Written By Dr. Jetske Ultee on 16 September 2011

The (Cosmetic) Treatment for Acne

Acne is more common than all other skin disorders put together and as much as even 90 percent of people suffer from it at varying degrees at some time in their lives. In the blog ‘Spots: Should I Go to the Doctor or Not?’ I have written all about the development of acne and how to deal with it. Today I’ll write more about treatment.

Step 1: mild products

There are very important rules which need to be observed when treating acne. The skin with acne is, by definition, over sensitive and irritated, and so needs to be treated as such. Avoid perfumed products and products with denatured alcohol. Ensure you have a mild skincare regime. I have developed a skin analysis which gives you comprehensive advice about acne and how to look after your skin, depending on the extent of the acne. You’ll find it here. Regularly scrubbing and steaming also aggravates acne. Do not cleanse skin more than necessary and use products which are specific to skin with acne that contain ingredients which are proven to be effective.

Step 2: the active ingredients Salicylic Acid and Benzoyl Peroxide

One of the most effective cosmetic ingredients for the treatment of acne is Salicylic Acid. Salicylic Acid is an exfoliant and it combats cornification of the skin and blocking of the sebaceous glands. A concentration of 1 to 2% is usually enough for treating mild acne (blackheads). It can cause mild irritation but if you gradually build its use up it is often suitable for sensitive skin as well. Benzoyl Peroxide is also a very suitable ingredient for treating acne. You can buy Penzoyl Peroxide over-the-counter at the chemist in concentrations of 2.5% preferably. This is strong enough and causes less irritation. It kills the bacteria P. acnes and has been successfully used to combat acne for the last forty years. When used correctly (apply liberally once a day) most skin can tolerate it. Only 1 to 3 percent of users develop an allergy. Skin doesn’t ‘get used’ to it either, so it stays effective in the long term. Do not just apply Benzoyl Peroxide onto the spot but onto the whole of the affected area. Spots take about two weeks to appear. In other words, if you only treat the already present spots with a cosmetic product, there will be no improvement in your acne after two weeks. Benzoyl Peroxide also has a light exfoliating effect.

Anti-infammatory and barrier healing substances

Cosmetic ingredients that can improve acne really do exist!!! Think of ingredients that have an anti-inflammatory or barrier healing effect such as, for example, Niacinamide, green tea, Glycyrrhiza glabra or quercetin. What’s more, niacinamide inhibits sebum production (abstract). Many people are not aware that the effectiveness of a cream containing 3% Niacinamide is similar to that of clindamycine, an antibiotic cream which is often prescribed by a Doctor for treating acne. Localised use of Vitamin C is also known to improve acne. In fact the effectiveness of 5% Sodium Ascorbyl Phosphate is shown to be comparable to Vitamin A Acid but appears to work faster (abstract1/abstract2). Fortunately, most forms of acne can be treated successfully with the above written methods.

Step 3: plan of action for stubborn acne

For most people using skincare products with salicylic acid and or benzoyl peroxide is very helpful. But for stubborn cases there is certainly more needed. A skin therapist is often helpful here;

Peelings with a high concentration of glycolic acid or better still salicylic acid can make a big improvement to the acne. It can also fade pigmentation which has been caused by acne.
Laser or light treatment tackles the bacteria P. acnes and slows down the production of sebum. Examples are treatments with the KTP laser or the 1064 YAG laser. An advantage is that through this treatment pigmentation and scars also become less visible.
Less expensive are treatments with red or blue light, but the effects from these are only temporary.
For severe acne, Photodynamic Therapy is available which corrects the over active sebaceous glands. This is a new treatment with successful results. Sadly it is also very expensive.

Step 4: help! I’ve still got acne!

Many people with acne find going to the Doctor a difficult hurdle to overcome. In many cases good products/or treatments combined with remedies that a Doctor can prescribe are the best. That is why a good relationship between Beauty therapist and Doctor is also very important. Often the combination of good basic skincare with active ingredients, and an antibiotic cream or cream with Vitamin A Acid will give astonishing results. At the mention of severe acne, there might be the need for some more support in the battle. This can include taking oral antibiotics, the contraceptive pill that counteracts the effects of male hormones in your body and Accutane, a Vitamin A preparation. This should only be used if nothing else helps. It has unpleasant side effects and really dries the skin out because it practically stops sebum production.

Treatment for acne is very successful in the majority of cases. But it is not instantaneous. Acne does not have a simple cause, and an even less simple cure. I have written a more comprehensive piece on this for the Dutch magazine Estheticienne.