SKIN CARE: ACNE- TREATMENT
Specific treatment aimed at unblocking comedones (black-beads or whiteheads) involves the use of various topical preparations which may be applied to the skin. These include preparations containing salicylic acid or sulphur, which promote dryness of the skin and light scaling or peeling. The advantage of these preparations is that they may be gradually increased in strength to achieve the required effect. Other preparations which may be cosmetically more acceptable include retinoic acid. This is perhaps more effective in penetration, but is frequently irritating to the skin. Other preparations which are very useful in causing exfoliation of the skin and subsequent unblocking of comedones are the benzoyl peroxide gels. These may cause irritation but if used carefully are very helpful as an adjunct to treatment.
Ultraviolet light seems to have a similar exfoliating effect on the skin and is therefore most beneficial in the treatment of this condition. It appears to be further helped by salt water, due no doubt to its drying action.
Oral antibiotics, particularly tetracycline, have a most dramatic and beneficial effect. Their action appears to be threefold. They reduce comedone formation, resulting in less blockages of sebaceous gland ducts. Furthermore they reduce the acidity of the sebum, which then results in less tissue breakdown when the glands rupture. They also decrease the amount of propionibacterium acnes. This results in less chemical or enzyme being released into the skin when the glands rupture. The overall result of this is much less inflammation. It can be seen, therefore, that the antibiotics are used not so much for their anti-bacterial effect as for a side effect that they appear to have on the oil glands. Very small doses of these antibiotics may be used, in fact much smaller doses than those required for the treatment of normal mild infections of the skin. Consequently they may be used for prolonged periods, except of course with pregnant women or children under the age of 12 years, or if side-effects appear.
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