Acne is a common skin condition that, although not physically disabling, has a significant impact on depression, low-self esteem, and anxiety (Graber, 2017). As tempting as it might be, avoid squeezing pimples. The scars and hyperpigmentation left behind can be lifelong. Stress, family history, hormones, and lack of exercise can all contribute to acne. However, the main contributor is a bacteria called Cutibacterium, which thrives in sebum produced by sebaceous or oil glands.
There are three clinical stages of acne, which are important to determine before advising a specific treatment plan.
1) Comedonal (non-inflammatory) acne or mild papulopustular (whiteheads) and mixed comedonal (blackheads) : 2) Moderate papulopustular and mixed acne 3) Severe acne (eg, nodular acne).
The steps to acne treatment (may include combinations of below)
1) Medications. Keep in mind, certain medications can contribute to acne, such as glucocorticoids, phenytoin, lithium, isoniazid, androgens (Graber, 2017). 2) Regular face washing morning and night with a good cleanser, such as DermNurse Salicylic acid wash or ZO Oilacleanse, is the foundation to improving acne. 3) Wear less make-up or make-up that is non oil based 4) Exfoliating with ZO Glycogent or DermNurse AHA clarifier product 5) Birth control pill for female clients. Acne can flourish under androgen hormone excess such as high testosterone or estrogen levels. If you also suffer from menstrual irregularity and facial hair you should get your blood checked to rule out underlying health issues contributing to your acne. 6) Red and Blue light laser therapy: 7) Topical Retin A such as ZO Retamax or prescription Retin A. Not recommended for women who are pregnant or breastfeeding. Cream applied in a thin layer at night (avoid eyes and mouth) after washing and drying face. Alternatives to Retin A include azelaic acid and salicylic acid (Graber, 2017). 8) Benzoyl peroxide 9) Topical antibacterial prescription gels such as Biacna or Clindoxyl gel 10) Oral antibiotics such as Minocycline or Aprilon 11) Accutane or Isotretinoin. This is the last resort solution for acne because it can have multiple adverse effects and is highly teratogenic (harmful to fetus). It works by shrinking sebaceous glands and reducing sebum secretion. You can not be pregnant or breast feeding while taking this medication and it is mandatory for females to be taking a reliable form of birth control. Your liver function will be assessed regularly, via blood tests, to ensure this medication is not harming your liver.