Acne is the most common skin disorder in the United States, affecting 40 to 50 million persons of all ages and races.
Acne is a chronic inflammatory disease involving the pilosebaceous unit. It is typified by the eruption of a comedo within the follicle, which is preceded by a microcomedo.
Four main factors lead to the formation of acne lesions: (1) increased sebum production by sebaceous glands, in which androgens have an important role; (2) hyperkeratinization of the follicle, leading to a microcomedo that eventually enlarges into a comedo; (3) colonization of the follicle by the anaerobe Propionibacterium acnes; and (4) an inflammatory reaction.
The 17 Best Acne Treatments, According To Dermatologists
Acne is diagnosed by the identification of lesions. The spectrum of acne lesions ranges from noninflammatory open or closed comedones (blackheads and whiteheads; Figure 1) to inflammatory lesions, which may be papules, pustules, or nodules (Figures 2 through 4). Lesions are most likely to occur on the face, neck, chest, and back, where there is a higher concentration of sebaceous glands. Other conditions can mimic acne, and even include the term acne in their nomenclature, but they lack the presence of comedones. Table 1 outlines the differential diagnosis for acne.
Grading acne based on the type of lesions and their severity can help in deciding which therapies are warranted (Figure 5); however, there is no consensus on the best grading system.
They prevent the formation and reduce the number of comedones, making them useful against noninflammatory lesions. Topical retinoids also possess anti-inflammatory properties, making them somewhat useful in the treatment of inflammatory lesions.
Face Washes For Acne Prone Skin In 2023
Topical retinoids are indicated as monotherapy for noninflammatory acne and as combination therapy with antibiotics to treat inflammatory acne. Additionally, they are useful for maintenance after treatment goals have been reached and systemic drugs are discontinued.
Overall, adapalene (Differin) is the best tolerated topical retinoid. Limited evidence suggests that tazarotene (Tazorac) is more effective than adapalene and tretinoin (Retin-A). There is no evidence that any formulation is superior to another.
Topical antibiotics are used predominantly for the treatment of mild to moderate inflammatory or mixed acne. Clindamycin and erythromycin are the most studied (Table 3).
Best Pimple Creams Of 2023, According To Top Dermatologists
Azelaic acid should be considered for use in pregnant women. The cream formulation (Azelex) is approved by the U.S Food and Drug Administration (FDA) for the treatment of acne vulgaris, but the gel (Finacea) has significantly better bioavailability.
It has mixed antimicrobial and anticomedonal effects, and may be effective for the treatment of mild to moderate inflammatory or mixed acne.
Dapsone is the first agent in a new class of topical acne medications to achieve FDA approval in the past 10 years.
The 19 Best Acne Treatments For Every Skin Type 2022
Although it is an antibiotic, it likely improves acne by inhibiting inflammation. In studies, dapsone was minimally more effective than placebo in reducing inflammatory and noninflammatory lesions, but it has never been compared with other topical agents.
Benzoyl peroxide is an over-the-counter bactericidal agent that comes in a wide array of concentrations and formulations. No particular form has been proven better than another.
Salicylic acid is present in a variety of over-the-counter cleansing products. These products have anticomedonal properties and are less potent than topical retinoids, but there have been only limited high-quality studies examining their effectiveness.
The 15 Best Acne Spot Treatments Of 2023
). The best-studied antibiotics include tetracycline and erythromycin. Based on expert consensus on relative effectiveness, the American Academy of Dermatology recommends using doxycycline and minocycline (Minocin) rather than tetracycline.
Trimethoprim/sulfamethoxazole (Bactrim, Septra) and trimethoprim alone may be used if tetracycline or erythromycin cannot be tolerated. Because of the potential for bacterial resistance with the use of an oral antibiotic, it is recommended that benzoyl peroxide be added to any regimen of oral antibiotics.
Topical retinoids are sufficient to prevent relapses in most patients with acne vulgaris, especially if the disease was originally classified as mild or moderate. If the patient's acne was initially classified as severe inflammatory, benzoyl peroxide with or without an antibiotic can be added for maintenance therapy.
Acne Management Guidelines By The Dermatological Society Of Singapore
Oral isotretinoin is FDA-approved for the treatment of severe recalcitrant acne. Evidence suggests that it is also useful for less severe acne that is treatment resistant.
The usual dosage for severe treatment-resistant acne is 0.5 to 1.0 mg per kg per day for about 20 weeks, or a cumulative dose of 120 mg per kg.
Total cumulative doses of less than 120 mg increase relapse rates, and doses of more than 150 mg increase the incidence of adverse effects without producing greater benefits.
Guidelines Of Care For The Management Of Acne Vulgaris
Approximately 40 percent of patients achieve long-term remission with a 120-mg cumulative dose, 40 percent require retreatment with topical therapy or oral antibiotics, and 20 percent require retreatment with isotretinoin.
Physicians, distributors, pharmacies, and patients must register in the iPLEDGE program (http://www.ipledgeprogram.com) before using isotretinoin. This program was established to prevent pregnancy in patients taking the medication. Isotretinoin is a potent teratogen and is associated with abnormalities of the face, eyes, ears, skull, central nervous system, cardiovascular system, thymus, and parathyroid glands. Negative pregnancy tests are mandated before starting therapy, then monthly before receiving a prescription refill, immediately after taking the last dose, and one month after taking the last dose. The use of isotretinoin has been suggested to worsen depression and increase the risk of suicide, but no causal relationship has been established.
Required laboratory monitoring during therapy includes a complete blood count, fasting lipid panel, and measurement of liver transaminase levels. Common adverse effects include headaches, dry skin and mucous membranes, and gastrointestinal upset.
Sulfur Ointment 10% Acne Medication Ointment
These agents generally are considered second-line therapies, but they may be considered first-line treatments in women with adult-onset acne or perimenstrual flare-ups.
However, there is insufficient evidence to recommend one agent over another, including those that are FDA approved versus those that are not. There is also no evidence to support their use over other studied therapies.
Spironolactone (Aldactone) is an androgen receptor antagonist with unclear effectiveness in the treatment of acne. It is usually reserved as a second- or third-line agent, or as an alternative to isotretinoin for women who cannot use this medication. A 2009 systematic review found insufficient evidence to recommend the use of spironolactone for the treatment of acne.
Clearasil Tinted Acne Treatment Cream Reviews In Blemish & Acne Treatments
Common adverse effects include menstrual irregularities and breast tenderness. It is a potassium-sparing diuretic and may cause severe hyperkalemia. Additionally, it is a potential teratogen.
Light and laser therapies can be used for the treatment of acne. Examples include visible light, pulsed-dye laser, and photodynamic therapies. There is insufficient evidence to recommend the routine use of these therapies for the treatment of acne.
Studies of these products typically lack controls, have small sample sizes, are short term, and do not compare these therapies with validated pharmacologic treatments. There are no established guidelines on the optimal dosing, device, timing, and frequency to be used.
Buy Oxy 5 Acne Vanishing Cream 25g Online At Chemist Warehouse®
Table 6 summarizes other therapies that are used in the treatment of acne, with varying levels of evidence to support their use.
Treatment goals in patients with acne include the prevention of scars, the reduction of psychological morbidity, and the resolution of noninflammatory and inflammatory lesions. Therapy should be continued for a minimum of eight weeks before a treatment response can be accurately assessed. Referral to a dermatologist should be considered when treatment goals are not met or when there is significant scarring.
Data Sources: We performed electronic searches of PubMed, the Cochrane database, Essential Evidence Plus, and the National Guideline Clearinghouse using the MESH terms acne, vulgaris, treatment, treat, and therapy. Search date: March 2011.
Acne Cream Cleanser To Clear Acne Breakouts
This content is owned by the . A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the . See permissions for copyright questions and/or permission requests.
0 Response to Acne Medication Rating
Posting Komentar