Treating acne is often a very frustrating process, because we are impatient in nature. It is a complicated disease that can have many causes and treatments. The process is frustrating, because our self-esteem is heavily impacted and many misunderstandings still exist. It is never just as simple as ‘keeping your skin clean’ and ‘eating clean’. We at Not Just Skincare want you to know what your options are.
Nowadays, acne is treated in 4 general ways, the most common of which is topical treatments. Other options include orally administered medications, physical therapies and chemical exfoliation. All of these options are effective in varying ways dependent on the severity of the acne and the way they are administered, however often dermatologists and healthcare specialists will suggest a combined approach.
Topical treatments are the most widely available and commonly used method for good reason. They are accessible and show great efficacy when used properly, especially in patients with low to middling severities of acne. Even in severe cases, topical treatments will be administered in conjunction with any others. Here are some examples of topical treatments and how they work:
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Retinoids like tretinoin help to regulate cellular turnover rate and inflammation
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Salicylic acid softens the outside layer of the epidermis, breaks up acne spot contents, mediates inflammation and has very mild antibacterial activity.
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Azealic acid has mild antibacterial activity, reduces the overproduction of keratin that is characteristic of acne, reduces dark marks and inflammation.
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Benzoyl Peroxide is effective in its antibacterial activity, and shows some activity in reducing sebum and keratin production.
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Topical antibiotics like clindamycin and erythromycin specifically target bacteria on the skin, including acne causing bacteria and kill them in different ways, but the antibiotics are often used in conjunction with other topical treatments to minimise antibiotic resistance.
Orally administered treatments for acne are often prescribed to patients suffering with more stubborn and severe cases of acne. They are highly effective, but can have adverse effects, therefore they are always prescribed by a healthcare professional. Notably, almost always these will still be used in conjunction with topical treatments. Examples include:
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Orally administered antibiotics reach the pilosebaceous unit and target the acne-causing bacteria inside in various ways. There are many kinds and they continue to be developed to combat antibiotic resistance.
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Hormonal therapies like combined oral contraceptives often act in ways to reduce the amounts of androgens like testosterone being produced by the body, as testosterone is known to increase inflammation and sebum production.
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Oral retinoids like isotretinoin (commonly sold as Accutane) dramatically reduce sebum production and keratin production, it is only prescribed in extreme cases.
Physical therapies are ideal for patients who struggle to adhere to regular daily medication intake and skincare application. These therapies are also very effective to treat post-acne scarring and pitting. Examples of physical therapies for acne and post-acne treatment include:
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Laser therapy reduces sebum production, redness, and the inflammatory factors that exasperate acne pathology. Commonly used laser therapies are intense pulsed light, pulsed dye lasers and CO2 lasers.
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Photodynamic therapy disrupts the pilosebaceous unit. It utilises a light-reactive solution that is applied directly to the pimples/spots that when exposed to specific wavelength of light breaks down the sebaceous glands, resulting in less sebum production.
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Red and Blue light therapies, whereby the blue light has antibacterial and anti-inflammatory properties, and the red light penetrates deeper and has been shown to repair skin tissues.
Chemical peeling involves a controlled deep exfoliation with chemical agents, such as specific concentrations of salicylic acid. They work by controlling sebum production, dissolving acne lesion contents and killing off bacteria. This treatment method is still used in conjunction with other treatments. For post-acne scarring and pitting, higher concentrations may be used in regularly dispersed treatments. These treatments must be applied by a knowledgeable practitioner.
Wow, that’s a lot of knowledge to absorb. We at Not Just Skincare think that keeping one’s options open is the best choice, but we’re here for you if you need us. We use only the best ingredients and all our products are formulated by the best in their field. Having a good skincare routine, with ingredients that complement each other will save you a lot of heartache.(Baldwin, 2020; Blaskovich et al., 2019; Feng, 2024; Goodman., 2024; Lekakh et al., 2015; Leyden et al., 2017; Li et al., 2024)
Sources:
Baldwin, H. (2020). Oral Antibiotic Treatment Options for Acne Vulgaris. J Clin Aesthet Dermatol, 13(9), 26-32.
Blaskovich, M. A. T., Elliott, A. G., Kavanagh, A. M., Ramu, S., & Cooper, M. A. (2019). In vitro Antimicrobial Activity of Acne Drugs Against Skin-Associated Bacteria. Sci Rep, 9(1), 14658. https://doi.org/10.1038/s41598-019-50746-4
Feng, X. S., J.; Gu, Z.; Gong, J.; Chen, Y.; Liu, Y. . (2024). Azelaic Acid: Mechanisms of Action and Clinical Applications. Clin Cosmet Investig Dermatol.(17), 2359-2371. https://www.dovepress.com/azelaic-acid-mechanisms-of-action-and-clinical-applications-peer-reviewed-fulltext-article-CCID
Goodman., T. M. P. P. M. B. (2024). Benzoyl Peroxide. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK537220/#
Lekakh, O., Mahoney, A. M., Novice, K., Kamalpour, J., Sadeghian, A., Mondo, D., Kalnicky, C., Guo, R., Peterson, A., & Tung, R. (2015). Treatment of Acne Vulgaris With Salicylic Acid Chemical Peel and Pulsed Dye Laser: A Split Face, Rater-Blinded, Randomized Controlled Trial. J Lasers Med Sci, 6(4), 167-170. https://doi.org/10.15171/jlms.2015.13
Leyden, J., Stein-Gold, L., & Weiss, J. (2017). Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb), 7(3), 293-304. https://doi.org/10.1007/s13555-017-0185-2
Li, Y., Hu, X., Dong, G., Wang, X., & Liu, T. (2024). Acne treatment: research progress and new perspectives. Front Med (Lausanne), 11, 1425675. https://doi.org/10.3389/fmed.2024.1425675
