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What Myths exist about the Causes of Acne?
There are many myths about what causes acne. Chocolate and greasy foods are often blamed, but research has
shown that foods seem to have little effect on the development and course of acne in most people. Another
common myth is that dirty skin causes acne; however, blackheads and other acne lesions are not caused by dirt.
Who Gets Acne?
People of all ages get acne, but it is most common in adolescents. Nearly 85 percent of
adolescents and young adults between the ages of 12 and 24 develop the disorder. People
of all races can have acne, but it is more common among Caucasians. For most people,
acne tends to go away by the time they reach their thirties; however, some people in
their forties and fifties continue to have the disorder.
How Is Acne Treated?
By the time many people consult a doctor for their acne, they usually have tried a
drawerful of over-the-counter (OTC) medications. Acne is often treated by a dermatologist,
a doctor who specializes in diseases and disorders of the skin. Dermatologists treat all
kinds of acne, particularly severe cases. Doctors who are general or family practitioners,
pediatricians, or internists may treat patients with milder cases of acne.
The main goal of acne treatment is to prevent scarring. Additional goals are to reduce the number of painful
lesions and to minimize the psychological stress and embarrassment caused by this disease. Doctors often use
drug therapy as the first choice for treating acne. Drug therapy is aimed at reducing several problems that
play a part in causing acne: abnormal clumping of cells in the follicles, increased oil production, the
bacterium P. acnes, and inflammation. Depending on the severity of the person's acne, the doctor will recommend
one of several OTC or prescription topical medications (medication applied to the skin) or a prescription systemic
medication (medication taken by mouth). The doctor may suggest using more than one topical medication or using
both an oral medication and a topical medication at the same time.
How do you Treat Blackheads, Whiteheads, and Mild Inflammatory Acne?
Doctors usually recommend an OTC or prescription topical medication for people with blackheads,
whiteheads, and mild inflammatory acne. Depending on the type of medication, a topical drug is
applied directly to the acne lesions or to the entire area of skin affected. The medication
helps limit the formation of new blackheads and whiteheads and decrease inflammation.
What Treatments exist for Moderate to Severe Inflammatory Acne?
Patients with moderate to severe inflammatory acne may be treated with an OTC or prescription
topical medication, a prescription oral medication, or a combination of these.
Are there any Prescription Topical Medications?
Several types of prescription topical medications are used to treat acne, including benzoyl
peroxide, antibiotics, tretinoin, adapalene, and azelaic acid. Prescription and OTC benzoyl
peroxide work in the same way. Many doctors prescribe benzoyl peroxide instead of
recommending OTC versions to make sure patients get the most desirable formulation (cream, gel, or lotion
What Are The Advantages of Isotretinoin?
Isotretinoin is a very effective medication that can help prevent extensive scarring in
patients. After 16 to 20 weeks of treatment with isotretinoin, acne completely or almost
completely goes away in most patients (up to 90 percent). For some people, however, the
acne will come back, and they will need additional treatment with isotretinoin.
What Are The Disadvantages of Isotretinoin?
Patients should carefully consider the several disadvantages of isotretinoin. The drug
is not only expensive but is also linked to some adverse effects that can be severe.
Possible side effects include inflammation of the lip and mucous membrane of the eye;
dry mouth, nose, or skin; itching; nosebleeds; muscle aches; photosensitivity; and,
rarely, decreased night vision. Other more serious side effects include increased blood
cholesterol, lipid, and triglyceride levels and abnormal liver enzymes. To make sure
isotretinoin is stopped if these side effects occur, the doctor usually monitors a
patient's complete blood count, blood chemistries, cholesterol, triglycerides, and
liver enzymes before therapy is started and periodically during treatment. All of t
hese side effects usually go away after the medication is stopped. Patients who experience
side effects while using isotretinoin should tell their doctor. The doctor may be able
to reduce the dose of the drug so that the side effects are decreased or stopped.
The most serious potential adverse effect of isotretinoin is that it is teratogenic: it
can cause birth defects in the developing fetus of pregnant women who take the drug.
Therefore, it is crucial that women of childbearing age are not pregnant and do not get
pregnant while taking isotretinoin. Women must use an appropriate birth control method
for 1 month before therapy begins, during the entire course of therapy, and for 1 full
month after therapy stops. Women should talk to their doctor about when it is safe to
get pregnant after therapy with isotretinoin has stopped.
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