Part 2 of 4 reviewing the variety of treatments available for acne.

Acne Treatment Part 2

Mild Acne

Acne is classified as mild when it is limited to the face and lesions/ spots are not inflamed.

Treatment options

Topical retinoids

Topical retinoids are the next option if no response from benzoyl peroxide. Topical retinoids work by reducing production of sebum while also preventing dead skin cells plugging hair follicles. Adapalene (Differin^® 0.1% Gel or Cream) is a topical retinoid available in Ireland.

Topical retinoids can cause mild irritation and stinging of the skin. Starting topical retinoids too quickly/regularly increases risk of skin redness, soreness, and peeling. Topical retinoids should be avoided during pregnancy as they carry risk of causing birth defects. A six-week course is usually required but patients may need to continue it on an on-off basis.

Mild to Moderate Acne

Mild to moderate acne primarily affects the face but my affect the neck, shoulders, upper chest and back. Topical therapy is first line recommended and only consider oral medication if no improvement.

Treatment options (all applied to skin)

1. Benzoyl Peroxide and topical retinoids combinations

Combination topical therapies should be considered if one product on its own does not work. Combined products are rarely needed for mild acne. Epiduo^® gel is an all-in-one option containing benzoyl peroxide 2.5% and adapalene 0.1%.

1. Topical antibiotic options

Topical antibiotics reduce bacteria that infect plugged hair follicles. A six to eight-week course is recommended then stopped to reduce risk of antibiotic resistance. Side effects such as minor irritation, redness, burning, and peeling are uncommon.

Topical antibiotic options for acne include clindamycin (Dalacin T^®), Zindaclin^®) and erythromycin (Zineryt^®). A topical benzoyl peroxide combined with a topical antibiotic is a popular option with clinicians in Ireland. An all-in-one combination option is Duac^® which contains benzoyl peroxide 5% and clindamycin 1%.

1. Azelaic Acid

Azelaic acid (Skinoren^®) is a topical anti-inflammatory licensed for mild to moderate papular-pustular acne of the facial area. It works by dissolving dead skin and killing bacteria. It is applied twice daily or once daily for sensitive skin. It is considered less effective than benzoyl peroxide and topical retinoids. Azelaic acid can be considered an alternative to benzoyl peroxide and topical retinoids when side effects like skin irritation is an issue.

To be continued…Next week

For comprehensive and free health advice and information call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).