In addition to starting acne patients on a benzoyl peroxide cleanser regimen, Doris Day, a clinical associate professor of dermatology at NYU Langone Medical Center in New York City and the author of 100 Questions & Answers About Acne, typically prescribes powerful topical ingredients, such as Aczone, a cream. “It’s dapsone, which is a new category of anti-inflammatory,” she says. “I like it because you can use it in combination with other treatments, and it doesn’t make you more sun-sensitive. And it’s not particularly drying or irritating.” Day also suggests prescription products that combine benzoyl peroxide and clindamycin (an antibiotic that fights acne-causing bacteria), such as Acanya, BenzaClin, and Onexton. She says, “When you’re using an antibiotic for acne, benzoyl peroxide helps increase the effectiveness.”
Microneedling is a procedure in which an instrument with multiple rows of tiny needles is rolled over the skin to elicit a wound healing response and stimulate collagen production to reduce the appearance of atrophic acne scars in people with darker skin color. Notable adverse effects of microneedling include postinflammatory hyperpigmentation and tram track scarring (described as discrete slightly raised scars in a linear distribution similar to a tram track). The latter is thought to be primarily attributable to improper technique by the practitioner, including the use of excessive pressure or inappropriately large needles.
Today, virtually every case of acne can be successfully treated. Dermatologists can help treat existing acne, prevent new breakouts and reduce your chance of developing scars. If you have questions or concerns about caring for your skin, you should make an appointment to see a dermatologist.
Microdermabrasion isn’t suitable for deep acne scar removal, but it will help gently remove surface skin cells with each wash and make room for healthy skin growth beneath. Use with a foaming or gel anti-acne cleanser as part of your regular regimen for clear skin. Over time, microdermabrasion can help with light acne scar treatment.
^ Jump up to: a b c d e f g h i j k l m n o p q r Levy, LL; Zeichner, JA (October 2012). “Management of acne scarring, part II: a comparative review of non-laser-based, minimally invasive approaches”. American Journal of Clinical Dermatology (Review). 13 (5): 331–40. doi:10.2165/11631410-000000000-00000. PMID 22849351.
Acne vulgaris and its resultant scars have been associated with significant social and academic difficulties that can last into adulthood, including difficulties obtaining employment. Until the 1930s, it was largely seen as a trivial problem among middle-class girls – a trivial problem, because, unlike smallpox and tuberculosis, no one died from it, and a feminine problem, because boys were much less likely to seek medical assistance for it. During the Great Depression, dermatologists discovered that young men with acne had difficulty obtaining jobs, and during World War II, some soldiers in tropical climates developed such severe and widespread tropical acne on their bodies that they were declared medically unfit for duty.
Isotretinoin is strong medicine. It has the potential to cause some serious side effects. That’s why dermatologists carefully evaluate each patient. They weigh the pros and cons before prescribing isotretinoin. They carefully monitor every patient taking this medicine.
Azelaic acid has been shown to be effective for mild to moderate acne when applied topically at a 20% concentration. Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide 5%, isotretinoin 0.05%, and erythromycin 2%. Azelaic acid is thought to be an effective acne treatment due to its ability to reduce skin cell accumulation in the follicle, and its antibacterial and anti-inflammatory properties. It has a slight skin-lightening effect due to its ability to inhibit melanin synthesis, and is therefore useful in treating of individuals with acne who are also affected by postinflammatory hyperpigmentation. Azelaic acid may cause skin irritation but is otherwise very safe. It is less effective and more expensive than retinoids.
Jump up ^ Dutil, M (November–December 2010). “Benzoyl peroxide: enhancing antibiotic efficacy in acne management”. Skin Therapy Letter (Review). 15 (10): 5–7. PMID 21076800. Archived from the original on 27 February 2017.
If you have severe acne, your doctor may refer you to a dermatologist for assessment and further treatment.Severe acne can prevent a person from doing many things they usually enjoy because of a concern about their appearance and the opinion of others.
Most cases of acne fit within one of three main categories, says Macrene Alexiades-Armenakas, MD, PhD, an assistant clinical professor of dermatology at Yale School of Medicine and a specialist in laser therapy for acne, who practices in New York City:
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So make some changes to your meals. A study in the American Journal of Nutrition suggests you may have fewer breakouts if you add more whole grains, beans, and veggies and cut back on pasta, white rice, white bread, and sugar.
Topical therapy is the standard of care for mild to moderate acne.3 Retinoids and antimicrobials such as benzoyl peroxide and antibiotics are the mainstay of topical acne therapy. Such treatments are active at application sites, and they can prevent new lesions.4 The main side effect is local irritation. Gels, pledgets (medication-soaked pads), washes and solutions tend to be drying and are helpful for oily skin. Lotions, creams and ointments are beneficial for dry, easily irritated skin. Most topical preparations require at least six to eight weeks before an improvement is seen; they may be used for years as needed.6
If you’re still experiencing breakouts after eight weeks, visit a dermatologist, especially if you have big, angry pimples. “Scarring is preventable if you treat acne early but permanent if you don’t,” says Joshua Zeichner, the director of cosmetic and clinical research at Mount Sinai Hospital in New York City. Your exact treatment will depend on what the doctor learns after examining you and talking to you about your acne. But there are a few main paths that doctors take.
FDA-approval, by the way, does not mean a product is a wonder drug that immediately clears up acne in all cases. The US FDA has studied benzoyl peroxide and salicylic acid and declared them to be GRASE, or generally recognized as safe and effective. The FDA took over 20 years to examine scientific studies, medical case reports, and expert testimony to decide only in June of 2011 that: