Acne Treatments

Anti-acne drugs are medicines that help clear up pimples, blackheads, whiteheads, and more severe forms of acne.

Benzoyl peroxide is found in many over-the-counter acne products that are applied to the skin, such as Benoxyl, Clear By Design, Neutrogena Acne, PanOxyl, and some formulations of Clean & Clear, Clearasil, and Oxy. Some benzoyl peroxide products are available without a physician’s prescription; others require a prescription. Tretinoin (Retin-A) is available only with a physician’s prescription and comes in liquid, cream, and gel forms, which are applied to the skin. Isotretinoin (Accutane), which is taken by mouth in capsule form, is available only with a physician’s prescription. Only physicians who have experience in diagnosing and treating severe acne, such as dermatologists, should prescribe isotretinoin.

Acne is a skin disorder that leads to an outbreak of lesions called pimples or “zits.” The most common form of the disease in adolescents is called acne vulgaris. Antiacne drugs are the medicines that help clear up the pimples, blackheads, whiteheads, and more severe forms of lesions that occur when a teen has acne.
Different types of antiacne drugs are used for different treatment purposes, depending on the severity of the condition. For example, lotions, soaps, gels, and creams containing substances called benzoyl peroxide or tretinoin may be used to clear up mild to moderately severe acne. Isotretinoin (Accutane) is an oral drug that is prescribed only for very severe, disfiguring acne.

Acne is caused by the overproduction of sebum during puberty when high levels of the male hormone androgen cause excess sebum to form. Sebum is an oily substance that forms in glands just under the surface of the skin called sebaceous glands. Sebum normally flows out hair follicles onto the skin to act as a natural skin moisturizer. The glands are connected to hair follicles that allow the sebum, or oil, to empty onto the skin through a pore.

Sometimes the sebum combines with dead, sticky skin cells and bacteria called Propionibacterium acnes (P. acnes) that normally live on the skin. The mixture of oil and cells allows the bacteria to grow in the follicles. When this happens, a hard plug called a comedo can form. A comedo is an enlarged hair follicle. It can appear on the skin as a blackhead, which is a comedo that reaches the skin’s surface and looks black, or as a whitehead, which is a comedo that is sealed by keratin, the fibrous protein produced by the skin cells and looks like a white bump.

In addition, pimples can form on the skin. Types of pimples include:
•    papules, which are small, red bumps that may be tender to touch
•    pustules, which are pus-filled lesions that are often red at the base
•    nodules, which are large, painful lesions deep in the skin
•    cysts, which are painful pus-filled lesions deep in the skin that can cause scarring

Pimples form when the follicle is invaded by the P. acnes bacteria. The damaged follicle weakens and bursts open, releasing sebum, bacteria, skin cells, and white blood cells into surrounding tissues. Scarring happens when new skin cells are created to replace the damaged cells. The most severe type of acne includes both nodules and cysts.

Acne cannot be cured, but antiacne drugs can help clear the skin and reduce the chance of scarring. The goal of treating moderate acne is to decrease inflammation and prevent new comedones from forming. Benzoyl peroxide and tretinoin work by mildly irritating the skin. This encourages skin cells to slough off, which helps open blocked pores. Benzoyl peroxide also kills bacteria, which helps prevent whiteheads and blackheads from turning into pimples. Isotretinoin shrinks the glands that produce sebum. It is used for severe acne lesions and must be carefully monitored because of its side effects. Antibiotics also may be prescribed to kill bacteria and reduce inflammation.

Combination Skin Causes and Care

It can be utterly frustrating to deal with combination skin; one day it is dry and tight, the next it is oily and blotchy. Seasonal weather changes only serve to make matters worse. Your skin can wrinkle in some areas and flake in others. If that’s the case, then you may have combination skin - varying skin conditions in different zones of the face. But not to worry; combination skin is quite common. In fact, more people have this skin type than any other.

Combination skin is characterized by a mixture of oiliness and dryness. Typically, the oily areas tend to be the T-zone, consisting of the forehead, nose and chin. The cheeks are normal to dry. The degrees of oiliness and dryness can vary. Pores may be larger in the oily areas - with pimples, blackheads and breakouts sometimes occurring - and dry areas may feel rough and irritated.

The “tissue test” can help you determine if you have combination skin. Take a tissue and hold/press it against your face. If there’s oil on the tissue where it touched your T-zone, but no oil where the tissue touched your cheeks, you most likely have combination skin.

Causes

Many factors can cause combination skin, including hormones, age, genetics, the way in which lipids are organized in our skin and even the weather. Hormonal changes can lead to changes in skin’s oiliness or dryness. Teens and young adults tend to have oilier skin, especially in the T-zone, but with age, hormones change and the oil production may decrease (but unfortunately, acne is still an issue for many adults). Also, hormones change due to menstruation and the birth control pill, which can make skin oilier in certain areas. Lipids also play a role in combination skin: These proteins affect skin’s softness and feel. When lipids aren’t evenly spread throughout the skin, certain areas will feel drier and rougher, while other areas may feel soft but oily or greasy. The organization of lipids in skin is due to genetics and hormones. Finally, weather can exacerbate combination skin. Dry cold weather can cause skin to dry out and become irritated. Conversely, hot humid weather can increase oil production. This can affect your T-zone as well as your cheeks.

Care Plan

Combination skin requires special care to balance the oily and dry areas of the face. Proper cleansing, treatment, moisturizing and sun protection are all necessary.

• Cleansing: People with combination skin often have difficulty finding a cleanser that works for their unique skin needs. Formulas designed for oily skin may leave combination skin too dry, especially in the cheeks, while formulas designed for dry skin may leave combination skin greasy, especially in the T-zone. It’s best to avoid products that are either too drying or too rich. Instead, use a foaming or gel cleanser to get rid of dirt and oil without causing irritation or dryness. A cleanser to try is one that removes excess oil and impurities while still being gentle and not drying out skin.

You should also exfoliate your skin regularly to remove dry, dead, rough skin cells. These cells may be particularly prominent on your cheeks. They can flake off and block pores, causing blemishes and blackheads. Try a product that might include papaya and pineapple juice, olive derivatives and Ginkgo Bilbao.

• Treatments: Treatment products are another important skincare component, helping to balance your skin. One treatment to try is one which moisturizes dry areas but prevents excess oil, especially in the T-zone. This product also contains antioxidants to prevent aging. Another type of treatment is a mask, and you’ll find an array of products for every skin type. Some experts advise using a hydrating/moisturizing mask on dry areas (cheeks) and a deep-cleaning clay mask on oily areas (T-zone). While using two different masks is certainly an option, you can also use a mask specifically designed for combination skin. If you suffer from breakouts, which may occur around the T-zone, use acne treatment products with salicylic acid. For problem skin, try a blemish serum or a spot treatment.
  
  
• Moisturize: Combination skin needs balance, and part of that balance means moisturizing your skin. Moisturizing is especially important for drier areas of the face, but your entire face needs moisture. Some experts suggest using separate moisturizers - a lightweight one for the T-zone and a deeper one for cheeks. You may choose to use separate moisturizers, but you can also use a single moisturizer designed for combination skin. Try a lotion which balances skin with witch hazel and aloe extract to help skin stay soft. Pay careful attention to dry areas, as they may require more frequent moisturizing than oily areas. Generally, experts recommend moisturizing dry areas twice a day and moisturizing oily areas once a day. Keep in mind that your individual skin has unique needs, so you might want to adjust your moisturizer - how often you use it, where you need it and how much you need.
• Sun Protection: Like all other skin types, combination skin needs protection from the sun. UVA and UVB rays can damage skin, so use oil-free sunblock all over your face daily (and on any other exposed areas). Try an oil-free sunlotion or sunblock because it protects your skin from UV rays and won’t make skin greasy.

Natural Treatments

Natural treatments such as aromatherapy oils, home-made exfoliants and masks may help treat your combination skin. For example, try mixing essential oils like chamomile, lavender and ylang ylang (just a few drops) together with your oil-free moisturizer. These ingredients have antibacterial properties and may help to rid skin of dirt or bacteria. However, if your skin is sensitive or easily irritated, or if you’re pregnant, you shouldn’t use these essential oils.

Exfoliating treatments can be made at home by mixing and grinding nuts, seeds or oatmeal along with water. These will slough off dead, dry skin cells - especially common around the cheeks. You can add citrus peels from fruit - like orange or grapefruit - to the mix and apply it to the oily T-zone.

To make a mask for dry areas, use ingredients like yogurt, mashed bananas or avocados to moisturize. On oilier areas, try pureed strawberries and apples.