While you may feel alone in your struggle against acne, rest assured that it is COMMON! Approximately 85% of the population will struggle with acne at some point in their life. Acne is not just a disease of teenage years. It may persist well into our forties, and for some, beyond. Once we take off the makeup and get rid of the filters, many of us have to face this very common struggle.
It’s certainly not dirt or even dirty skin, so there’s no need to scrub your face so hard. There are several factors at play, but the root cause is a tiny clogged pore called the microcomedone. Our hormones bombard our oil glands which then pump oil, or sebum, into this clogged pore. Then, bacteria mixes with the sebum to produce inflammation in form of red bumps, pus bumps, or cystic bumps. The severity of our acne has to do with our genetic background and certain environmental exposure, such as medications we take, stress, and likely the food we eat.
A standard first line of treatment is to address the clogged pore with a topical retinoid product (e.g. Retin-A, tretinoin, adapalene, etc.). Retinoids promote cell turnover, and as such, they also help with evening skin texture and tone as well as anti-aging properties. Another first line recommendation in many acne regimens is benzoyl peroxide, which may come in many formulations ranging from a cleanser or a cream. Benzoyl peroxide essentially functions as an antibacterial agent, helping wipe out the bacteria which causes acne bumps. Beyond retinoids and benzoyl peroxide, your Dermatologist may add other medicated or OTC cleansers, topical antibiotics, or oral antibiotics to your regimen. For severe cases of scarring acne, isotretinoin (previously marketed as Accutane) is first line therapy.
For “hormonal acne” occurring in women, we may add on a medication called spironolactone. There’s an array of treatments out there and no one-size-fits-all routine. Everyone’s skin is different. Consult with a board certified dermatologist to determine the best acne treatment plan for your individual needs.
Accutane (Isotretinoin) is a medication that is used to treat severe acne or acne that has not responded to other acne treatments. It is a vitamin A derivative that works by decreasing oil production and changing oil glands in the skin. Most of the time, oil production permanently decreases, which lowers the risk of acne returning long-term.
Accutane is a very effective medication, and it must be closely monitored by your healthcare provider. Accutane can be associated with side effects, the most serious of them all is birth defects. Females that are pregnant or trying to get pregnant cannot take this medication. In 2005, the FDA created an online monitoring program to make sure females are not and do not get pregnant while taking Accutane. This is
enforced with monthly pregnancy tests for all females.
Dry skin, dry lips, dry nose and dry eyes are the most commonly associated and expected side effects of Accutane. It is important to stay hydrated and use moisturizer and ChapStick while taking Accutane. Patients taking Accutane are also highly sensitive to the sun, so sunscreen is an absolute must!
Laboratory work is required while taking Accutane. Liver function and triglyceride levels are monitored while on Accutane because Accutane is processed through the liver. The frequency of the lab work done is determined by your healthcare provider. Visits with your provider are required every month since Accutane can only be prescribed as a 30-day supply, as mandated by the governing program.
Accutane is a serious and closely monitored medication, and side effects should always be discussed with your provider. Accutane really helps to not only treat and cure acne, it also can change a person’s life by improving the appearance of their skin and in turn improving overall self-esteem.
