An Overview Of The Diagnosis And Treatment Of Acne In Adult Patients
Salicylic acid increases anti-inflammatory and peeling activity, while benzoyl peroxide kills bacteria and is known to cause drying and mild peeling. Benzoyl peroxide-based cleaners and creams are available externally at concentrations of 5 percent or less, or at higher prescription concentrations. Regardless of what you are trying to do, you should continue treatment for a few months before you see the difference. Visit your doctor if you don’t notice any improvement within six to eight weeks.
Expect your doctor to also prescribe local retinoids, benzoyl peroxide or other topical treatments. In addition to oral antibiotics, some dermatologists prescribe topical antibiotic creams and gels to treat and prevent acne. Topical antibiotics have fewer possible side effects than oral antibiotics and are generally prescribed for less severe and persistent acne cases.
However, there are additional considerations that you should consider during the treatment. Women over 25 often have a high percentage of failed treatments . About 80% of women fail in multiple cycles of systemic antibiotic medication and about 30% to 40% fail after one cycle of isotretinoin (Blasiak et al., 2013, Goulden et al., 1997a, Goulden et al., 1997b, Rademaker, 2016). The suspicion of an underlying endocrine disorder should be increased if acne repeat occurs shortly after treatment with isotretinoin . Generally avoid overly aggressive and hard cleaning agents, especially if you are already using a topical prescription ingredient. With dry, sensitive skin, a creamy cleanser may be a better option.
Acne in adult patients may begin and persist or appear in adulthood during adolescence. Acne has various psychosocial effects that affect the quality of life of patients. Acne treatment in adult women specifically has its challenges due to considerations of patient preferences, pregnancy and breastfeeding. Treatments vary widely and treatment should be specially adapted for each individual woman. Dr. Palm notes that dermatologists have the ability to prescribe retinoids that are stronger than the available over-the-counter options. Differin is like “dipping your toes in the baby pool”, but in more serious cases, Dr. Palm says it moves to Tretinoin, the strongest retinoid they have.
Isotretinoin is known to cause serious birth defects and therefore two methods of contraception are required while taking this drug. Topical retinoid medications are prescription drugs from Vitamin A (Bradford and Montes, 1974, Krishnan, 1976, Lucky et al.1998, Acne Dermatologist Shalita et al. 1999). Current retinoid medications are often used as first-line treatment for patients with mild to moderate acne, especially when acne is primarily comedonal. Retinoid therapy is comedolytic and resolves the microcomedon injury precursor.
Current antibiotics are believed to accumulate in the follicle and can act through anti-inflammatory and antibacterial effects (Mills et al. 2002). Due to increased antibiotic resistance, monotherapy with local antibiotics is not recommended in the treatment of acne. Topical antibiotics are best used in combination with BP (Zaenglein et al. 2016). Hormonal, cystical, stress-induced – forget all the terminology you’ve heard.
All of these topics are suitable for mild to moderate non-inflammatory inflammatory acne. Many local and oral acne treatments are contraindicated during pregnancy. If you are a woman in your years of pregnancy, it is important to discuss acne treatments with your healthcare provider and to warn them if you become pregnant.
For mild to moderate to severe acne, it generally starts with a combination of local treatments or antibiotic tablets combined with topical treatments. Antibiotics usually start to remove the skin within four weeks and the treatment can take months. However, there is a risk that acne bacteria will develop antibiotic resistance and imperfections will reappear.
The most common side effects with isotretinoin mimic the symptoms of hypervitaminosis A (Zaenglein et al. 2016). With the standard dose, these side effects disappear after treatment discontinuation (Zaenglein et al. 2016). The evaluation of each acne patient should include a complete medical history and a physical examination.