Acne can be divided into various grades depending on the severity and types of lesions with Grade I being the mild one and Grade IV being the severe one that may lead to scarring and disfiguration.
Acne vulgaris can be a debilitating disease and can cause severe psychological stress and isolation from the peer group.
The different grades of acne are:
Grade I – Comedones (blackheads or whiteheads)
Grade II – Red color eruptions also known as papules
Grade III – Pustules or lesions filled with pus or yellow serum like fluid
Grade IV – Nodulocystic or lesions with depth
There are infinite acne treatment modalities available both doctor prescribed as well as over the counter. The line of treatment also differs depending on the grade of acne. The treatment of acne can be divided into topicals and oral medications.
TOPICALS. These are creams and ointments used for surface application over the acne lesions. The various cream options available are:
Medicated Facewash – Cleanse twice daily with a 5% benzoyl peroxide wash. An alternative for those who are allergic to benzoyl peroxide is 2% salicylic acid.
Clindamycin phosphate – It is an antibiotic gel useful in resolution of acne lesions by reducing the P. Acnes bacterial population
Benzoyl Peroxide – It is again an antibiotic gel available in two concentrations: 2.5% and 5%. The mechanism of action is the same as clindamycin phosphate.
Salicylic Acid – It is a mild keratolytic agent and causes reduction in the size of sebaceous gland and hence reduces the severity of acne lesions.
Nicotinamide – It is an antibiotic gel that reduces the bacterial population as well as the size of involved sebaceous gland.
Retinoids – These are epidermal modulating agents that regulate the net skin growth hence reduce the size of the acne lesions. Retinoids should be avoided in females planning to conceive or are pregnant. Direct exposure to the sun should also be avoided.
ORAL MEDICATIONS. These are tablets that supplement the topical treatment.
Doxycycline – It helps in reduction of acne by reducing the population of P. Acnes bacteria.
Minocycline – It also reduces the size of acne lesions by preventing proliferation of P. Acnes bacteria.
Azithromycin – It is given in a pulse dose and reduces the bacteria and hence prevents recurrence of acne lesions.
Retinoids – Oral retinoids are the mainstay of treatment in severe form of acne and in acne scars. It should be strictly used after consulting your dermatologist.
It is advised that you do not opt for self-medication and undergo any of the above treatment under the supervision of a dermatologist.
There are non-pharmacological procedures available as well for acne treatment that I shall cover in my next blog. So stay tuned 🙂