The treatment of acne needs to be tailored based on the severity of the skin condition, the patient's age, and lifestyle habits. The treatment goal is not only to eliminate existing lesions but also to prevent inflammatory papules from turning into permanent scars. Modern medicine combines medications, medical procedures, and lifestyle adjustments to form a multifaceted treatment strategy.
The treatment principle emphasizes "graded management"; mild acne is primarily treated with topical medications, while moderate to severe cases may require oral medications or physical therapy. Physicians will choose a single treatment or combination plan based on skin examination results and regularly assess efficacy and side effects, adjusting medication dosages and combinations as needed.
Current acne treatments are divided into four major categories: topical medications, oral medications, physical therapy, and surgical adjunctive treatments. Topical treatments act directly on the skin, while systemic medications target inflammation or hormonal factors. Physical therapies such as light therapy or chemical peels can enhance drug absorption or directly kill acne bacteria.
Choosing treatment options should consider the patient's skin type and allergy history. For example, oily skin may respond better to benzoyl peroxide, while sensitive skin should avoid irritating ingredients. Physicians may recommend a "stepwise treatment" approach, starting with low side effect medications and gradually adding more potent therapies.
Topical medications are the foundation of acne treatment. Benzoyl peroxide can kill bacteria and reduce pore blockage, usually used in rotation with other medications to delay resistance. Retinoid medications (such as Retinoic Acid) can promote keratin metabolism and prevent follicular occlusion, but care should be taken regarding sun sensitivity.
Moderate to severe acne requires the addition of oral medications. Tetracycline antibiotics (such as Doxycycline) can inhibit acne bacteria and reduce inflammation, but care should be taken regarding resistance issues. Oral retinoids (such as Isotretinoin) are suitable for nodular acne, regulating sebum secretion and keratin metabolism, but liver function and potential teratogenic risks need to be monitored.
If female patients experience recurrent outbreaks due to hormonal imbalances, physicians may prescribe contraceptives (such as those containing cyproterone acetate) or anti-androgen medications (such as spironolactone) to regulate acne caused by polycystic ovary syndrome.
Blue light and red light therapies utilize specific wavelengths of light to kill acne bacteria while reducing skin inflammation. Intense Pulsed Light (IPL) can shrink sebaceous glands, improving the acne-generating environment of oily skin. Treatments typically require 4-6 sessions, with each session spaced 2 weeks apart.
Laser treatments are divided into ablative and non-ablative types: non-ablative lasers (such as 1440-nm lasers) stimulate collagen repair for scars, while chemical peels (AHA/BHA) accelerate keratin renewal, preventing follicular blockage. These therapies are often used in conjunction with medication treatments to enhance effectiveness.
For cystic or nodular acne, physicians may perform minor surgeries to drain abscesses or inject corticosteroids to shrink nodules. Microdermabrasion can physically remove keratin plugs, improving early comedones. These therapies are usually adjunctive to medication treatments.
Daily care is the cornerstone of treatment. It is recommended to use oil-free cleansing products and avoid over-cleansing, which can damage the skin barrier. In terms of diet, reducing high sugar and dairy intake is advised, as studies show that IGF-1 in dairy products may stimulate sebum secretion.
Research is focusing on regulating skin microbiome ecology, such as developing phage therapy targeting acne bacteria or using probiotics to modulate skin immune responses. In gene therapy, scientists are attempting to target specific receptors in keratinocytes to block key steps in follicular blockage.
New directions in drug development include selective androgen receptor modulators (SARMs), which can block hormonal stimulation of sebaceous glands while avoiding systemic side effects. Local drug delivery systems such as nanocapsules can enhance drug penetration and reduce irritation.
When acne leads to significant scarring, leaving erythema or pigmentation, medical evaluation for laser or microneedling treatment is necessary. If there is no improvement after 6 weeks of self-medication or if cystic acne appears, immediate referral to a dermatologist is advised to prevent worsening tissue damage.
Special populations such as pregnant or breastfeeding women need to have medication safety evaluated by a physician. Those on oral antibiotics for more than 3 months should have regular liver function tests to avoid drug accumulation damage.
Some topical medications (such as retinoids) may increase skin sensitivity to ultraviolet light, so it is recommended to use SPF 30 or higher sunscreen daily during treatment, along with physical barriers (such as wearing hats). If using medications like benzoyl peroxide, the impact of sun exposure is less significant, but it should still be used according to the instructions.
Does consuming high sugar or dairy products directly trigger acne worsening?Current research shows that a high-sugar diet may promote inflammatory responses, and certain components in dairy products may stimulate androgen secretion, indirectly affecting sebum secretion. Although not a direct causative factor, reducing high sugar and full-fat dairy intake can still have a supportive effect on improving acne.
After acne scars form, what non-invasive therapies can reduce their appearance?Mild scars can be improved through topical products containing retinoids or salicylic acid to promote keratin renewal; chemical peels (such as glycolic acid treatments) can improve uneven textures. Microneedling can also stimulate collagen regeneration but should be performed by qualified aesthetic professionals to avoid infection risks from self-treatment.
If undergoing oral antibiotic treatment for acne, should probiotics be taken concurrently?Long-term use of antibiotics may disrupt the balance of gut microbiota; short-term courses (within 6 weeks) typically do not recommend routine use of probiotics. If the treatment period exceeds 8 weeks or gastrointestinal discomfort occurs, consult a physician about using specific strains of probiotics to maintain gut health.
What scientific basis is there for stress management improving acne?Stress stimulates cortisol secretion, promoting sebaceous gland activity and inflammatory responses. Studies show that reducing stress through meditation, regular exercise, or mindfulness training can indirectly decrease the frequency of acne outbreaks. It is recommended to adopt stress management strategies in conjunction with treatment for better overall control.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
