Acne Remedies - What You need to Know

There are many acne remedies to treat acne (acne vulgaris) which is a skin disease most often affecting adolescents but often lasting into adulthood and we have detailed some of the more popular ones here. In adolescence the cause is a change in hormone levels and usually decreases on its own in the early twenties. Some people however unfortunately continue to suffer from acne for much longer. It is caused by the bacteria Propionibacterium acnes. Oily skin tends to attract dust and dirt which clogs pores and allow the bacteria to thrive. Many acne remedies sold over the counter have not been clinically tested, effective treatments usually take a few weeks to several months to work. They work by a combination of all or some of the following effects :

• Preventing pore blockage


• Killing the bacteria that cause acne (Propionibacterium acnes)


• Reducing inflammation


• Changing hormone levels
  

Methods that are effective include topical bactericides, oral antibiotics, topical antibiotics, topical retinoids, oral retinoids, light treatment and more.

Topical Bactericides

Over the counter bactericides usually contain benzoyl peroxide and are best used with mild or moderate acne. These acne remedies are marketed as creams or gels or as washes or soap that contains 2-10% active ingredient. benzoyl peroxide works by dissolving the keratin that plugs the pores and kills Propionibacterium acnes. Unlike antiobiotics, benzoyl peroxide does not induce resistance in the bacteria. Side effects can include redness, irritation and dryness. Other bactericides that are used include chlorhexidine gluconate and triclosan. Although these are generally less effective than benzoyl chloride they do not have so many side effects. Benzoyl peroxide is also available by prescription with the active ingredient at the same maximum concentration but more able to penetrate the pores of the skin.

Oral antibiotics

Oral antibiotics that kill Propionibacterium acnes include tetracycline, oxytetracycline, erythromycin or others. However the bacteria are becoming resistant to these antibiotics. In addition killing the bacteria does not deal with the blocked pores or increased oil secretions that initially cause the blocked pores. Acne often reappears some time after the end of the course of antibiotics and there are side effects of the tetracycline antibiotics including yellowing of the teeth and problems of the digestive tract due to killing all the beneficial bacteria. They can also interfere with the efficiency of oral contraceptives. Oral antibiotics are generally only used after topical treatments prove ineffective.

Topical antibiotics

Antibiotics can be applied directly to the skin and kill the bacteria in the pores. Some that are used include tetracycline, erythromycin, and clindamycin. Using topical antibiotics avoid the side effects of using oral antibiotics but are less able to be used if the acne covers a large area.

Topical and Oral Retinoids

Retinoids are derivatives of vitamin A and include tretinoin, tazarotene and adapalene which are available on prescription and retinol which is available OTC. They work by preventing the overproduction of keratin which blocks the pores. They can cause irritation and redness of the skin and a flare up of the acne at the start of treatment. retinol is milder than the retinoids in prescription treatments and, although less effective also causes less side effects. Oral retinoids include isotretinoin which can reduce the acne effectively over 4 to 6 months. It is suitable for severe acne and in one study over 80% of acne sufferers saw a significant improvement. Long term treatment can result in a complete cure. It is necessary to be closely supervised by a dermatologist as there are side effects, sometimes severe, including dry skin, nosebleeds and often severe initial flare ups of the acne. It is also not suitable for pregnant or nursing mothers or for those at risk of becoming pregnant as it can cause birth defects. It is usually used only for severe cases when other methods have failed to bring improvement.

Light Treatment

visible light has been shown to be effective when used daily or twice a week. Intense light in the range 405-420nm (purple) or 600nm (red) has been shown to improve acne lesions by about 60% and 70% respectively. It is thought to work by porphyrins in the bacteria producing free radicals when irradiated that then kill the bacteria. There are no apparent side effects but the equipment is expensive and the treatment relatively new.

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