Acne treatments: Emerging therapies for clearer skin
With the right treatment, you can keep acne under control. But what's the best acne treatment for you? Many options are available, including prescription creams and antibiotics, which target the various causes of acne. But even with the wide range of acne treatments, chronic breakouts may still be difficult to treat.
New acne treatments — such as blue light therapy or diode laser therapy — may be an effective option but are often reserved for people who don't respond to more traditional therapy.
Laser and light therapy
Most laser- and light-based therapies reach the deeper layers of skin without harming the skin's surface. Some laser systems are thought to damage the oil (sebaceous) glands, causing them to produce less oil. Other laser and light therapies target Propionibacterium acnes (P. acnes), the bacterium that causes acne inflammation. These therapies can also improve skin texture and lessen the appearance of scars, so they may be good treatment choices for people with both active acne and acne scars.
Several types of laser and light therapies exist:
- Blue light therapy. Exposing the skin to a low-intensity blue light source is believed to destroy P. acnes. This painless procedure is usually done through a series of sessions. P. acnes multiplies rapidly, however, so ongoing treatment is necessary for best results. Possible side effects of blue light therapy include temporary redness and dryness in the treated areas. A newer type of light therapy that includes a combination of blue and red light may be more effective than blue light alone.
- Pulsed light and heat energy therapy. Together, pulsed light and heat energy is thought to destroy P. acnes and shrink sebaceous glands, which decreases oil production. Side effects of this therapy include temporary redness in the treated areas.
- Diode laser therapy. Diode lasers can destroy sebaceous glands in the dermis, the thick middle layer of skin, without harming the outer layer of skin. Laser treatment may be painful, but the pain can be controlled with analgesics applied to the skin before treatment. Side effects of diode laser therapy include temporary redness and swelling of the treated areas.
- Photodynamic therapy. This therapy combines topical medications and light-based therapies. During treatment, a medication, called a photosensitizing agent, is applied to your skin to enhance the effects of light therapy. This is followed by blue, red, pulsed light or another type of light therapy. Side effects can include redness, swelling, crusting and acne flare-ups.
- Photopneumatic therapy. This therapy uses vacuum suction to remove the oil and dead skin cells from within the sebaceous glands. The targeted area is then treated with blue and red light therapy to destroy P. acnes and reduce inflammation.
Still unknown is who would benefit the most from laser and light therapies, the effectiveness of these treatment options, and what the long-term risks or benefits might be. Furthermore, laser and light therapy acne treatments can be expensive and may not be covered by your insurance company.
Steroid injections are most often used for nodules and cysts — two types of acne that cause large, painful lumps beneath the surface of the skin. These types of acne can take weeks to resolve on their own. After a steroid injection, the acne lesion flattens, and symptoms resolve within two to four days. Though effective, complications can include:
- Thinning of the skin (atrophy)
- Appearance of small blood vessels on the surface of the skin (telangiectasia)
- Skin tone that turns lighter than normal (hypopigmentation)
Steroid injections are typically used as a temporary or occasional fix for stubborn acne lesions. They aren't used to treat widespread acne because of potential complications and the need for frequent doctor visits.
Chemical peels and microdermabrasion may be helpful in controlling acne. These cosmetic procedures — which have traditionally been used to lessen the appearance of fine lines, sun damage and minor facial scars — are most effective when used in combination with other acne treatments.
- Chemical peels. Chemicals, such as glycolic acid or salicylic acid, applied to your skin help remove dead skin cells, unclog pores, remove whiteheads and blackheads, and can generate new skin growth. These chemical peels are often used with acne creams or gels for better penetration of the medication. Depending on strength of the chemical, side effects of chemical peels range from temporary redness, blisters, scaling and crusting to scarring, infection and abnormal skin coloring.
- Microdermabrasion. This type of treatment involves a hand-held device that blows crystals onto skin. These crystals gently abrade or "polish" the skin's surface. Then, a vacuum tube removes the crystals and skin cells. The procedure exfoliates and unclogs pores. Similar to chemical peels, microdermabrasion is often used with other acne treatments to increase their effectiveness.
These procedures are best done by a doctor. Trying these treatments at home could cause infections, acne flare-ups or scars. If your skin tends to form scar tissue, chemical peels or microdermabrasion could make your complexion worse.
Keep realistic expectations
If you're interested in new acne treatments, talk to your doctor about your options and the risks and benefits of each. He or she can help you create a treatment plan that's right for you.
Regardless of the treatment you use, keep realistic expectations. Acne can't be medically cured, only controlled. You won't start seeing improvements from most treatments for six to eight weeks, and your acne might appear worse before it gets better. But if you stick to your treatment regimen, your patience usually pays off with clearer skin.
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