Acne vulgaris is the common dermatological disorder that has wide range of aetiology aspects. The pathogenic factors, which are responsible for the Acne have to be identified exactly to opt for the appropriate treatment. Some of the pathogenic factors include excess sebum, inflammation, follicular hyper proliferation and Propionibacterium acnes. The seriousness and intensity of the stages of Acne will help the physician to choose a particular type of treatment or a combination of a few strategies.
Treatment Using Topical Applications
The two conditions like hyper keratinization and follicular hyper proliferation are normalized using the topical retinoids that are anti-inflammatory and comedolytic. The number of inflammatory lesions, comedones and micro comedones are decreased by the topical retinoids.
The topical retinoids can be used along with the other acne medications. The most common topical retinoids used for treating acne vulgaris are tazarotene, tretinoin and adapalene. The retinoids are usually applied for one time per day.
Side effects of Topical Retinoids
Initially most of the people using these retinoids might encounter irritation towards the medicine like peeling of the skin and skin redness. But, after using it for some time the skin irritation subsides and the problem gets resolved. The dosage of the medicine can be used in the alternate days in case the irritation continues. Retinoids are also known to reduce the thickness of stratum corneum. This will increase the sun sensitivity.
These antibiotics are used against the pathogen named as Propionibacterium acnes. These antibiotics also function as anti-inflammatory. To alleviate the resistance progress by the pathogen against the topical antibiotic, a combination of topical antibiotic with the systemic antibiotic can be used accompanied by benzoyl peroxide. These antibiotics are not comedolytic.
Clindamycin is one of the common topical antibiotics used by the people for Acne vulgaris besides using benzoyl peroxide. Clindamycin is used one time or two times per day. The solutions and gels available for topical antibiotics are found to be irritating compared to the lotions and creams. Clindamycin is found to be more efficient compared to the erythromycin.
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Benzoyl Peroxide Products
These products are topically used and they are effective on P acnes. The benzoyl peroxide products are obtainable as non-prescribed medications or prescribed in topical applications such as gels, soaps, creams, washes and lotions. The benzoyl peroxide derived compounds rarely cause contact dermatitis that is either allergic or irritant when used along with tretinoin.
The systemic antibiotics are used for treating Acne vulgaris and they are known to have anti-inflammatory characteristics. These antibiotics are found to be operative against Propionibacterium acnes. The common antibiotics that are prescribed for Acne are tetracycline. But, lipophilic antibiotics such as minocycline and doxycycline are more efficient rather than tetracycline.
The efficacy of minocycline is higher as the P acnes is found to be less resistant against the minocycline. It is observed that the most commonly used antibiotics for Acne vulgaris these days are found to be resistant against P acnes. The use of erythromycin is completely stopped as the pathogen has developed total resistance against this antibiotic.
Other antibiotics like trimethoprim accompanied by azithromycin and sulfamethoxazole are also considered more useful in treating Acne vulgaris.
Hormonal Therapies Birth control tablets are found to have relevance in the treatment of Acne vulgaris. Spironolactone is used in the treatment of Acne vulgaris.
Severe recalcitrant Acne vulgaris is treated by Isotretinoin, a systemic retinoid. Isotretinoin is usually given at the initial dosage of 0.5mg/kg/d for about four weeks and enhanced upto 120 to 150 mg/kg.
Surgical care can also be taken by the extraction of comedones and phototherapy is considered as a potential treatment for acne vulgaris.