Notwithstanding the testimonials seen on late-night television infomercials for acne preparations, there is no "one size fits all" treatment for acne. In fact, the active ingredients in these advertised preparations can usually be obtained less expensively in other over-the-counter products.
Over-the-counter products effectively manage many cases of mild acne, but prescription medications may be required for severe cases. In this issue, I will present a summary of the various topical agents that are available to manage acne.
When choosing treatment for the various types of acne, the modes of action of each agent should be considered.
Dermatologists generally employ these agents in various combinations and in conjunction with oral antibiotics, if necessary.
BENZOYL PEROXIDE
Potent antibacterial agents, benzoyl peroxide preparations improve both inflammatory and no inflammatory lesions. They dry and peel the skin, and they help to clear blocked follicles. Benzoyl peroxide may be used alone to treat mild acne, but for more severe cases, it should be used in conjunction with topical retinoid. Benzoyl peroxide is an ingredient of many brand name over-the-counter products, such as Vilantae and Clearasil 5 and 10, as well as less-expensive generic products.
These products include both water- and alcohol based vehicles; some are soaps, medicated pads, and washes. The soaps and washes may not be as effective as the lotions, creams, or gels, which will not wash off the skin as readily.
Advantages of benzoyl peroxide based products:
- Available over the counter.
- No reported bacterial resistance.
- Available in many formulations, including cream and liquid. (Water-based gels are less irritating than alcohol-based preparations.)
Disadvantages of benzoyl peroxide based products:
- Occasionally irritating (causes stinging, redness)
- Contact sensitivity may occasionally occur.
- May bleach clothing and bed linen.
HYDROXY ACIDS CONTAINING GLYCOLIC ACID
Also known as fruit acids - hydroxyl acids (AHAs) that contain glycolic acid have become very popular. Although they are not comedolytic, they may help some patients with mild acne, particularly when used in combination with topical retinoid. AHAs loosen the bond of dead skin cells and thus accelerate exfoliation. They also appear to smooth and repair photo aged skin. Over-the-counter products contain low concentrations of AHA. Peels and products applied and dispensed by physicians for the treatment of wrinkles and pigmentary disorders are stronger and much more effective exfoliating agents.
RETINOLS
Although retinols were originally marketed to fight aging skin, they are currently being touted for use in treating acne. Their efficacy in acne has not been scientifically tested.
MULTI-INGREDIENT OVER-THE-COUNTER PRODUCTS
There are numerous products that contain various combinations of resorcinol, aloe, glycolic acid, sulfur, and salicylic acid. Also, there are herbal remedies with aloe and benzoyl peroxide, some of which contain betonies as a tint. Such products are difficult to evaluate clinically.
Read Acne treatment product reviews: acne-stop.com
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