Jul
2
Acne: Prescription Lotions and Gels
July 2, 2009 | Leave a Comment
Prescription Lotions and Gels for Acne Treatment
If treatment with benzoyl peroxide doesn’t get your pimples under control within a couple of months, check with a physician. Dermatologists often prescribe topical antibiotic gels or lotions in addition to or instead of benzoyl peroxide. Erythromycin and clindamycin are old standbys. Because they have been so widely used however, bacteria have begun to develop resistance to them. As a result, dermatologists have been restricting their use and instead turning to other approaches.
One other medication that is being prescribed is azelaic acid (Azelex, Finevin). Like benzoyl peroxide, this topical treatment seems to keep pores from clogging and to discour-age the multiplication and spread of bacteria. It too may result in burning, stinging, redness, or dryness of the skin. In rare instances, dark skin exposed to azelaic acid may develop lighter patches. If you have a cold sore or fever blister that gets worse while you are using an azelaic acid product, notify the prescribing physician immediately.
Isotretinoin or a similar compound in the vitamin A family can be very effective in treating acne and reducing the inflammation associated with severe acne. Using topical vitamin A–like compounds (retinoids) early in the course of acne lessens the likelihood of scarring, a complication of the condition. Some doctors prescribe tretinoin together with benzoyl peroxide or with an oral antibiotic such as doxycycline to clear the skin faster.
Clindamycin Gel (Cleocin T, Clinda-Derm, Evoclin Topical Foam
Clindamycin is an antibiotic that can be applied to the skin to fight acne-causing bacteria. It may take 2 months to see significant improvement, but generally this treatment is effective. Other topical antibiotics such as erythromycin gel are also effective. Some prescription products combine an antibiotic with benzoyl peroxide for greater effectiveness. These include BenzaClin and Duac Gel (clindamycin plus benzoyl peroxide) and Benzamycin (erythromycin plus benzoyl peroxide). These are effective but expensive because no generic equivalents are available.
Side effects: Itching, burning, dryness, and peeling. A rare but very serious and dangerous side effect of clindamycin that is extremely unlikely to occur but still possible with the topical form is pseudomembranous colitis. Notify your doctor immediately if you develop persistent or bloody diarrhea.
Downside: Skin bacteria (P. aches) are beginning to develop resistance to topical clindamycin.
Cost: Approximately $50 for a 60-gram tube Tretinoin Gel (Retin-A).
Retin-A speeds up cell turnover and normalizes the lower levels of the skin. With 6 weeks or more of treatment, it is frequently very helpful against acne.
Side effects: Stinging, dryness, redness, flaking, and irritation.
Downside: Retin-A makes skin more sensitive to sunburn and sun damage, so stay out of the sun and use effective protection against ultraviolet rays.
Cost: $35 to $50 for 15 grams.
There is another prescription gel or cream that is based on a vitamin. Nicomide-T gel or cream contains nicotinamide, a form of niacin. Like Retin-A, it is topical but not an antibiotic, so theoretically bacteria should not develop resistance to it. A preliminary study showed that Nicomide-T gel is as effective as clindamycin gel in reducing blemishes.” Other research confirmed that it can protect the skin and is less likely to dry it than a number of other acne treatments. It is not clear whether Nicomide-T is as effective as Retin-A, though some studies conducted by the manufacturer, Sirius Laboratories, suggest that adding it to other treatments boosts the effectiveness of both.
Jul
2
Acne: Over-the-Counter Treatment
Benzoyl peroxide is the primary ingredient in most OTC acne treatments. This compound has antimicrobial activity and is usually quite effective for mild acne.
Q. My teenage son has a mild case of acne, but to him it is huge. He washes with strong cleansers and uses a variety of acne medicines. Can you recommend something that will clear up his skin so he doesn’t scrub so much? His face is bright red after all the washing, and I don’t think that is good.
A. You’re right! Acne is not caused by dirt, so vigorous washing won’t help. It may even make things worse.
OTC benzoyl peroxide (Benzac, Clearasil Acne Treatment, Oxy 5, etc.) should do the job. If not, your son should see a dermatologist. Retin-A (tretinoin) and/or antibiotics can work wonders.
Benzoyl peroxide is found in a number of different products, from cleansing bars and liquid cleansers to lotions and even shaving creams. Read the instructions on the label and follow them; the procedure varies a little for the different forms. Benzoyl peroxide can dry the skin and cause irritation. If that happens, use it a little less frequently or look for a product with a lower concentration of the ingredient.
Benzoyl peroxide unplugs pores and discourages thegrowth of skin bacteria. It is not, however, an antibiotic, and skin bacteria don’t seem to develop resistance to it.. Follow the instructions on the product label for application and use.
Side effects: Skin irritation, dryness, redness, scaling, and rash.
Downside: Acne may worsen initially before improving. Use the product for 6 weeks to 2 months to evaluate its effectiveness..
Cost: Varies, depending on - the product; approximately $20 to $30 for a month’s worth of gel .
individuals are allergic to benzoyl peroxide and break out in hives or swelling, so try it out on your forearm first to make sure you will not react badly. If you do, you will have to forgo benzoyl peroxide treatment and look for another way to manage your acne.
A few nonprescription acne products contain active ingredients other than benzoyl peroxide. Resorcinol is generally used in combination with sulfur (Clearasil Adult Care contains them both). Salicylic acid is also found in some OTC acne products. None of these should be used in combination with benzoyl peroxide. All may irritate and dry the skin, and they should not be combined with other products that might irritate the skin. Prescription acne treatment drugs are Cipro and Accutane which are commercial names for generic Ciprofloxacin and Isotretion.