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Prescription acne treatments carry risks

01 Jul 2013

Acne is particularly prevalent during adolescence, and some teenagers will face an on-going battle with this common skin condition.

There is a wide range of treatment options available in pharmacies, both OTC and on prescription, but health professionals should be aware of both the risks and the benefits of using them.

Acne develops when skin gets greasy and pores block up to form whiteheads, blackheads and pimples.

According to everybody.co.nz, acne can improve with topical treatments, but they can take several weeks or months to be effective.

However, getting in early with treatment can help prevent future scarring.

People may prefer to try a product on a small area of the face to start with to test how the skin reacts, but most products are designed to be used on the entire affected area and not individual spots.

Acne face washes and cleansers can reduce the greasiness of the skin. Products may include an antiseptic or antibacterial agent, or mild salicylic acid.

Benzoyl peroxide, found in some acne creams, lotions and gels, can eliminate some bacteria on the skin. It peels off the skin’s top layer, which unblocks the pores.

However, if the person has a lot of blackheads, it can aggravate the skin. If this occurs, the pharmacist should advise the customer to discontinue use.

Retinoid gels or creams such as tretinoin are mainly used for blackheads, to dry out the skin and make it peel.

As retinoid solutions can irritate the skin, people should only apply a small amount, spread very thinly, and use it no more than once a day.

These products may initially make the acne worse, but this should improve after a few weeks. People using retinoid products should be extra vigilant with sun protection as they are more susceptible to sunburn. The products are also not suitable for pregnant women.

Azelaic acid creams are a twice-daily acne treatment. If the cream irritates the skin, people can reduce application to once a day, or apply a smaller amount.

Pharmacists can also offer some general advice to manage acne – cleanse regularly but avoid over-scrubbing, do not pick or squeeze pimples and opt for non-oily moisturizers.

Pharmacists should refer patients to a GP if the acne does not respond to topical treatments or if the person’s acne is severe.

Be aware of side effects

A GP or dermatologist may prescribe isotretinoin, an oral retinoid, as an acne treatment, but there is a range of possible side effects, everybody.co.nz says.

Women who are pregnant, or who become pregnant while taking isotretinoin, or less than one month after treatment, have a high risk of causing damage to the baby and must not use it.

There are also links between the use of isotretinoin and depression, and the New Zealand Medicines and Medical Devices Safety Authority (Medsafe) advises health professionals to monitor patients for the development of depression during treatment.

People may also take oral antibiotics as an acne treatment. They must take them for three months or more, depending on the severity of the acne.

Females on the oral contraceptive pill should be aware that antibiotics can reduce the effectiveness of the pill, so they may need to use additional forms of contraception.

Diet still a controversial area

While there is debate in the medical field around links between diet and acne, studies have shown a low glycemic index diet can help prevent acne.

This includes plenty of fresh fruit and vegetables, whole grain, lean meats and seafood, and reducing the intake of processed foods. –PTNZ

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