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ACNE TREATMENT

Acne treatment strategies have evolved significantly in recent years, with the introduction of new medications and a greater emphasis on combination therapies. There is a notable shift from monotherapy to combination therapies in acne treatment . This approach addresses multiple acne pathways and leads to better outcomes.  

Topical Treatments

Topical medications are applied directly to the skin and are often the first-line treatment for mild to moderate acne.
Retinoids: These vitamin A derivatives work by unclogging pores and reducing inflammation . Examples include adapalene, tretinoin, tazarotene, and trifarotene .  
Benzoyl Peroxide: This antimicrobial agent reduces acne-causing bacteria on the skin . It is often used in combination with other topical treatments .  
Topical Antibiotics: These medications reduce inflammation and bacterial growth . Examples include clindamycin and erythromycin .  
Combination Medications: Combining different topical agents can enhance efficacy and address multiple acne pathways . Examples include fixed-dose combinations of clindamycin, adapalene, and benzoyl peroxide .
  Clascoterone: This topical androgen receptor inhibitor addresses hormonal causes of acne in both males and females .  
Salicylic Acid: This keratolytic agent helps unclog pores and exfoliate the skin .  
Azelaic Acid: This medication unclogs pores, reduces inflammation, and has antibacterial properties
Teenage Acne
Pustular Acne

Systemic Treatments

Systemic treatments are taken orally and are typically reserved for moderate to severe acne or cases that do not respond to topical therapy.
Oral Antibiotics: These medications reduce bacterial growth and inflammation . Examples include doxycycline, minocycline, and sarecycline . Due to the growing concern of antibiotic resistance in acne treatment, there is a need for antibiotic stewardship . Strategies to minimize antibiotic use and prevent resistance include limiting the duration of antibiotic treatment, using topical antibiotics whenever possible, and combining antibiotics with benzoyl peroxide.  
Hormonal Therapies: For women with hormonally influenced acne, combined oral contraceptives or spironolactone may be prescribed .  

Isotretinoin: This oral retinoid is highly effective for severe or treatment-resistant acne . However, it has potential side effects and requires close monitoring . In some cases, isotretinoin treatment can be challenging, with issues such as relapse, acne worsening, acute inflammation, sinus tracts, and inflamed keratinous cysts .

Pediatric Acne

Acne treatment in children may differ from that in adults . Some medications, such as isotretinoin, may not be suitable for younger patients. Dermatologists consider factors such as the child’s age, acne severity, and potential side effects when developing a treatment plan..

New Research and Findings

Ongoing research continues to shed light on the pathogenesis of acne and explore novel treatment approaches.

Topical Minocycline Foam

A new 4% minocycline foam offers a topical delivery system for this antibiotic, minimizing systemic absorption and reducing the risk of antibiotic resistance .   


Tranexamic Acid

Topical tranexamic acid has shown promise in reducing inflammatory acne lesions and improving post-inflammatory erythema .   

 
N-acetyl-GED

This topical agent targets sebaceous glands directly, offering a novel mechanism of action for reducing sebum production and acne development .   

 
Spongilla lacustris Extract Mask

A once-weekly mask derived from Spongilla lacustris extract is under development, with potential anti-inflammatory and antimicrobial properties .  

 
Oral Probiotics

Studies have shown that oral probiotics may have beneficial effects in acne treatment by inhibiting C. acnes and modulating the immune response .  

 
Metformin

Metformin, traditionally used to treat diabetes, has shown potential as an adjunctive therapy for acne, particularly in patients with polycystic ovary syndrome .  

 
Upcoming Treatment Options

Several promising acne treatments are currently under development:

  • 1726 nm Lasers: These lasers specifically target sebaceous glands, offering a potential alternative to systemic therapies like isotretinoin . Emerging technologies like 1726 nm lasers have the potential to revolutionize acne treatment by offering targeted and less invasive options.   
     
  • Topical meclizine gel: This topical gel is being investigated as a potential new treatment for acne .   
     
  • Topical surfactant-oil gel: This topical gel is being explored as a potential treatment option for inflammatory acne vulgaris .   
     
  • Topical nitric oxide and its derivatives: Studies are underway to evaluate the use of topical nitric oxide and its derivatives in acne treatment .   
     
  • Antimicrobial peptides: These peptides have shown potential as future therapeutic agents for acne due to their ability to kill bacteria and modulate the immune response .   
     
  • Immunotherapy: Researchers are exploring ways to modulate the immune response to treat acne . This includes developing vaccines or immunomodulatory agents that can target specific immune cells or pathways involved in acne development.   
     
  • Micro-needling and Micro-needling Patches: These techniques involve creating tiny punctures in the skin to stimulate collagen production and improve acne scars . Micro-needling patches can deliver medications directly into the skin, enhancing their effectiveness.   
     

Potential Side Effects and Complications

Acne treatments can have potential side effects, including:

Topical Treatments
  • Dryness, irritation, peeling, burning, and temporary worsening of acne . 
  • Allergic reactions, although rare.
Systemic Treatments
  • Oral Antibiotics: Gastrointestinal upset, photosensitivity, and the risk of antibiotic resistance .  
     
  • Isotretinoin: Dry skin, cheilitis, elevated liver enzymes, mood changes, and potential teratogenicity 
     

Other Treatment Modalities

  • Light therapy: Potential side effects include redness, swelling, and changes in skin pigmentation.
  • Chemical peels: May cause temporary redness, burning, and peeling.
  • Laser and light-based devices: Potential side effects include pain, redness, swelling, and changes in skin pigmentation.

Complications of Acne

  • Scarring: Acne scars can be permanent and may require cosmetic procedures for improvement . Scarring is more common when severe acne is not treated promptly.   
     
  • Post-inflammatory Hyperpigmentation: Dark spots can persist after acne lesions heal, particularly in individuals with darker skin tones .   
     
  • Acne Fulminans: A rare but severe form of acne characterized by the sudden onset of painful nodules and ulcers . This condition primarily affects male adolescents with preexisting acne.   
     

 

Contact Derma Clinic For Best options for your Acne Treatment
Call: 9801358600 To Book your Appointment.
Derma Clinic
Basundhara Chowki
Kathmandu
Nepal

 

 

 

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