic medical procedure which is known as derm abrasion. The surface of the skin is removed by abrasion. The abrasion is also known as the sanding. The sun damaged skin must be removed and is helped to remove the scars and dark spots present on the skin. It is a painful procedure and requires the help of general anesthesia. It is also known as the twilight anesthesia. In this case the patient is little bit conscious and the skin becomes raw and red later on. It takes many months for the skin to re grow and heal. The scar is removed by this process and the scar is raised above the skin. This condition is not effective in the case of sunken scars. This procedure was done with the help of small, sterilized electric sander in the past.

14. A carbon bi oxide laser is also a good technique to be used now days. The laser technique is better as it can be controlled easily and gauged. It is a bloodless technique. There is another technique known as the micro dermabrasion which came from dermabrasion. This technique is gentler and a more natural skin care. It is a less intensive technology for the exfoliation on the skin. The goal of this technique is to eliminate the superficial layer of the skin which is known as the epidermis.

On touching the abraded surface of skin one can feel the surface roughness on it. It is mainly due to the presence of keratinocytes which are present in the basal layer of skin. The stem cells proliferate to form the keratinocytes. They are moved into the epidermis and experience the gradual specialization in which it carries on until they reach the stratum corneum. They form a layer of dead cells which are flat and keratinized and are known as the squamous cells. It does not allow the foreign material to enter inside it and act as a barrier. It also prevents the loss of moisture. The new keratinocytes are replaced by the stratum corneum layer. The time of transit from basal layer to shedding is one month. The keratinocytes form the corneocytes during the terminal stages of the squamous epithelia.

15. The micro dermabrasion removes few corneocytes and these cells cause the impermeability of the skin. The skin foliation removes the scars and skin lesions along with the blotchiness of skin along with the stretch marks. The skin re modeling works on these principles. The results are average and there is a requirement of the moderate treatment when the scars are superficial. The scars which are present during the time of puberty or later can also be treated with the micro dermabrasion.

16. The treatment of acne in the short period can be done with the help of light exposure. A visible light has been used to treat this condition which has been quite successful in treating the mild or moderate cases of acne. This is referred as the photo therapy. In the intense ultra violet light which is produced by the florescent lightning, bulbs and lasers there is reduction in the acne around 64 percent when it is used twice in a week. It is more effective when it is used daily and it acts by the porphyrin mechanism. The free radicals are generated by the P. acnes when they are radiated by the 420 nm and short wavelength light. These free radicals kill the bacteria when they are applied for many days.

The porphynis are not present in the skin and if there is no use of ultraviolet lights it appears to be a safe mechanism. This has been licensed by the U.S FDA. If the ultra violet light is used along with the red light the treatment is more successful. It results in three fourth of the reduction in acne and three months of the daily treatment can reduce the acne in almost 80 percent of the patients. The overall clearance was better than the benzoyl peroxide. The chances of the bacterial resistance are very unlikely and are better than the other treatments. The clearance is long lived after the treatment and is better than the other treatments. This treatment has certain draw backs as it is new and is expensive. The overall cost is very high and is more than the other treatments.

17. There is another treatment which involves the use of photo dynamic therapy. There are few dermatologists which are related to the basic science and clinical work and have given the evidence that the intense blue or ultra violet light can decrease the inflammatory acne lesions by two third. It occurs during the four week of therapy. Mainly, it occurs when the P.acnes is pre treated with the delta amino levulinic acid. It is also known as ALA. It increases the production of porphyrins. This therapy is very controversial and has not been published in any of the peer journal. There was a phase 2 trial which showed the improvement but it did not show the improved response as compared to the previous method.

When the scars are deep rolling which are left by the acne they are treated with the help of subcision. It involves the separating of skin tissue in the affected areas and involves the deeper scar tissues. It allows the blood to move under the affected area and causes the deep rolling scar to level off and it lies with the rest of skin. After this phase there are other treatments which can be used to smooth out the scarred tissue and includes the laser resurfacing or chemical peels.

18. There is a laser surgery which is being used recently to reduce the scars which are left by the acne. There are few researches on lasers which have been done to prevent the formation of acne. The laser acts by a number of mechanisms. It burns away the follicle sac which gives rise to hair. It burns away the sebaceous gland which forms the oil and helps in the formation of oxygen in bacteria by killing them.

The thermal damage to the skin is caused by the lasers and intense pulsed light. These treatments can cause hyper pigmented spots or may lead to the dryness of skin. There are few companies which have been approved by the US to treat the acne condition. The efficacy studies used a very small sample size. It was a used for the period of less than half a year. No contradictory results were seen. As the laser treatment is relatively new the protocol remains to be amended. It is very expensive. There are some Smooth beam lasers which need a recall. The coolant may get fail which may result in the painful injuries.

19. There are certain treatments which are not widely used. It includes the use of aloe vera which is mentioned in the Ayurveda. It also includes the use of neem, haldi and papaya. The evidence about these products in the medical literature is limited. They show anti inflammatory effects except aloe vera.

20. In the case of mild comedonal acne azeliac acid is used. In the case of suspension and as an inflammatory agent calendula is used. In the case of spots cortisone is used. The heating is also successful in killing the bacteria in the developing pimple and increases the speed of healing. In the case of moderate acne one can use ibuprofen as it provides anti inflammatory effect.

21. There is a form of vitamin B3 which is known as the nicotinamide. It can be used topically as a gel. A study done in the year 1995 showed its comparable efficacy with topical antibiotics and was used for comparison.

22. The topical antibiotic is available both for the prescription and over the counter. They are effective in treating due to their anti inflammatory nature. It increases the synthesis of collagen, keratin and involucrin. It also decreases the skin hyper pigmentation. It increases the skin moisture and decreases the wrinkles.

23. There is tea tree oil which is also known as the melaleuca oil and is dissolved in a carrier which has 5 percent strength. It can be compared with the benzoyl peroxide. If it is not dried properly it can kill p. acne and shows anti inflammatory nature also. The pre menustral acne vulgaris has been improved by the use of Rofecoxib.

24. It has been proven in a placebo controlled study. The zinc is administered orally as a zinc gluconate. It shows anti inflammatory nature also. It is less effective in case of tetracyclines.

25. The treatment of acne is done with the help of detoxification. There are no studies which prove these results. In this process the body toxins are cleansed with the help of medicines and are caused by the use of environment, drugs and food.

What is the future treatment of Acne ?
There has been a vaccine against the inflammatory acne which has been tested successfully in case of mice and one is hopeful that it can work in the humans also. In the year 2007 a micro biology article reported that the first genome sequencing said that one must greatly enhance the development of potential bacteriophage therapy. It is done to treat the acne and it overcomes the problems which are linked with the long term antibiotic therapy along with the bacterial resistance. There is a retinoic acid metabolism blocking agent which is known as Talarazole. It is under the investigation as its use in the acne therapy.

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