Understanding Dermatology Part I
Acne is a problem that affects most teenagers at one time or another but can continue well into adulthood. It can be embarrassing and disfiguring particularly during the sensitive teenage years. Acne occurs when pores on the face, neck, chest, back or shoulders become clogged with excess oil, known as sebum produced inside the hair follicle. Once the pore is clogged, it may become infected with bacteria and lead to pain and inflammation.
The development of acne is often brought about by fluctuating levels of hormones, particularly during puberty and the menstrual cycle. Acne can also be a side effect of taking certain types of medications. If not treated, severe acne can lead to permanent facial scarring but there are several options for dermatology acne treatment ranging from medications to cosmetic procedures which can be performed by a dermatologist.
Medications
Acne treatment with medication is meant to reduce the causes of acne by reducing oil production, eliminating bacteria and reducing inflammation. For milder cases, a physician may recommend the use of topical over the counter medications such as benzoyl peroxide, salicylic acid and resorcinol.
These topical medications are available in creams, gels, lotions, soaps and pads to be applied to the site of the acne. They work by reducing bacteria, limiting oil production and decreasing shedding of skin cells that can block the pores.
Prescription medications may be needed for more severe cases of acne. Topical prescription antibiotics such as erythromycin or clindamycin will kill the bacteria on the skin. Retinoids are derivatives of Vitamin A that work to unplug the pores and will allow other medications to work better. Retinoids such as adapalene (Differin), retinol (Retin-A), and tazarotene (Tazorac) may also increase new skin cell production so that the top layers of the skin are shed and the acne plug rises to the surface.
Other topical medications such as azelaic acid (Azelex) and prescription strength benzoyl peroxide may be used to reduce comedone formation and kill infecting bacteria.
Oral prescription medications may be used for dermatology acne treatment for severe or resistant cases. Oral antibiotics such as tetracycline, clindamycin and erythromycin may be prescribed to reduce skin bacteria and limit acne formation. Some patients may need to take antibiotics for many years to prevent a recurrence of acne. In women, hormonal treatments may be used including birth control pills, spironolactone and corticosteroids such as prednisone to suppress androgen formation and reduce oil production.
Isotretinoin, (Accutane) may be used in the most severe cases of nodular or cystic acne. Isotretinoin is an analog of Vitamin A which reduces the size of the oil glands. Isotretinoin should not be used by those who may become pregnant as it is widely known to cause birth defects. It also has a number of known side effects that include nausea, itching, poor night vision, sun sensitivity, depression and changes in liver functioning.
Learn more about the different cosmetic procedures, chemical peels and phototherapy in Understanding Dermatology Part II.
