Combination Topical Skin Care for Acne
Teens and adults suffer from acne due to hormone
fluctuations and stress. Some feel diet may play a role. These factors
stimulate sebaceous glands that causes the oil production that the P. acne live
on. Most patients have tried a variety of over-the-counter acne remedies before
they get to our clinic.
Acne can range from mild blackheads and whiteheads (comedonal
acne) caused by pores blocked by sebum and skin cells to inflammatory acne that usually
presents with redness and inflammation under blocked pores. The most severe
form of acne is cystic acne. Cystic acne usually is painful related to a deeper
bacterial infection most commonly by propionibacterium acnes. Cystic acne may
lead to disfigurement and result in residual scarring and the goal would be to
treat as soon as possible to avoid further scarring.
Over the Counter
For milder cases of acne, various soaps, washes, toners and
cleansers have been effective. Two of the most common are benzoyl peroxide and
salicylic acid. Benzoyl peroxide acts as an antibacterial treating
propionibacterium acnes. Salicylic acid is a keraolytic agent that softens and
exfoliates the outer layer of skin, the stratum corneum, and helps prevent
clogging of the pores with sebum and skin.
solution can be useful in treating mild comedonal acne. Patients usually do not complain of
irritation with use of this product.
Topical Antibiotics such as clindamycin, erythromycin
and sodium sulfacetamide have been effective against propionibacterium acnes.
Topical Retinoids work to reduce
outbreaks by modulating cell turnover, which prevents inflamed skin cells from
clogging pores. It reduces the frequency and severity of acne breakouts. Side
effects such as increased sensitivity to sunlight, dryness, redness and peeling
need to be discussed. These side effects can be managed to improve compliance
Antibiotic resistance is always of concern. Combining
topical antibiotics with benzoyl peroxide has been one approach to reduce
antibiotic resistance. In addition, combination therapy using clindamycin or
erythromycin with low dose benzoyl peroxide has proven to be more effective
than clindamycin or erythromycin alone, in some studies.
Combining topical retinoids enhance the penetration of
topical antibiotics and improves treatment outcome. Later this month, I will
address added benefits to combination therapy using laser and light