Adolescent Acne - Many Treatments, Few Cures

Implications: Adolescent acne is a challenging problem to treat.  This is a medical problem that has social and psychological consequences.  Acne can affect one's self-esteem, psychological growth, and adversely impact one's educational and career development.  Therefore, it is of paramount importance that adolescent acne be treated effectively.  Unfortunately, there is no cure - only a plethora of treatments.  Determining which one is most effective in a given patient requires patience and perseverance. 

Analysis: Despite the plethora of products available to treat acne, there are very few "cures" for adolescent acne.  This has led to an explosion in the number of products available in the marketplace.  If a cure existed for this problem, every dermatologist and plastic surgeon would be prescribing a similar regimen.  There are, however, many different treatment options available.  Trying different treatments increases the likelihood of finding which one which is most effective for a given patient.  The earlier treatment is started, the more likely one is to be successful.  Using gentle skin cleansers with alpha- or beta-hydroxy acid will help soften and dissolve the keratin plugs at the end of the pilosebaceous units.  Some of these products contain salicylic acid as well.  A popular regimen using this combination is ProActiv solution.  Reducing the bacterial load is also of benefit.  This is usually accomplished by using topical medications and/or oral antibiotics.  Applying a benzoyl peroxide aqueous gel increases the concentration of free oxygen radicals in pores and kills Propionibacterium acnes, the bacteria that multiply in clogged follicles.  Other treatment options include topical retinoids, oral contraceptives, or oral retinoids (e.g., Accutane).  Before prescribing a treatment regimen, it is important for healthcare professionals to counsel patients and their parents on the risks and side effects of using each of the aforementioned medications.