Lifestyle Choices

Acne can very often be effectively treated by special cleansers and topically applied formulations. There are four main non-prescription acne medications which alone or in combination with prescription medications are the mainstay for acne treatment. All of these are also available in stronger prescription form.

Salicylic acid .is one of the most effective topical medications. This is a beta-hydroxy acid that is a peeling agent, because it is “keratolytic” and loosens dead surface cells that stick within pores, thereby curing clogged pores at the very onset. Sulfur and resorcinol are not only keratolytic, but also anti-bacterial. They are often mixed as flesh-tinted lotions to cover blemishes (Longevite Concealer).

Sulfur is particularly effective for people with a pink or ruddy complexion.

I formulate Longevite skincare products, including a Therapeutic Cleanser with salicylic acid and sulfur. This is particularly effective in controlling acne and in smoothing the surface of the skin and making pores appear smaller. The Longevite Exfoliant immediately removes dead surface cells, which both makes the skin clearer and unclogs the pores.

The fourth highly effective, non-prescription ingredient for the treatment of acne is benzoyl peroxide, an anti-bacterial product available in both over-the-counter and prescription preparations. Benzoyl peroxide acts by releasing oxygen to kill bacteria and is keratolytic. Benzoyl peroxide can be purchased in gel, cream and lotion forms at the strength of 2.5%, 5% and 10% (the higher concentrations are by prescription only). Often dabbing 10% benzoyl peroxide directly onto a new spot successfully dries it out. In general, the gel forms are more effective, but can be rather drying. Benzoylperoxide should be started at low concentrations and applied only once per day. It is important to start slowly since some people may be allergic.

If your acne does not respond to some combination of store-bought medications, you should consult a dermatologist, who may prescribe stronger formulations alone or in combination with prescription medications such as topical antibiotics or retinoic acid.

Antibiotics need not be taken orally to treat acne; they can be very effective when simply applied to the skin. Topical antibiotics exist in many forms: most frequently prescribed are clindamycin (Cleocin) and erythromycin in alcohol solutions (ATS, Eryderm, Staticin), as an ointment (Aknemycin), and on disposable pads (Erycette Pledgets) as well as in combination with benzoyl peroxide (Benzamycin Gel). The alcohol solutions can be drying, so they should be applied at least 15 or 20 minutes after washing your face. Naturally, if you experience any burning, stinging, itching or redness after using any of these medications you should discontinue them straightaway and tell your doctor, who will recommend an alternative.

The prescription medication which is perhaps the most effective anti-acne medication available is retinoic acid or Retin A, the natural form of vitamin A found in the skin. Since the late 1960s retinoic acid has been used as a medication for treating acne. Its major action is keratolytic, so that cells within the blocked pores no longer stick to the skin surface.

The problem with retinoic acid is that it can be irritating, causing dry, red flaky skin, especially when first used. Some people cannot use retinoic acid, even at a low concentration. Retinoic acid also increases the skin’s sensitivity to the sun and to any other products applied to the skin, such as perfumes and cosmetics.

Retin A is a very powerful prescription drug. It is available in six forms. You need apply only a tiny amount of Retin A to the acne-prone areas of your skin at night about 10 minutes after washing your face. The great news is that Retin A is also effective in correcting tiny wrinkles and dark spots caused by exposure to the sun.

An exciting new medication which has been available in Europe since 1989 but is not yet widely used in the United States is azeleic acid, a natural acid found in cereal grains. It acts differently from other medications, altering the structure of the outer skin cells so that they are less adherent. It also directly kills bacteria and inhibits melanin formation, thereby preventing and treating darkened scars from acne and mottled pigmentation from sun damage. Azeleic acid may prove to be even better than retinoic acid, with less dryness and sensitization.

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