At-Home Treatment of Acne

Many of the over-the-counter acne medications on the market today rely on similar chemical-based keratolytic agents (substances that act to unclog pores) such as benzoyl peroxide or salicylic acid. Benzoyl peroxide, resorcinol, salicylic acid, and sulfur are the most common topical OTC medicines used to treat acne. Each can be purchased over the counter, and each works differently. Benzoyl peroxide is best at killing bacteria and may reduce oil production. Resorcinol, salicylic acid, and sulfur help break down blackheads and whiteheads. Salicylic acid also helps cut down the shedding of cells lining the follicles of the oil glands. Topical OTC medications are available in many forms, such as gel, lotion, cream, soap, or pad. Patients must keep in mind that it can take 8 weeks or more before they notice their skin looks and feels better.

There are problems with over the counter acne medications. In some patients, OTC acne medicines may cause side effects such as skin irritation, burning, or redness. Benzoyl peroxide can cause skin irritation and drying. Salicylic acid is also an irritant and can cause erythema and peeling. When properly used, these products may contribute to a hygiene regimen that will reduce the incidence and severity of acne in some individuals; however, over-the-counter acne medications do little to impact the blemishes that inevitably occur. The problems with traditional at home treatment of acne has led many people to seek prescription medications.

Prescription Acne Medicines

Systemic Treatments/Topical Preparations

A variety of prescription medicine methods are used to prevent and treat acne: pill, topical, and injectables. Topical therapies such as Retin-A account for roughly half of the US prescription acne medicine market. Systemic therapies such as Isotretinoin (commonly called Accutane) make up the other half of this market (Micrologix BioTech 2003). In general, mild to moderate acne cases are treated with topical medications, with more severe acne cases being treated with systemic or a combination of topical and systemic therapies. Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline or erythromycin are often prescribed for moderate to severe cases, especially when there is a significant amount of acne on the back or chest. Antibiotic treatment is used to kill the bacteria P. acnes that cause acne flares. Prescription oral and topical medicines are sometimes combined.

Problems exist with most of these acne treatment options. Accutane has been linked to serious side effects. Antibiotics are not as useful as they once were as P. acnes has developed resistance to them. Antibiotic resistance in P. acnes strains has been reported worldwide, and the incidence of antibiotic resistant P. acnes has increased dramatically from 20% in 1978 to 60% in 1996 (Guttman; Micrologix Biotech 2002). In addition, the use of antibiotics has also been linked to serious side effects.

Recently Introduced Prescription Acne Therapies

Doctors sometimes use other procedures in addition to drug therapy to treat acne. For example, the doctor physically removes the patient's comedones during office visits. Some doctors inject cortisone directly into lesions to help reduce the size and pain of inflamed cysts and nodules.

Recently, prescription acne therapies have been introduced to the dermatology community involving either ultraviolet light or laser light. While these therapies are making some inroads to the acne treatment market, they are also receiving publicity for the novelty of their approaches. Such therapies not only require medical supervision, but they involve potentially harmful radiation, substantial investment in equipment and very high treatment costs. Finally, none of these therapies have been shown to be as effective at treating blemishes as Zeno.

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