Acne : Clearing Up Acne, Treating Serious and Severe Cystic Acn

by Food and Drug Administration (FDA)

(Page 2 of 2)

Acne sufferers often report that their acne improves in the summer, leading to the belief that the sun has a modifying effect. A recent Swedish study on the influence of sunlight on skin found that the majority of people with acne experienced improvement after exposure to sun.

However, medical opinion on the value of sunlight varies. "It's hard to say whether it's the sun or psyche that has an effect on acne," says Evans. "The sun may have a modest effect in some people, but the relaxation usually associated with summer is also probably a factor."

One thing is certain, though. The idea that the sun improves acne by drying out greasy skin is incorrect. Sun increases oil production, which is why people tend to have oilier skin in the summer.

Clearing Up Acne

What can you do to clear up mild acne?

Evans advises the following:

Get a nonprescription acne medicine and apply regularly. Over-the-counter drugs containing sulfur, resorcinol, salicylic acid, and benzoyl peroxide are all effective for treating mild acne.

Use ordinary hygiene on affected areas, washing your face once or twice daily with your usual soap or cleanser. Deodorant soaps may be used, but they are of no particular value for acne.

Avoid any food or drink you know is a trigger.

If these measures don't work, Evans advises, see a dermatologist.

While it might be tempting to pick at pimples and squeeze blackheads, this can injure the skin and underlying tissues. Doctors advise patients not to pick pimples. Medical instruments called comedo extractors are used to remove blackheads. Some doctors may suggest that their patients use such an instrument themselves. Other doctors would rather remove the blackheads in their office or clinic because of a risk of scarring.

Treating Serious Acne

One drug dermatologists sometimes prescribe for serious acne is tretinoin, commonly known as Retin-A. A derivative of vitamin A, Retin-A comes in cream, gel and liquid forms and is rubbed onto the skin once nightly. It is highly effective for treating blackhead acne and modestly effective for treating pimples and pustules. Retin-A usually begins to clear up acne in two to three weeks, although in some cases it's more than six weeks before any improvement is noticed.

Scientists do not know exactly how Retin-A works, but research suggests that it both pushes out the comedo plugs beneath the skin and helps prevent their re-formation.

One of the main side effects of Retin-A — one that occurs in all users — is a heightened susceptibility to sunlight. Therefore, those who use Retin-A should stay out of the sun as much as possible, and when in the sun should minimize its effects with sunscreens and protective clothing. Retin-A users should also avoid sun lamps because their ultraviolet rays mimic those of the sun.

Another common side effect of Retin-A is drying, irritation or peeling of the skin. When this occurs, the doctor may suggest patients cut back use to two or three times a week.

Some antibiotics are effective for treating and preventing pustules and cysts of severe acne. Tetracyclines and erythromycin are the most commonly prescribed.

Treating Severe Cystic Acne

For very severe, disfiguring acne unresponsive to the treatments mentioned, the doctor may prescribe isotretinoin, commonly known as Accutane. Also a vitamin A derivative, Accutane is taken orally in capsule form. It is highly effective for treating severe cystic acne and preventing the deep pits and scars that result.

Scientists do not know exactly how Accutane works, but evidence suggests that it reduces the size of the sebaceous gland and the amount of sebum secreted. In any case, it completely clears up the disease in many people.

Women should use Accutane with extreme caution, however, because it can cause miscarriage and birth defects. If a woman becomes pregnant while taking the drug, there is a great possibility her baby will be born deformed. Therefore, Accutane's use is tightly regulated by FDA. Doctors may only prescribe it for a woman who has had a negative pregnancy test and does not intend to become pregnant while taking it, and who has signed a consent form that she has been fully informed of its side effects. (See "New Warning About Accutane and Birth Defects," in the October 1988 FDA Consumer.)

In addition to the danger of fetal malformation and miscarriage, there are a number of minor side effects associated with Accutane. Ninety percent of those who take the drug experience inflammation of the lips (and less frequently of the eyes), and 80 percent experience drying of the skin, nose or mouth.

In severe cases of acne, the dermatologist may surgically drain large pustules or abscesses. In addition, plastic surgery is sometimes used to smooth over deeply pitted and scarred skin. Dermabrasion — a technique to remove scars that is like sandpapering the skin — is being used less frequently. Dermabrasion has become less popular because it can discolor the face and because new acne medicines have made it increasingly less necessary.

However unpleasant and embarrassing acne is, it usually begins, peaks, and runs its course in adolescence, slowly fading away in early adulthood. During those critical teen years, modern medicines and treatment can do much to ease the discomfort and embarrassment of the acne sufferer.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.