Doctors Treat Acne with Prescription & OTC Drugs

What Causes Acne?

Acne is a disorder of the pilosebaceous unit, which consists of a hair follicle, sebaceous gland and a hair. These units are found everywhere on the body except on the palms of the hands, soles and tops of the feet and the lower lip. The number of pilosebaceous units is greatest on the face, neck and chest.

Sebaceous glands produce a substance called sebum, which is responsible for keeping the skin and hair moisturized. During the teen-aged years, sebaceous glands enlarge and produce more sebum under the influence of hormones, also known as androgens. After about age 20, sebum production usually decreases.

The sebum that is produced by the sebaceous gland combines with the cells that are sloughed off within the hair follicle, filling up the hair follicle. When the follicle is ‘full’, the sebum spreads over the skin surface, giving it an oily appearance. When this process is working correctly, the skin is moisturized and healthy.

Acne Treatments

In the early stages of acne, there are a number of both over-the-counter (OTC) and prescription (RX) medications that help clear blemishes, including:

• Benzoyl peroxide (OTC) kills bacteria and helps prevent P. acnes from overgrowing
• Salicylic acid 2% lotion (OTC) is a beta hydroxy acid that reverses the ‘stickiness’ of skin cells
• Tretinoin products like Retin-A, Retin-A Micro, and Avita (RX) also reverse the ‘stickiness’ of the skin cells, allowing them to slough normally

As acne eruptions and inflammation increases, other prescription medications may help in reducing break-outs and possible infection, including:

• Topical antibiotics (RX) kill the P. acnes bacteria and might be used if whiteheads are infected
• Oral antibiotics (RX) also kill the P. acnes bacteria and might be used if there are infected whiteheads and papules or pustules

When the sebaceous material and bacteria leak into the surrounding skin, infection can spread wider and deeper, causing scarring and the formation of nodules or cysts. These are the deep acne lesions that are very red, painful and resistant to over-the-counter treatments. In addition to the previously noted prescription medications, Isotretinoin (Accutane) may be prescribed to treat moderate to severe cystic acne. Accutane has serious side effects, requiring close monitoring by the prescribing medical professional.

Baby Acne

Baby acne, also known as acne neonatorum, is a condition that affects about 20% of newborns. Lesions appear at about two weeks after birth and usually disappear after about three months. Lesions include small, red papules, which usually affect the baby’s cheeks and bridge of the nose. Infants usually develop baby acne due to the stimulation of the baby's sebaceous glands by lingering maternal hormones. These hormones cross the placenta into the baby and, after delivery, they cause the oil glands on the skin to form bumps that look like pimples. Baby acne often disappears after a few weeks but may linger for months. Treatment is usually a low-dose topical antifungal.

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