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Acne medicine therapy – Types and classes

Introduction
With reference to medical drug treatment of acne or acne medicine therapy, choices are limited and mostly prescription-based. Also, most of these medicines act temporarily to reduce symptoms such as itching and burning of skin. They do not really eliminate the underlying cause of acne. Based on its mode of administration (route which is used to take a specific medicine in your body), acne medicine therapy is of the following types:

1- Oral drug treatment

Oral antibiotics


acne medicineYour doctor may recommend a course of antibiotic tablets (pills) for you to take by mouth which will be taken in
combination with suitable topical treatment. Oral antibiotics help the inflamed spots of acne but have no effect on un-inflamed ones such as blackheads. They are only suitable for widespread acne because topical treatments may then be difficult to apply properly to all of the affected areas. Antibiotics need to be taken for at least two months, and are usually continued until there is no further improvement. Common oral antibiotics used for acne include erythromycin & tetracycline. Be sure to read the special instructions and warnings on the medicine’s label. Let your doctor know if you are taking any other medicines including birth control pills, antihistamines, asthma medicines, and vitamins. Also, let your doctor know if you may be pregnant or are planning a pregnancy.

Side effects & limitations of oral antibiotics: While the more common side effects of antibiotics are nausea and an upset stomach, other side effects are possible: yeast infections (for women), recurring headaches, and sensitivity to the sun. It is also a generally accepted fact that people who take antibiotics frequently will, at a later time, no longer experience relief because the antibiotics are no longer working. There are also certain strains of bacteria that resist antibiotics.

Some of the other commonly used oral medications in acne include:

Accutane (Isotretinoin)
For severe cases of acne like cysts and nodules, patients are prescribed certain oral drugs like Isotretinoin (Accutane) which is intended primarily to shrink the oil glands. Accutane can cause severe, life threatening defects if a pregnant woman takes the medication. Furthermore, women taking Accutane are required to use birth control, due to the known ability of Accutane to affect the ears, eyes, face, skull, heart, and brain of the fetus. That is why; individuals who receive Accutane treatments are advised not to get pregnant for a whole year from the start of treatment and must also be monitored up to five months after treatment is terminated. There have been also some reports about Accutane causing serious skin irritation, elevated lipids and birth defects in the child. Accutane is, therefore, considered as an effective treatment by doctors but patients receiving this treatment must be supervised because of potentially serious consequences, particularly on the liver and on the unborn fetus. Other side effects of this drug may include dry eyes, itch¬ing, mood changes, and changes in the blood. You and your derma¬tologist can decide whether this medi¬cine is right for you based on the pros and cons.

Oral contraceptives (hormones)
Hormonal treatments are also available. They are recommended for adult women who show signs of androgen excess, have irregular menstrual periods or who have thinning hair. Types of hormonal treatments that are prescribed are birth control pills (with equal amounts of estrogen and progesterone in small doses) and corticosteroid pills. Like other treatments, people may experience side effects with hormonal treatments.
The most effective of such treatments contain a hormone blocker (for example cyproterone), which reduces the amount of oil the skin produces. However, these may take up to four months before they start to work and have their own side effects.


2- Topical drug treatment

Topical treatments are those that are applied directly to the skin (locally). These include a variety of active anti-acne ingredients such as benzoyl peroxide, nicotinamide, antibiotics, azelaic acid, and retinoids. Topical treatments are usually recommended for people with mild to moderate acne. They should be applied to the whole of the affected area and not just to the spots themselves. Topical medications and oral antibiotics may be used alone or together. A topical medication might be an antibiotic lotion or gel (Clindamycin, Erythromycin, Tetracycline, Doxycycline or Minocycline) or a liquid or cream containing Benzoyl Peroxide or Retin A.

However even topical antibiotics are not that effective Very few controlled, randomized studies have been performed comparing acne medications. In one such recent study*, five different treatments were evaluated on 649 patients over 18 weeks. According to the results, residual acne was present in as much as 95% of the participants at the end of the study. The authors concluded that most people in the community with mild to moderate inflammatory acne of the face responded only partially to topical or oral antibiotic treatments.

(Reference: Lees CW, Strauss JS, Downing DT,Analysis of soluble proteins in comedones, Acta DermVenereol (Stockh) 1977, 57:117-20)
The question of allergies triggered by prescription medicine is another reason why people prefer herbal treatments over topical medications in acne. While certain topical skin therapies may temporarily eliminate acne, there is always the possibility that the medication can cause mild to severe allergies.
One of the commonly used topical anti-acne medications is Benzoyl Peroxide:

Benzoyl Peroxide
Benzoyl peroxide can be obtained over-the-counter (Clearasil being the most common, although there are other brands in the market today) or by prescription (Persagel and others). Benzoyl peroxide gets to work on acne-aggravating bacteria that are on the surface of the skin. Side effects such as irritation or redness may occur and there is also a risk of allergy or skin irritation as a result of the continued use.

Is there any permanent solution?
While it is true that there has been no “medical cure” available for acne to date, various other options (e.g. herbal or natural acne therapy) are rapidly emerging in the market with promising results. If you want to try one of such options, you must do your own research to find what will suit you the best. One of the most advanced and research-based and “home based” treatment options for acne has recently arrived in the form of natural & herbal products. These anti-acne kits actually comprise of a “system” consisting of several treatments that all work together to address various issues related with your acne simultaneously.

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