|Megan Fox with acne|
Following on from my post on How to Get Rid of Mild Acne, this post delves on how to treat the more extensive 'Moderate' acne.
While mild acne is characterised by blackheads and whiteheads, moderate acne has more inflammatory lesions - small papules and pustules on the face and a few spots on the chest and back.
In this case, as well as the use of maintenance topical retinoids and spot treatment with benzoyl peroxide, antibiotic lotions and creams and hormonal therapies can be considered. These are available on prescription.
Let's break down the additional treatments for moderate acne below:
As mentioned in my post on What Causes Acne?, one of the main factors in the formation of acne is the colonisation of and inflammation caused by normal skin flora P. acnes. These can be treated with antibiotic lotions containing clindamycin and erythromycin. These are used when the inflammatory lesions are present.
The problem with topical antibiotics is the development of resistance that reduces effectiveness of this treatment over time. These courses should be limited to 12 weeks' at a time. Using topical retinoids and benzoyl peroxide in addition to topical antibiotics improves its efficacy by targetting the different causes of acne simultaneously.
For women, androgens can drive an increase in sebum production causing acne, and these are countered using oral hormone therapies. These exist in two main types: combined oral contraceptives and androgen receptor blockers.
The combined oral contraceptives suppress the production of androgens as well as provide the added benefit of contraception. In the UK, the most common ones we prescribe contain cyproterone acetate and ethinyl oestradiol.
When accompanied by increased hair growth and weight gain, conditions that have high levels of androgens such as PCOS can be causing acne. Despite this, most women who suffer from acne have normal androgen levels still benefit from hormonal therapies.
So in summary, once topical retinoids and benzoyl peroxide have failed or you have more extensive acne, the next steps include treatment with topical antibiotics, while hormonal therapies can also be considered.
Do you have cystic acne and more extensive involvement of your chest and back? Stay tuned for my post on How to Get Rid of Severe Acne.
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Read my other posts on acne: What is Acne Vulgaris, What Causes Acne? and How to Prevent Acne