DC Metro Area Medical Malpractice Law Blog

Stress has been shown to worsen acne in teenagers, and what could be more stressful than starting a new year of school following a summer vacation?  According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a division of the National Institutes of Health, there are several standard treatments for acne that your family physician or dermatologist might employ to help resolve an acne flare-up.  These treatments may include:

• "Benzoyl peroxide – destroys P. acnes, and may also reduce oil production.
• Resorcinol – can help break down blackheads and whiteheads.
• Salicylic acid – helps break down blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicles.
• Sulfur – helps break down blackheads and whiteheads.
• Antibiotics – help stop or slow the growth of bacteria and reduce inflammation.
• Vitamin A derivatives (retinoids) – unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac).
• Others – may destroy P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation. Some examples are prescription strength Benzoyl peroxide, sodium sulfacetamide/sulfur-containing products, or Azelaic acid (Azelex).
• Oral antibiotics -- these are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Common antibiotics used to treat acne are tetracycline (Achromycin V), minocycline (Dynacin, Minocin), and doxycycline (Adoxa, Doryx, and Monodox).
• Less-common oral medicines -- less commonly used are clindamycin (Cleocin), erythromycin, or sulfonamides (Bactrim). Some people taking these antibiotics have side effects, such as an upset stomach, dizziness or lightheadedness, changes in skin color, and increased tendency to sunburn. Because tetracyclines may affect tooth and bone formation in fetuses and young children, these drugs are not given to pregnant women or children under age 14. There is some concern, although it has not been proven, that tetracycline and minocycline may decrease the effectiveness of birth control pills. Therefore, a backup or another form of birth control may be needed. Prolonged treatment with oral antibiotics may be necessary to achieve the desired results.
• Isotretinoin (Accutane) -- a retinoid (vitamin A derivative). Isotretinoin is an oral drug that is usually taken once or twice a day with food for 15 to 20 weeks. It markedly reduces the size of the oil glands so that much less oil is produced. As a result, the growth of bacteria is decreased."

For people particularly self-conscious about the appearance of their skin, acne can sometimes contribute to changes in mood that may not quickly resolve.  There have been a number of reported suicides and suicide attempts among people taking Accutane (Isotretinoin).  No direct connection has been proven, and the correlation is not fully understood.  However, if you or someone you know exhibits the signs or symptoms of depression, whether in conjunction with Accutane treatment or not, you should consult a physician immediately.

The organization offers the following tips for caring for your skin during an episode of acne:

• "Clean Skin Gently -- Gently wash your face with a mild cleanser, once in the morning and once in the evening, as well as after heavy exercise. Wash your face from under the jaw to the hairline and be sure to thoroughly rinse your skin.  Using strong soaps or rough scrub pads is not helpful and can actually make the problem worse. Astringents are not recommended unless the skin is very oily, and then they should be used only on oily spots.
• Avoid Frequent Handling of the Skin -- Squeezing, pinching or picking blemishes can lead to the development of scars or dark blotches.
• Shave Carefully -- Men who shave and who have acne should test both electric and safety razors to see which is more comfortable.  Shave gently and only when necessary to reduce the risk of nicking blemishes.
• Avoid a Sunburn or Suntan -- Many of the medicines used to treat acne can make you more prone to sunburn. A sunburn that reddens the skin or suntan that darkens the skin may make blemishes less visible and make the skin feel drier. However, these benefits are only temporary, and there are known risks of excessive sun exposure, such as more rapid skin aging and a risk of developing skin cancer.
• Choose Cosmetics Carefully -- Choose products labeled noncomedogenic (meaning they don't promote the formation of closed pores). In some people, however, even these products may make acne worse."

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