Treatments for acne?
If you haven't been able to control your acne adequately, you may want to consult a primary care physician or dermatologist. Here are some of the things you can assist with:
* 1.Topical (externally applied) antibiotics and antibacterials: These include erythromycin, clindamycin (Benzaclin), sulfacetamide (Klaron), and azelaic acid (Azelex).
* 2.Retinoids: Retin-A (tretinoin) has been around for years, and has become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and mild increase in sensitivity to the sun. Wit proper sun protection, however, they can be used even during sunny periods. For more, please read the Sunburn and Sun-Sensitizing Drugs article.
* 3.Oral antibiotics: Most doctors start treatment with tetracycline or one of the related "cyclines," such as doxycycline and minocycline. Other oral antibiotics that are useful for treating acne are cefadroxil, amoxicillin, and the sulfa drugs.
o Problems with these drugs can include allergic reactions (especially sulfa), gastrointestinal upset, and increased sun sensitivity. Doxycycline, in particular, is generally safe but can sometime cause esophagitis (irritation of the esophagus, producing discomfort when swallowing) and an increased tendency to sunburn.
o Despite many people’s concerns about using oral antibiotics for several months or longer, such use does not “weaken the immune system” and make them more susceptible to infections, or unable to use other antibiotics when necessary.
o Recently published reports that long-term antibiotic use may increase the risk of breast cancer will require further study, but at present are not substantiated. In general, doctors prescribe oral antibiotic therapy for acne only when necessary and for as short a time as possible.
* 4.Oral contraceptives: Oral contraceptives, which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been to shown to have modest effectiveness in treating acne.
* 5.Cortisone Injections: To make large pimples and cysts flatten out fast, doctors inject them with a form of cortisone.
* 6.Isotretinoin: (Accutane was the original brand name; there are now several generic versions in common use.) Isotretinoin is a wonderful treatment for severe, resistant acne, used on millions of patients since it was introduced in 1982. It should be used for patients with severe acne, chiefly of the cystic variety, which has been unresponsive to conventional therapies like those listed above.
o Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for 5-6 months. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, relatives of cholesterol which often rise a bit during treatment, but rarely to the point where treatment has to be modified or stopped.
o Even though isotretinoin does not remain the body after therapy is stopped, improvement is often long-lasting. It is safe to take two or three courses of the drug if unresponsive acne makes a comeback. It is, however, best to wait at least several months and to try other methods before using isotretinoin again.
o Isotretinoin has a high risk of inducing birth defects if taken by pregnant women. Women of childbearing age who take isotretinoin need two negative pregnancy tests (blood or urine) before starting the drug, monthly tests while they take it, and another after they are done. Those who are sexually active must use two forms of contraception, one of which is usually the oral contraceptive pill. Isotretinoin leaves the body completely when treatment is done; women must be sure to avoid pregnancy for one month after therapy is stopped. There is, however, no risk to childbearing after that time.
o Another concern, much discussed in the popular press, is the risk of depression and suicide in patients taking isotretinoin. Government oversight has resulted in a highly-publicized and very burdensome national registration system for those taking the drug. This has reinforced the understandable, but unfortunate and inaccurate, sense many patients and their families have that isotretinoin is dangerous. In fact, large-scale studies have shown no increased risk for depression and suicide in those taking isotretinoin compared with the general population. Although it is important for those taking this drug to report mood changes (or any other symptoms) to their doctors, even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients who have suffered and been scarred from acne for years.
* 7.Laser treatments: Recent years have brought reports of success in treating acne using lasers and similar devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective. However, what isn’t clear at this time, is how long the effects will last. In addition, health insurers do not generally reimburse for these procedures, so they can be costly. At this point they are best thought of as adjuncts to conventional therapy, rather than as substitutes.
* 8.Chemical peels: Whether the superficial peels (like glycolic acid) performed by Estheticians, or deeper ones performed in the doctor's office, chemical peels are of modest, supportive benefit only, and in general do not substitute for regular therapy.
* 1.Topical (externally applied) antibiotics and antibacterials: These include erythromycin, clindamycin (Benzaclin), sulfacetamide (Klaron), and azelaic acid (Azelex).
* 2.Retinoids: Retin-A (tretinoin) has been around for years, and has become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and mild increase in sensitivity to the sun. Wit proper sun protection, however, they can be used even during sunny periods. For more, please read the Sunburn and Sun-Sensitizing Drugs article.
* 3.Oral antibiotics: Most doctors start treatment with tetracycline or one of the related "cyclines," such as doxycycline and minocycline. Other oral antibiotics that are useful for treating acne are cefadroxil, amoxicillin, and the sulfa drugs.
o Problems with these drugs can include allergic reactions (especially sulfa), gastrointestinal upset, and increased sun sensitivity. Doxycycline, in particular, is generally safe but can sometime cause esophagitis (irritation of the esophagus, producing discomfort when swallowing) and an increased tendency to sunburn.
o Despite many people’s concerns about using oral antibiotics for several months or longer, such use does not “weaken the immune system” and make them more susceptible to infections, or unable to use other antibiotics when necessary.
o Recently published reports that long-term antibiotic use may increase the risk of breast cancer will require further study, but at present are not substantiated. In general, doctors prescribe oral antibiotic therapy for acne only when necessary and for as short a time as possible.
* 4.Oral contraceptives: Oral contraceptives, which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been to shown to have modest effectiveness in treating acne.
* 5.Cortisone Injections: To make large pimples and cysts flatten out fast, doctors inject them with a form of cortisone.
* 6.Isotretinoin: (Accutane was the original brand name; there are now several generic versions in common use.) Isotretinoin is a wonderful treatment for severe, resistant acne, used on millions of patients since it was introduced in 1982. It should be used for patients with severe acne, chiefly of the cystic variety, which has been unresponsive to conventional therapies like those listed above.
o Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for 5-6 months. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, relatives of cholesterol which often rise a bit during treatment, but rarely to the point where treatment has to be modified or stopped.
o Even though isotretinoin does not remain the body after therapy is stopped, improvement is often long-lasting. It is safe to take two or three courses of the drug if unresponsive acne makes a comeback. It is, however, best to wait at least several months and to try other methods before using isotretinoin again.
o Isotretinoin has a high risk of inducing birth defects if taken by pregnant women. Women of childbearing age who take isotretinoin need two negative pregnancy tests (blood or urine) before starting the drug, monthly tests while they take it, and another after they are done. Those who are sexually active must use two forms of contraception, one of which is usually the oral contraceptive pill. Isotretinoin leaves the body completely when treatment is done; women must be sure to avoid pregnancy for one month after therapy is stopped. There is, however, no risk to childbearing after that time.
o Another concern, much discussed in the popular press, is the risk of depression and suicide in patients taking isotretinoin. Government oversight has resulted in a highly-publicized and very burdensome national registration system for those taking the drug. This has reinforced the understandable, but unfortunate and inaccurate, sense many patients and their families have that isotretinoin is dangerous. In fact, large-scale studies have shown no increased risk for depression and suicide in those taking isotretinoin compared with the general population. Although it is important for those taking this drug to report mood changes (or any other symptoms) to their doctors, even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients who have suffered and been scarred from acne for years.
* 7.Laser treatments: Recent years have brought reports of success in treating acne using lasers and similar devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective. However, what isn’t clear at this time, is how long the effects will last. In addition, health insurers do not generally reimburse for these procedures, so they can be costly. At this point they are best thought of as adjuncts to conventional therapy, rather than as substitutes.
* 8.Chemical peels: Whether the superficial peels (like glycolic acid) performed by Estheticians, or deeper ones performed in the doctor's office, chemical peels are of modest, supportive benefit only, and in general do not substitute for regular therapy.
posted by mixterr @ 9:10 AM
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