MEDICAL TREATMENT OF TEENAGE ACNE

Conventional treatments are aimed at reducing sebum production, reducing bacteria responsible for acne infection, and exfoliating dead skin cells to prevent clogged pores. Conventional treatments can reduce or even eliminate acne, but in many cases, the breakouts return after treatment is discontinued since the whole picture of health has not been addressed. There are many side effects associated with conventional treatments. Some of these can be very serious.

Benzoyl Peroxide

Benzoyl peroxide reduces P. acnes bacteria on skin and is a peeling agent. Must be used continuously to keep acne at bay. Available over-the-counter in creams, lotions or gels. Often works well for mild cases. Benzoyl peroxide is a bleach. It may bleach clothing and can be irritating. It generates free radicals, which could theoretically increase skin cancer later in life. Side effects include irritation, drying, itching, redness, and peeling.

Topical Antibiotics

Topical antibiotics available by prescription only and applied to the skin in creams, gels, pads or lotions. Topical antibiotics are limited in penetrating the skin. They inhibit inflammation caused by bacteria, rather than having a direct bactericidal effect. There is a risk of development of resistant strains of P. Acnes.

Oral (systemic) antibiotics

Oral (systemic) antibiotics, taken by mouth, circulate through the body and into the sebaceous glands. Most common are erythromycin, minocycline and tetracycline. Antibiotics work by killing off the P. acnes, but do not address the other aspects of how acne develops. They are usually used in combination with other drugs that help to “unclog” follicles. They may take several weeks or months to show any improvement. Improvement is usually temporary, while still taking the antibiotics.

Antibiotics also kill the beneficial intestinal bacteria needed to maintain health. Long-term antibiotic use, as is prescribed for acne, lowers immune function and could increase susceptibility to infection. Adverse affects include yeast overgrowth, vaginal yeast infections, upset stomach, allergies, increased susceptibility to sun-damage, yellowing of teeth, decrease in absorption of some vitamins and minerals, increased risk for cancers, and increased bacterial resistance. Many are not safe during pregnancy and may reduce the effectiveness of birth control pills.

Vitamin A derivatives (retinoids)

Vitamin A Deriviatives (retinoids) or topical vitamin A acid - normalizes the way skin grows and sheds and helps unclog pores. Creates an unwelcome environment for P. acnes. Retin-A cream or gel is available by prescription only. The side effects of higher concentrations include red skin and peeling, sun sensitivity. Not to be used in pregnancy.

Accutane (oral retinoid)

Accutane (oral retinoid) decreases the secretions and size of the sebaceous glands, improves shedding of skin and reduces the P. acnes. Can clear severe nodular or cystic acne. Used for treating severe acne that has not improved by other methods, including antibiotics. There is an extremely high risk of birth defects if pregnant while taking accutane. The FDA issued a statement that advised doctors and patients about reports of “depression, psychosis, and rarely suicidal thoughts and actions” related to using accutane. The most common side effects are dry skin, lips, hair and eyes (as accutane inhibits the oil glands), headaches, nosebleeds and changes in blood lipids.

Birth Control Pills

These hormones can help to counteract the effect of the male hormone androgen on acne. It is used for the treatment of moderate acne vulgaris in women 15 years of age or older. In clinical studies, improvement of acne was reported in more than 80 percent of the studies’ participants. The serious side effects include blood clots, stroke and heart attacks as well as an increased risk of developing breast cancer, particularly at a young age. This risk is related to the duration of use.