Posted by Dr Joe on August 3, 2020 · Leave a Comment
In my last post I discussed the pathophysiology of acne and how a pimple is formed. From the initial plugging of the duct going from the small gland in the skin to the outside to the colonization of the thick material stuck in the duct with bacteria. The growth of bacteria and the eventual formation of a pimple was the final common pathway to the process.
All of the forms of treatment are aimed at relieving one of the above factors. The simplest form of treatment is the use of keratolytic agents which cause the top layers of skin to peal faster than they ordinarily do. You must remember that our skin is constantly pealing and replacing itself. In an effort to prevent plugging of the ducts an effort is made to try to keep the skin pealing frequently.
The two most common keratolytic agents are benzoyl peroxide, and retinoic acid. When used too rapidly these can cause flushing and irritation of the skin, so we usually start using it less frequently than we use it eventually. The other process involves bacteria getting into the pores from the skin (we all have bacteria on our skin) and growing to produce a painful pimple. For this there are a variety of antibiotics that can be used both topically (placed right on the skin) or systemically (taken by mouth). The problem is that the process of formation of a pimple takes quite a long time, and the stimulus for teenage acne (hormones) does not stop while treatment begins. So, it is usually a prolonged process to clear the acne (months versus weeks or days).
There are all types of combinations of medications to use for acne and if one does not work it is reasonable to change products. A few of these are found over the counter such as proactive, but most are prescription medications.
Of course, regular soap and water washes help also and avoidance of picking or squeezing the pimple is very important because it can change simple acne in the skin to a much larger cyst or abscess under the skin that can then scar the skin.
Most kids get some degree of acne at one point or another, but keep reminding your children that there are ways to deal with acne, because is can be an emotionally upsetting time for adolescents.
