What you need to know about Acne Treatment
Acne may have
several causes but when it comes to acne treatment we can
summarize them into at least 3 categories (antibacterial acne medication,
pore unblockers, oil reducing acne medication). Most acne treatment medications
are using what we know as “monotherapy” acne treatment . Monotherapy
is an acne treatment procedure utilizing only one anti-acne
treatment product. This single anti-acne treatment product
may function as an antibacterial agent, keratolytic agent
or both. The best acne treatment product or acne medication
should be able to kill acne-causing bacteria, prevent the
formation of comedo or pore blockage and reduce the sebum
output of the oil glands.
best acne treatment product should also be able to reduce
skin irritation, accelerate skin repair and moisturize the
skin. Since there is no single anti-acne treatment product
or procedure that can address all the major causes of acne,
the only option that dermatologists have is to combine them
in a synergistic way. This acne treatment method is known
as multi-therapy acne treatment. Multi-therapy acne treatment
is better than monotherapy acne treatment because it utilize
the synergistic effect of several anti-acne medication or natural anti-acne products. Multi-therapy
acne treatment also includes bioactive ingredients that
are designed to accelerate skin repair, moisturize the skin
and reduce skin irritation.
Acne Treatment using Antibacterials: The main purpose of this acne medication
is to reduce the population of acne-causing bacteria known
as Propionibacterium Acnes. This bacteria cause redness
and inflammation of the oil glands; in more advanced cases
they cause the formation of pus. If left untreated, bacterial
infection can cause damage to the dermis, which would leave
depressed acne scars. Antibacterials can be taken orally or applied
topically. Topically applied antibacterials used in acne treatment has the least
amount of side effects and is generally safer to use. Oral
antibiotics are reserved for moderate to severe acne because
of its side effects to the internal organs and the issue
of “bacterial resistance”.
Common example of Antibacterials used as acne medication:
Azelaic Acid (Topical)
Topical and Oral Antibiotics
Acne Treatment using Keratolytic/Comedolytic agents: These are acne medications
that open up blocked pores and prevent them from being clogged;
This type of acne treatment is designed to open up the pores by encouraging the skin to peel. Peeling
removes trapped sebum and dead skin cells inside the pores.
In acne prone skin, there is an excess production of keratin
that causes the pores to become blocked with dead skin cells
and trapped sebum. Trapped sebum encourages the growth of
acne-causing bacteria because sebum is their main source of
nourishment. It is therefore necessary for an effective acne
treatment strategy to always keep the pores free from blockage.
Examples of Keratolytic/Comedolytic acne medication used in acne treatment:
Acid Family (Glycolic Acid, Lactic Acid)
Beta-Hydroxy Acid Family (Salicylic Acid)
Retinoids (Retinoic Acid, Adapalene, Retinol Palmitate)
3. Acne Treatment using Anti-Androgens: Oral anti-androgens are
effective in suppressing the male hormone, which causes the
oil gland to produce more oil. The problem with oral anti-androgen acne treatment
is that it can only be used by females. It cannot be used
by males for the purpose of just treating acne because it
can cause the reversal of male secondary sex characteristics.
Anti-androgens are used only by males under medical supervision
and in certain conditions such as in treating hypersexuality,
prostate enlargement and male pattern baldness. Currently,
there are no topical anti-androgens that are as effective
as oral anti-androgens.
Examples of Anti-Androgen acne medication used in acne treatment:
Cyproterone acetate (Androcur, Climen, Diane 35, Ginette 35)
Flutamide (Eulexin), nilutamide (Anandron, Nilandron)
Finasteride (Proscar, Propecia)
4. Acne Treatment using
Sebosuppresive agents: These are acne medications
that reduce the production of sebum in the oil glands. The
most effective sebosuppresive agent is oral isotretinoin.
Oral isotretinoin makes the size of the small glands smaller
thus they produce less oil. However, oral isotretinoin is
reported to produce very nasty side effects including liver
damage, depression, tendonitis and blood sugar problems. Since
oral isotretinoin is a bit dangerous, it is only prescribed
as a last line treatment for severe acne.
of oral sebosuppresive acne medication used in acne treatment:
Oral Isotretinoin (Accutane)
are topical sebosuppresive agents that are safer compared
to oral sebusuppresive agents but they are very modest in
reducing the amount of facial oil. Zinc Oxide and Copper Peptide
seems to block 5-Alpha Reductase. 5-Alpha Reductase is an
enzyme responsible for converting testosterone to dihydrotesterone,
the hormone responsible for triggering the oil glands to produce
more oil. Isolutrol is an extract from the bile of sharks
and is also aimed at reducing the oil secretion of the oil
glands. However, the results of the studies using Isolutrol
to reduce facial oiliness are mixed. Some studies say that
it can reduce facial oiliness while others say that it is
not effective. Topical niacinamide one study demonstrated
some ability to reduce facial oiliness.
of topical sebosuppresive acne medication used in acne treatment:
(Zinc Oxide, Copper Peptide, Isolutrol, Topical Niacinamide)
1. Combination azelaic acid therapy for acne vulgaris. J Am
Acad Dermatol. 2000 Aug;43(2 Pt 3):S47-50.
2. Acne therapy with topical benzoyl peroxide, antibiotics
and azelaic acid, J Dtsch Dermatol Ges. 2006 Apr;4(4):293-300.
3. Topical therapy for acne. Am Fam Physician. 2000 Jan 15;61(2):357-66.
4. A randomized, double-blind, multicenter, parallel group
study to compare relative efficacies of the topical gels 3%
erythromycin/5% benzoyl peroxide and 0.025% tretinoin/erythromycin
4% in the treatment of moderate acne vulgaris of the face.
J Cutan Med Surg. 2003 Jan-Feb;7(1):31-7. Epub 2002 Oct 9.
5. Study results of benzoyl peroxide 5%/clindamycin 1% topical
gel, adapalene 0.1% gel, and use in combination for acne vulgaris.
J Drugs Dermatol. 2007 Jun;6(6):616-22.
6. Efficacy and safety of azelaic acid and glycolic acid combination
therapy compared with tretinoin therapy for acne.Clin Ther.
7. The comparative efficacy of benzoyl peroxide 5%/erythromycin
3% gel and erythromycin 4%/zinc 1.2% solution in the treatment
of acne vulgaris. Br J Dermatol. 1997 Feb;136(2):235-8.
update: May 21, 2008