Which Acne Treatment is Most Effective?
There are four main reasons we get pimples.
The four pathologic features of acne must all be addressed to fully eliminate acne – and there is a specific treatment for each effect:
Clogged Follicles
Clogged follicles are formed because, normally, the skin sheds about every two weeks. However, the epidermis does not shed properly sometimes, particularly at the hair follicle level, and the skin builds up on itself. This causes something known as follicular plugging or a clogged pore.
Clogged pores or follicular plugging is best treated with medication like retinols. These are known to help the shedding process of the skin. Retinols also cause increased cell turnover, so whatever debris you have in those hair follicles, retinols will clean them out. Retinols come in over-the-counter forms as well as prescription forms. Prescription retinol can be irritating to the skin but tend to be more effective overall.
Oil Production
The sebaceous units are attached to a hair follicle, and every hair follicle on your body has at least one sebaceous gland. The hair follicles on your face have multiple sebaceous glands attached to each follicle.
Oil stimulation occurs when endogenous hormones stimulate the oil gland epithelium to produce oil. If your hair follicles were open, the oil would travel out of the hair follicle to the surface of the skin. When a pore is clogged, oil cannot escape, so it gets trapped.
The medication most effective for oil production is isotretinoin (Accutane). Accutane is used in varying dosages and regimens and can be a safe and very effective treatment – especially for scarring nodulocystic acne. Other oral medications like spironolactone have an anti-androgen effect and these medications are also used in hormonal acne – or acne that is mainly in the jawline and worse with the menstrual cycle. Spironolactone works best for those with hormone-related acne and can only be used in women. A new option is Winlevi, a spironolactone cream. These medications all work by inhibiting oil production.
Bacterial Overgrowth
Our hair follicles contain bacteria, which are usually controlled by exposure to oxygen. Clogged follicles allow bacteria to overgrow in this enclosed environment. These bacteria contribute to the development of acne.
Medications that can be used to treat acne-causing bacteria include clindamycin, erythromycin, dapsone, and benzoyl peroxide. Most dermatologists consider benzoyl peroxide the standard of care for antibacterial acne treatment. Other antibiotics have anti-inflammatory properties that make them effective against rosacea-like acne.
Inflammation
Not all pimples are inflamed. Blackheads and whiteheads are clogged pores without inflammation. However, inflammation is a critical part of the acne process. Due to differences in immune systems, some people have a stronger inflammatory response to acne. Inflamed acne can cause painful cysts and acne scarring.
Sulfur-based products are a widely used option for controlling inflammation. We also use antibiotics, particularly the tetracycline family, in acne therapy. They are used in acne for their anti-inflammatory properties.
What is the Best Acne Treatment for Me?
The most effective acne treatment is a comprehensive treatment plan that includes treatments for all the underlying components causing your acne. You will not achieve clear skin until all your acne-causing factors have been addressed. If you are scarring you may need oral medicine and more than just topicals. Facials and expensive, trendy creams will not cure your acne. At ZENA Medical we provide a customized approach to fully address your acne and help you achieve clear, pimple-free skin. Our goal is to make you 100% better and to educate you on what is right for your skin type and your specific type of acne.
Reach out to Dr. Zena and her team today to find out how they can help you get your acne under control.
Take the Next Step
If you have questions about effective acne treatments, we encourage you to schedule a private consultation today at ZENA Medical in Newport Beach, California. Our doctors, nurse practitioners, skin care specialists, and expert injectors will ensure your outcome is optimal and safe. Call us at (949) 269-8198 or fill out our convenient contact form on ZENAmedical.com. We look forward to meeting you!