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Although not a life-threatening condition, acne vulgaris has a huge impact on a person’s life. This disorder affects people at the most sensitive age (adolescence) when all kinds of physical and psychological changes occur. 

Some persons have very mild to no problems with acne, but there are very extreme cases with inflamed and profound acne which leave deep and unpleasant scars if untreated. The ultimate treatment and prevention have not yet been discovered, although there are fairly effective methods of managing this disorder. Here are some of the current approaches to acne vulgaris treatment.

Topical Treatment

If the symptoms of acne are mild, they can respond well to some topical treatment choices. Dermatologists often recommend a combination of two topical medications: a comedolytic (eliminates comedones – the main structural units of acne) and an antibiotic. The antibiotic is used to kill the bacteria called Propionibacterium Acnes which have been found to contribute to the development of acne. The topical combination which is most commonly in use includes benzoyl peroxide (a comedolytic) and clindamycin (an antibiotic).

Oral Treatment

Oral treatment includes several types of medications with different mechanisms of action. Some of them are aimed to eliminate the existing acne while others contribute to prevention against creation of new acne.

Antibiotics. Oral antibiotics have a greater impact on Propionibacterium Acnes than topical antibiotics. Earlier, the most commonly used antibiotic was erythromycin, but this bacteria has developed resistance to this and many other antibiotics over time. Currently, doxycycline and minocycline are considered first-line treatments. In cases of allergy to these medications, ciprofloxacin can be used instead. Studies have shown that in moderate and severe cases, oral antibiotics are very effective for settling the existing inflammation. The therapy often lasts for several months, so it is necessary to use probiotics in order to protect the normal bacterial flora of the digestive system.

Hormonal treatment. Although increased androgen hormone levels can increase severity of acne, it is a false premise that people with acne necessarily have higher levels of androgen hormones. In other words, in people with severe acne, levels of testosterone and other androgen hormones do not differ significantly. However, in women with higher androgen levels, there are ways to lower androgen concentration by using oral contraceptive pills or oral corticosteroids. Hormonal treatment can unfortunately be applied only in women. Androgen levels in men are too important to keep high, especially during adolescence.

Retinoids. Retinoids are derivatives of vitamin A. Although they can also be used topically, oral use is far more effective. Of these retinoids, isotretinoin is most commonly used. This drug introduced the first real help for patients with a severe form of acne vulgaris.


It has several amazing effects on acne, some which are anti-inflammatory, slowing the development of sebaceous glands, and correcting the improper growth of the layers of the skin cells. Although this treatment is highly effective, it carries a high incidence of side effects and several precautions are needed. The most common side effects include a dry mouth, dry skin and eyes, rashes, and muscle pain. Less frequent side effects are hepatitis, depression, and disturbed vision, but these side effects have not yet been fully investigated.

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