Adult acne often presents itself as inflammatory or non-inflammatory lesions, though in most cases there may be both. Changes in skin’s structures caused by fluctuating hormones, stress, improper diet and environmental changes can all lead to inflammatory and non inflammatory acne. The main reason for acne is that the skin’s pores get clogged due to dead skin cells, bacteria and oily secretions which then develop into blackheads and whiteheads (also known non inflammatory acne). As the bacteria in the clogged pores multiply further, they lead to acne lesions or pimples (also called nodular/papule acne or inflammatory acne). In this guide, we will study comedonal acne treatment as well as ways to treat non inflammatory acne in adults.
1st line of treatment for inflammatory acne
- For mild inflammatory/comedonal acne– The first line of treatment is combination therapy that consists of topical and oral medicines. Your dermatologist might prescribe Benzoyl peroxide or retinoid or along with an oral antibiotic medicine.
- For moderate inflammatory acne-Your doctor might prescribe topical and oral antibiotics alongside topical retinoid plus topical benzoyl peroxide. Most doctors prefer prescribing just topical retinoid with topical benzoyl peroxide to see if patient responds to the medicines. If no response is seen, then the doctor might prescribe antibiotics.
- Severe comedones treatment– For severe inflammatory acne lesions, dermatologists usually prescribe oral isotretinoin. In early stages though, most prefer placing patients only on antibiotics or topical treatment in the form of benzoyl peroxide plus retinoid plus oral antibiotics.
2nd line of treatment
- For mild nodular acne- To the above, dermatologist may add alternate retinoid or topical Dapsone.
- For moderate papule acne- Doctor might recommend oral contraceptives or Spironolactone to women. Oral isotretinoin is also considered.
- For severe inflammatory acne-Doctor may recommend another antibiotic alongside spironolactone and oral isotretinoin.
Non inflammatory acne treatment-dos and don’ts
1. Avoid over cleansing
Washing your face over and over causes excess oil production which could lead to acne.
2. Avoid abrasion
Handbags, scarves, pillowcases etc can all cause friction and lead to acne. Try to avoid these as far as possible. Wash pillowcases, yoga mats and scarves to limit bacteria.
3. Change your cosmetics
Many cosmetics clog pores and cause inflammatory as well as non inflammatory acne. Use dermatologist recommended products and avoid ones that are comedogenic. Stay away from heavy or greasy hair and skin products.
4. Is your diet to blame?
Improper eating habits can also be one of the non inflammatory acne causes. So watch what you eat. A healthy diet for clear skin ideally includes fruits, vegetables, whole grains, and lean meat. Avoid refined products containing dyes, sugar and preservatives. Stay away from dairy, gluten, soy and other allergens. Keeping a food journal can help as it will help you identify foods that trigger acne flare ups.
5. Manage stress
Stress can also lead to excess hormone production which in turn can cause acne. The key to a clear complexion is a stress free life. You can combat day to day stress through exercise, proper diet, and relaxation methods like deep breathing, yoga etc.
6. Avoid certain medicines
Many medicines like oral contraceptives, steroids, iodides and lithium can lead to acne lesions. Talk to your doctor if you are taking these medicines.
Medicines for non-inflammatory acne
Today there are many products to combat acne. Here are some you can use to get rid of non-inflammatory acne:
- Benzoyl peroxide– this is one of the most popular comedones treatment. It is available over the counter as topical preparations. However, these products can be drying and could cause the skin to peel.
- Retin A– This is a derivative of Vitamin A and causes pores to unplug to prevent blackheads and whiteheads.
- Oral/topical antibiotics– For very severe non inflammatory acne, your doctor might prescribe antibiotics which kill off the acnes bacteria that cause acne. However, if you only have blackheads and whiteheads without any raised nodular acne or papule acne, it is best to avoid these medicines.
- Accutane– This is an aggressive acne treatment for severe inflammatory acne lesions. This medicine can have side effects so it is best to use it with caution. Accutane combats oil production and is mainly prescribed to patients who do not respond to any other acne treatment.
Talk to your dermatologist about these treatment options. Whatever medication you choose, give it at least 3-4 weeks to work. This is the period you need to see results.