Individualized
The treatment of acne for each patient must be individualized, taking into account the main types of acne lesions present.
Lesions in acne can be inflammatory or non-inflammatory. Non-inflammatory lesions are comedones (whiteheads and blackheads). Inflammatory lesions are papules (small red bumps), pustules (small pus-filled bumps), nodules (larger painful red swellings), and cysts (pus-filled cavities). Both types of lesions often occur together, although one form may be more prominent.
Mild acne
Topical agents are generally used for comedonal acne. For very mild comedonal acne, benzoyl peroxide or acne creams can be used. These are available as over-the-counter medication; a prescription is not required. Mild to severe comedonal acne requires the use of topical retinoids such as tretinoin and adapalene. Persistent comedones may require physical therapy.
For mild inflammatory acne, the patient can be prescribed benzoyl peroxide to be used in the morning and a topical retinoid to be used at night. If this is unsuccessful, a topical antibiotic such as erythromycin clindamycin can be added to the regimen.
Moderate acne
Moderately severe inflammatory acne calls for systemic therapy. First-line treatment consists of oral antibiotics, with topical retinoids and/or benzoyl peroxide. Women also have the option of hormonal therapy, either alone or in combination with oral antibiotic.
Another alternative is the use of systemic isotretinoin if antibiotic treatment fails.
Severe acne
Oral isotretinoin is used for very severe acne, or acne that is unresponsive to oral antibiotics. Hormonal treatment can be considered for women, either alone or in combination with systemic isotretinoin.
Besides medical treatment of acne, the patient should take other general steps — cleanse the skin gently, use non-comedogenic skincare products and cosmetics, identify and avoid aggravating factors. The patient should continue going to a doctor.
Best Acne Treatment
