How to treat breakouts

How to treat breakouts. Considerations and topical treatments

There is no single best mode of treatment for all acne lesions. Treatment is determined by many factors, including the type of lesions present, duration of disease, past and present response to various treatments, tendency for scarring and development of acne spots. Current medical condition and medications especially oral contraceptives, corticosteroids and antibiotics may affect its treatment . Psychological factors may have great impact on the way treating breakouts is pursued. Also patient's overall hygiene, facial care, hair grooming and cosmetics must be considered. There are two important points that acne patients should be aware of. First, six to eight weeks of therapy may be required before improvement is noted. Second, body lesions including back, chest and shoulder lesions respond more slowly to various treatments than do those on the face.

A rational approach to treat blemishes could be to selectively target the treatment to factors involved in development of acne and its pathogenesis. These approaches provide a guidline for different treatments. First, prevention of comedones. Second, reduction of sebum production. Third, preventing rupture of comedones. Fourth, resolution of inflammation in acne lesions. Fifth, preventing and correcting acne scars.

It is important to note that severe form of acne must be consulted with a physician. Best treatments for mild forms of acne such as comedones (white heads and black heads), small pustules and scattered papules are topical desquamating agents such as benzoyl peroxide. Among leading over-the-counter treatments, benzoyl peroxide could be counted. Its antibacterial efficacy is noteworthy with rapid suppression of Porpionibacterium acnes. This suppressive effect is much faster compare with that of antibiotics. In contrast to antibiotics, resident organisms do not become resistant to this agent. This anti acne agent also demonstrates anti-inflammatory effect due to a reduction of oxygen free radicals. Its comedolytic effect is comparatively slight in contrast to other topical agents used for acne. Contact allergy is quite rare with it.

Comedolytic treatments suchas salicylic acid, which could be used as alternative or adjunct to benzoyl peroxide. This combination therapy maybe a treatment of choice for moderate forms of acne. Salicylic acid comedolytic activity justifies its therapeutic value in acne. Salicylic acid is also moderately effective in destructing P.acnes. Application of alpha hydroxy acids may resolve the comedones and prevent more severe acne.

Tretinoin (topical form of isotretinoin)is among topical treatments especially when other forms of treatment has failed. Tretinoin is prescribed drug and an skin irritant particularly in liquid form. Cold climates and exposure to sunlight may cause marked irritation. Retin-A (tretinoin) has an antikeratinization effect and prevents comedone formation. Retin-A differs from benzoyl peroxide and topical antibiotics in having no or a controversial effect on P.acnes and causing no reduction in surface free fatty acids. Tretinoin effectiveness against micorcomedones compare with other treatments for acne provides a rationale for its use in most forms of the disorder. This agent is particularly helpful in reduction of non-inflammed lesions and comedones thereby indirectly reduces the number of inflammed acne. This drug is a powerful exfoliant and can cause tenderness, redness and scaling.

Treating blemishes with azelaic acid is indicated in mild forms of acne such as acne comedonica. Sebum production is not affected by this agent. At high concentration, azelaic acid is bactericidal. However, the degree of bacterial suppression is considerable less than with benzoyl peroxide. Azelaic acid has also an anti-inflammatory effect to some degree by decreasing production of reactive oxygen species. Mild sides effects such as redness and scaling is associated with use of the drug.

One of the oldest treatments in history of acne is sulfur. For a long time sulfur was the most common ingredient in anti acne formulations. Sulfur while banishes inflammatory lesions, simultaneously it incites formation of the comedones from which new acne starts.

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