Treatment options
Treatment options
Treatments for acne tend to be divided into topical products that are applied directly to the skin – many of which can be sold over the counter (OTC) – and oral treatments such as antibiotics, which are only available on prescription.
As there is no cure for acne, treatments target some of the main causes of the condition. They may work to reduce the production of sebum in the skin’s glands, or they may speed up skin turnover so that pores are less likely to become blocked. Some treatments fight bacterial infection or minimise inflammation. All products take time to have an effect, so advise customers that it may take several months for their skin to noticeably improve.
OTC topical treatments
Benzoyl peroxide has an antiseptic action, so it kills off the bacteria that can infect the skin’s pores and helps to reduce the formation of whiteheads and blackheads. It also acts as an anti-inflammatory. Benzoyl peroxide should be used sparingly (at most, twice a day). It can have a bleaching effect, so care should be taken when applying it near hair or clothes. Common side effects include skin dryness, irritation, redness and peeling. These should pass once the treatment has finished.
Benzoyl peroxide usually comes in cream or gel format. Example: Acnecide Gel. It may also be combined with the antimicrobial potassium hydroxyquinoline sulphate. Example: Quinoderm Cream. Products come in different strengths, so customers should start with the lowest strength and work up, if necessary.
When applied to the skin, salicylic acid works to promote the shedding of skin cells to help prevent pores from becoming blocked. It may cause mild stinging, irritation or dryness. Examples include: the Clearasil range, the Clean & Clear range, the CeraVe SA Smoothing range, various products from brands such as Eucerin and La Roche-Posay.
Also known as niacinamide, this is an anti-inflammatory ingredient related to vitamin B3. It helps to reduce the redness and inflammation of acne lesions. OTC examples include Freederm Gel, Nicam Gel and CeraVe Foaming Cleanser.
Other ingredients include antibacterials such as chlorhexidine and cetrimide. These are sometimes included in cleansers as soap substitutes (e.g., Quinoderm Face Wash). Some products also contain sulphur, retinol (vitamin A) or alpha hydroxy acids such as glycolic acid and lactic acid. All of these have exfoliating effects, so they help to remove dead cells from the surface of the skin, thus preventing pores from becoming blocked.
Additional advice
Customers with acne or blemish-prone skin should be advised to:
- Cleanse their skin gently – avoid abrasive scrubs, astringents and oil-stripping masks. Skin should be cleansed twice daily with lukewarm water and a mild, soap-free cleanser
- Remove all make-up before going to bed and gently wash their skin after sweating
- Avoid heavy, oily moisturisers that may block pores and make symptoms worse
- Look for products labelled ‘non-comedogenic’ as these are less likely to clog pores
- Be careful when shaving – it may be trial and error to see if a traditional or an electric razor works best
- Wash their hair regularly and try to prevent it from falling across their face
- Be cautious in the sun. A daily broad-spectrum sunscreen should be used, especially as some acne treatments (e.g., benzoyl peroxide) can make the skin more sensitive to the sun’s rays and more likely to burn
- Use acne treatments as prescribed and persevere – allow at least eight weeks for skin to improve. Even if the skin clears, medication should be continued as advised to help prevent future breakouts
- Apply topical acne medication five to 10 minutes after cleansing and before applying make-up.