Many
Acne Treatments Found Effective
Over-the-counter
products for mild-to-moderate facial acne are just as effective
as prescription antibiotics, and they can cost much less, according
to a study reported in the medical journal The
Lancet.
The
big difference between the products is price, with over-the-counter
preparations containing benzoyl peroxide sometimes costing one-tenth
the price of some prescription antibiotics.
Benzoyl
peroxide is found in dozens of over-the-counter acne treatments,
the researchers say.
"There
were no vast differences [in effectiveness] between different
treatments, including the treatments you can get over-the-counter,"
remarks Dr. Tony Avery, co-author of the study and a physician
at Queen's Medical Centre, University of Nottingham, in England.
Some
dermatologists say the study's conclusions were not particularly
new and would not lead to substantive changes in their clinical
practice.
"Basically
if someone with mild acne presents for treatment, your first
line of defense will be a topical regimen," says Dr. Sumayah
Jamal, an assistant professor of dermatology at New York University
School of Medicine.
"Most
dermatologists do not prescribe an oral antibiotic for someone
with just mild-to-moderate acne," Dr. Jamal says.
According
to the study authors, most adolescents have acne at some point.
Antibiotics have been an important part of treatment for the
past 40 years.
However,
concerns exist about increasing antibiotic resistance due to
overuse of the drugs.
Dr.
Avery compared five treatment options for acne in about 650
participants. The treatments included the oral antibiotics oxytetracycline
or minocycline; the topical antibiotic erythromycin; the antimicrobial
lotion benzoyl peroxide; or a combination of topical erythromycin
and benzoyl peroxide.
Effectiveness
was similar in all groups. Fifty-five percent of those individuals
in the oxytetracycline group reported moderate or greater improvement
at 18 weeks and 54 percent in the minocycline group reported
similar improvement.
In
addition, the other groups had similar success rates - 60 percent
of those taking benzoyl peroxide alone, 66 percent of those
taking topical erythromycin plus benzoyl peroxide in a combined
formulation, and 63 percent of those taking topical erythromycin
and benzoyl peroxide separately.
It
is not entirely clear how the different therapies actually work
against acne, says study co-author Hywel C. Williams, a professor
at Queen's Medical Centre, University of Nottingham.
"Oral
antibiotics probably work partly as anti-inflammatory agents,
as well as having a direct antibiotic effect in killing the
bacteria," he explains. "Topical antibiotics and topical benzoyl
peroxide also decrease inflammation and kill bacteria.
"But,
they also have a beneficial effect in preventing a build-up
of dead skin that clogs up the pores (blackheads), the first
step in the development of an acne lesion," Dr. Williams says.
Benzoyl
peroxide was the cheapest treatment (12 times less expensive
than minocycline) and was as effective as the combination that
included erythromycin and benzoyl peroxide. That was a surprise,
Dr. Avery says.
Always
consult your child's physician for more information.
|
Acne
is a disorder of the hair follicles and sebaceous glands.
With
acne, the sebaceous glands are clogged, which leads to pimples
and cysts.
Acne
is very common - nearly 17 million people in the US are affected
by this condition. Acne most often begins in puberty.
During
puberty, the male sex hormones (androgens) increase in both
boys and girls, causing the sebaceous glands to become more
active - resulting in increased production of sebum.
The
sebaceous glands produce oil (sebum) which normally travels
via hair follicles to the skin surface.
However,
skin cells can plug the follicles, blocking the oil coming from
the sebaceous glands. When follicles become plugged, skin bacteria
(called Propionibacterium acnes, or P. acnes) begin to grow
inside the follicles, causing inflammation.
Acne
progresses in the following manner:
-
Incomplete blockage of the
hair follicle results in blackheads (a semisolid, black
plug)
-
Complete blockage of the
hair follicle results in whiteheads (a semisolid, white
plug)
-
Infection and irritation
cause whiteheads to form
Eventually,
the plugged follicle bursts, spilling oil, skin cells, and the
bacteria onto the skin surface. In turn, the skin becomes irritated
and pimples or lesions begin to develop.
Acne
can be superficial (pimples without abscesses) or deep (when
the inflamed pimples push down into the skin, causing pus-filled
cysts that rupture and result in larger abscesses).
Rising
hormone levels during puberty may cause acne. In addition, acne
is often inherited.
Other
causes of acne may include the following:
-
hormone level changes during
the menstrual cycle in women
-
certain medications (such
as corticosteroids, lithium, and barbiturates)
-
oil and grease from the scalp,
mineral or cooking oil, and certain cosmetics may worsen
acne
-
bacteria inside pimples
Acne
can be aggravated by squeezing the pimples or by scrubbing the
skin too hard.
Acne
can occur anywhere on the body. However, acne most often appears
in areas where there is a high concentration of sebaceous glands,
including the face, chest, upper back, shoulders, and neck.
The
following are the most common symptoms of acne:
The
symptoms of acne may resemble other skin conditions.
Always
consult your child's physician for a diagnosis. |
