Acne is treated by dermatologists, endocrinologists and nutritionists. This multidisciplinary approach suggests that the causes of the disease are several and only a holistic approach would lead to good results. In recent decades, there has been great progress in topical acne treatments. They manage to influence precisely its mechanisms such as excessive sebum production, follicular hyperkeratosis and inflammation around the follicle from C. acnes. And which are the proven effective means of treating the disease, you can read in the article. its mechanisms such as excessive sebum production, follicular hyperkeratosis and inflammation around the follicle from C. acnes.
Basic remedies for topical acne treatment
Topical retinoid. Retinoids are a key drug in the treatment of acne because they "open" closed comedones, prevent the formation of new ones and have an anti-inflammatory effect. The retinoids that you can find locally in Bulgaria are mainly tretinoin and adapalene. In both products a short period of adaptation with redness, irritation can be observed. Among the side effects are dry skin, increased photosensitivity, numbness. But these symptoms can be overcome with proper concomitant cosmetics, and are negligible in the face of the irreplaceable effectiveness of retinoids.
Benzoyl peroxide (BPO). Benzoyl peroxide has an antibacterial effect and with the help of free radicals destroys C. acnes. BPO is found in pharmacies in the form of a gel as a stand-alone product or in combination with another active drug. The most used concentrations in the fight against acne are 2.5% and 5%. The first few days of using the product may pass with slight redness and irritation in the treated areas.
Azelaic acid. I will not hide that azelaic acid is my favorite active ingredient in detergents and lotions. This acid is also formed naturally in our body by yeast fungi that inhabit our skin. Azelaic acid has comedonolytic, antibacterial and anti-inflammatory effects. And my favorite side effect is - lightening of pigmentation. This makes it a unique product for the treatment of both active acne and in the fight against scars, postlesional hyperpigmentation. Suitable for sensitive and prone to rosacea skin. How can it not be my favorite?
Topical antibiotics. Here my attitude is quite the opposite - I do not prescribe topical antibiotics as monotherapy for acne. The reason for this is that for me acne is not an infectious disease. In addition, C. acnes is not always an active participant in the various types of acne. The increasing resistance of the microorganism to antibiotics has recently become a much-discussed problem.
Salicylic acid. This acid is betahydroxy and is applicable in all forms - washing gel / foam, lotion, serum, mask, chemical peel. It realizes its anti-acne potential by penetrating the skin and destroying the connection between dead cells and fatty acids and "cleans" the pores.
My first advice is not to choose your own products, because lately I have very often new or worsened acne from improper therapy.
My second advice is to follow the correct regimen for day and night therapy, given the increasing photosensitivity of the listed ingredients.
My third piece of advice is related to a question that acne patients always ask me during an examination - whether to clean their face mechanically. I do not recommend using a facial scrub because it causes inflammation. If your cosmetics are not enough as a cleansing / exfoliating agent, yes, then I agree that the skin should be cleansed. But with the proviso that he makes it a good specialist with a good apparatus. I am a fan of the aquapiling procedure, which uses both the described effect of betahydroxy acids and the vacuum for mechanical rather than manual extraction of sebum and detritus from the pores. I see good results from it in patients with acne in my practice when I combine it with the right therapy.