Treatments

Acne

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Overview

Acne is a long-term skin condition that can affect your face, back and neck. It is characterised by oily skin, whiteheads, blackheads and inflamed spots that can be painful to touch. The condition can also cause people to be embarrassed and lack confidence. Acne is most common in people aged between 11 and 30.

Causes

Acne is caused by the overgrowth of a bacteria called P. acnes on the skin and is linked to changes in hormones. Hormones called androgens control the amount of oil released onto our skin. A hormone imbalance means there is  a high level of production of the hormone, which causes blockages in our pores, resulting in spots and oily skin. The hormone imbalance varies in individuals and can be due to many factors such as, stress, weather, pregnancy, puberty or a woman’s menstrual cycle.

Treatments

Duac

Overview:

Duac is a gel treatment for mild to moderate acne and it contains two active ingredients: clindamycin and benzoyl peroxide. Clindamycin is an antibiotic and benzoyl peroxide is an antibacterial as well as a keratolytic (peeling) agent. These ingredients work in conjunction to reduce acne causing bacteria, resulting in reduction in blackheads, whiteheads and red/inflamed acne spots.

Directions:

Wash and dry the acne affected areas and apply a thin layer of duac gel to the affected areas once daily at bedtime. Rub the gel in with fingertips and use sparing amounts. Excess use of duac may irritate the skin further. Allow the gel to dry onto the skin - do not wash it off. Do not apply duac gel near the eyes, lips, nostrils or on any broken skin. Wash your hands thoroughly before and after use.

FAQ:

How long does it take to work?

Initial effects of the duac gel start to show in 2 to 5 weeks, with the maximum effect showing between 8 and 12 weeks. Duac gel should not be used for more than 12 weeks.

How do I store Duac?

Before purchase, duac will be stored in the refrigerator. Once the item is received, it can be stored out of the fridge at no higher than room temperature (25°C). Duac must be discarded after 2 months once opened.

Side Effects:

Side effects include a burning sensation, headaches and reddened and peeling skin. However, this is usually just for the first couple of weeks of use and symptoms will start to settle with continued use. Duac increases your sensitivity to the sun and sunlamps, so excessive or prolonged sun exposure while using Duac should be avoided. If you are using other acne medications alongside duac, duac can make them less effective. If any side effects get worse, please consult your doctor.

Patient Information Leaflet (from EMC):

 https://www.medicines.org.uk/emc/product/6/pil

 

Epiduo

Overview:

Epiduo is a gel treatment for moderate to severe acne and it contains two active ingredients: adapalene and benzoyl peroxide. Adapalene is classed as a third generation retinoid (a form of vitamin). It works to reduce inflammation and blackhead/whitehead formation by reducing the growth of the keratin surface skin cells that can block pores. Benzoyl peroxide is an antibacterial as well as a keratolytic (peeling) agent. These ingredients work in conjunction to reduce the symptoms of acne.

 

Directions:

Wash and dry the acne affected areas and apply a thin layer of epiduo gel to the affected areas once daily at bedtime. Rub the gel in with fingertips and use sparing amounts. Excess use of epiduo may irritate the skin further. Do not apply epiduo gel near the eyes, lips, nostrils or on any broken skin. Wash your hands thoroughly before and after use.

FAQ:

How long does it take to work?

The results of epiduo can be seen between 1 to 4 weeks of treatment. The treatment should still then be continued as acne will improve over time.

Is there anybody who cannot use Epiduo?

Epiduo is not suitable for those with a hypersensitivity to any of the ingredients or in pregnancy.

What should I avoid when using Epiduo gel?

●      Sunlight and UV lamps

●      Other acne products that contain retinoids or benzoyl peroxide

●      Products that irritate, dry or exfoliate the skin.

Side Effects:

Side effects include a warm/stinging sensation, dryness, scaling, iching, redness or a skin rash. However, this is usually just for the first couple of weeks of use and symptoms will start to settle with continued use.  If the initial side effects are too uncomfortable, wash your skin and apply non-spot forming cream to relieve the symptoms. If any side effects get worse, please consult your doctor.

Patient Information Leaflet (from EMC):

https://www.medicines.org.uk/emc/product/451/pil

 

Isotrex

Overview:

Isotrex gel contains the active ingredient, isotretinoin, which is used to treat mild to moderate acne. Isotretinoin is classed as a retinoid (a form of vitamin). It works to reduce inflammation and blackhead/whitehead formation by reducing the growth of the keratin surface skin cells that can block pores. It can be used on its own or with other creams, gels or antibiotic tablets. Isotrex is ideal for daily use to treat and prevent acne breakouts.

 

Directions:

Wash and dry the acne affected areas and apply a thin layer of isotrex gel to the affected areas. Rub the gel in with fingertips and use sparing amounts. Do not apply isotrex gel near the eyes, lips, nostrils or on any broken skin. Wash your hands thoroughly before and after use. Apply isotrex gel once or twice daily as instructed by your doctor.

FAQ:

How long does it take to start seeing results while using Isotrex?

To get the best results, isotrex should be applied consistently and continually. Results can be observed between 8 to 12 weeks if used correctly.

Side Effects:

Side effects include a warm/stinging sensation, dryness, scaling, iching, redness or worsening of acne. However, this is usually just for the first couple of weeks of use and symptoms will start to settle with continued use. If you are using other acne medications that contain benzoyl peroxide alongside isotrex, isotrex can make them less effective. In this case, apply the benzoyl peroxide at a different time of day. If any side effects get worse, please consult your doctor.

Patient Information Leaflet (from EMC):

NO PIL AVAILABLE ON EMC FOR GEL

 

Differin

Overview:

Differin cream or gel contains the active ingredient, adapalene, which is used to treat mild to moderate acne. Adapalene is classed as a third generation retinoid (a form of vitamin). It works to reduce inflammation and blackhead/whitehead formation by reducing the growth of the keratin surface skin cells that can block pores. Differin is ideal for daily use to treat and prevent acne breakouts.

Directions:

Wash and dry the acne affected areas and apply a thin layer of differin cream or gel to the affected areas once daily at bedtime. Do not apply differin near the eyes, lips, nostrils or on any broken skin. Wash your hands thoroughly before and after use.

FAQ:

What are the benefits of Differin (Adapalene) gel or cream?

●     Actively clears and prevents acne

●     Restores skin tone and texture

●     Non-comedogenic - does not clog pores

●     Fragrance-free

How long does it take to start seeing results while using Differin?

To get the best results, differin should be applied consistently and continually. Results can be observed between 8 to 12 weeks if used correctly.

Side Effects:

Side effects include a warm/stinging sensation, dryness, scaling, iching, redness or worsening of acne. However, this is usually just for the first couple of weeks of use and symptoms will start to settle with continued use. If any side effects get worse, please consult your doctor.

Patient Information Leaflet (from EMC):

https://www.medicines.org.uk/emc/product/920/pil

 

Treclin

Overview:

Treclin is a gel treatment for acne and it contains two active ingredients: clindamycin and tretinoin. Clindamycin is an antibiotic and tretinoin is a retinoid (a form of vitamin). These ingredients work in conjunction to reduce the production of acne causing bacteria and reduce inflammation and blackhead/whitehead formation by promoting the growth of new skin cells, causing shedding of cells that clog the hair follicles in areas with acne.

Directions:

Wash and dry the acne affected areas and apply a thin layer of treclin gel to the affected areas. Rub the gel in with fingertips. Do not apply treclin gel near the eyes, lips, nostrils or on any broken skin. Wash your hands thoroughly before and after use.

FAQ:

How long does it take to work?

Initial effects of the treclin gel start to show in 2 to 5 weeks, with the maximum effect showing between 8 and 12 weeks.

Side Effects:

The common side effects are the following. If any side effects get worse, please consult your doctor:

●      Sunburn

●      Dry, itchy or red skin

●      Rash, scaly rash, scaling of the skin

●      Application site reactions such as burning, or inflammation

Patient Information Leaflet (from EMC):

https://www.medicines.org.uk/emc/product/5371/pil

 

Lymecycline

Overview:

Lymecycline is a prescription-only antibiotic medication used to treat acne. It works by reducing the acne causing bacteria, resulting in reduced acne symptoms such as inflammation, blackheads and whiteheads. Lymecycline 408mg (generic) and tetralysal 300mg (branded) are the same strength, both contain 300mg of the active ingredient, lymecycline.

Directions:

Take one capsule once daily with a glass of water, usually in the morning - swallow the capsule whole, do not break or chew the capsule. It can be taken with or without food, however there is less risk of feeling nauseous if taken with food. Complete the full course of treatment to ensure the problem does not come back, even if you start to feel better.

FAQ:

What happens when you stop taking Lymecycline?

If your acne has not improved, another course of treatment may be prescribed or different treatments can be prescribed.

What is the difference between Tetralysal and Lymecycline?

Tetralysal is the branded version of Lymecycline. Both contain the same active ingredient, lymecycline. Lymecycline 408mg (generic) and tetralysal 300mg (branded) are the same strength, both contain 300mg of the active ingredient.

What should I do if I forget to take a dose?

Take it as soon as you remember, unless it is nearly time for the next dose. In this case skip the dose, do not double the dose of lymecycline as a makeup for the missed dose.

Side Effects:

The common side effects of lymecycline:

●      A headache

●      Diarrhoea

●      Feeling sick

●      Stomach ache

If you begin to experience any of the following symptoms, stop the treatment and consult your doctor:

●      Pale faeces with dark pee, yellow skin or the whites of your eyes turn yellow (this can be a sign of problems with the liver)

●      Skin sensitivity to the sun

●      Signs of an allergic reaction such as swelling of the tongue, difficulty breathing and hives
Patient Information Leaflet (from EMC):

https://www.medicines.org.uk/emc/product/926/pil

 

Oxytetracycline

Overview:

Oxytetracycline is a prescription-only antibiotic medication used to treat acne. It works by reducing the production of acne causing bacteria, resulting in reduced acne symptoms such as inflammation, blackheads and whiteheads.

Directions:

Swallow the tablets whole with a glass of water - do not break or chew. It should be taken 1 hour before food or 2 hours after. Do not consume dairy products whilst taking this medication as there are direct interactions that affect how much oxytetracycline is absorbed. Complete the full course of treatment to ensure the problem does not come back, even if you start to feel better.

FAQ:

What should I do if I forget to take a dose?

Take it as soon as you remember, unless it is nearly time for the next dose. In this case skip the dose, do not double the dose of lymecycline as a makeup for the missed dose.

Side Effects:

The common side effects of oxytetracycline:

●      A headache

●      Diarrhoea

●      Feeling sick

●      Stomach ache

If you begin to experience any of the following symptoms, stop the treatment and consult your doctor:

●      Severe skin rashes

●      Blurred vision

●      Difficulty breathing
Patient Information Leaflet (from EMC):

https://www.medicines.org.uk/emc/medicine/26648#gref

Symptoms

There are six types of spots (listed below) that may appear. All six may not be present at once in an acne breakout.

●      Whiteheads - white spots on the skin that are difficult to squeeze

●      Blackheads - black spots on the skin that get their colour from the hair follicle’s inner lining

●      Pustules - red spots that may feel tender

●      Papules - pus filled red spots with a white centre

●      Nodules - painful spots under the skin

●      Cysts - large spots that contain pus and cause scarring

FAQ

How can I control my Acne?

Use mild cleaners (not soap) to clean the skin no more than twice a day. Soap can inflame the skin further. Do not squeeze the spots as it may result in permanent scarring.

How do I Treat my Acne? 

Acne cannot be cured, however there are many prescription medications and over the counter medications available that work to reduce the inflammation of the skin and kill the acne-causing bacteria.