Patients now have multiple new sources of information about acne treatments, including direct-to-consumer advertising and the Internet.... Unfortunately, the information is not always accurate, and claims of effectiveness are not always substantiated.
Green tea is supposed to have anti-inflammatory and antioxidant properties. If it does, it might be appropriate for acne therapy because... inflammation is a major mechanism in the etiology of acne. The most recent newcomers in the fight against P acnes are the expanding number of topical
retinoids.
They may not be directly antibacterial, but since the topical retinoids reverse abnormal keratinization, they change the lipid content within the follicle and thereby make the skin less hospitable to the growth of P acnes. In the general medical community, there is a lot of concern about causing bacterial resistance because physicians might use some of these antibiotics to treat conditions other than acne.
Whether the concern is appropriate remains to be proven. Red and blue light therapy is a novel approach. In some instances, I use adapalene combined with an oral antibiotic for inflammatory acne. In most cases, I reserve the topical retinoids for patients who have at least some comedonal acne, either alone or mixed with inflammatory lesions. I usually give a therapy at least 3 to 4 months before I do a follow-up exam and recommend changes.
At that time, I will evaluate the patient's skin, find out what kinds of side effects the medications are causing, if any, and inquire about compliance. New systemic retinoids are on the horizon, and newer broadspectrum antibiotics are emerging. There do not seem to be any unique, novel classes of drugs, however.
As far as alternative therapies that patients sometimes elect to use, by which I mean the cosmeceuticals and herbal preparations, I would like to see well-controlled studies on how well they work versus the standard treatments, as well as the risks involved.
As far as alternative therapies that patients sometimes elect to use, by which I mean the cosmeceuticals and herbal preparations, I would like to see well-controlled studies on how well they work versus the standard treatments, as well as the risks involved. The retinoids, though, have changed over the years. First was retinoic acid, and now there are adapalene, which is a naphthoic acid derivative, and other retinoids that have different pharmacologic properties from the original formulation.
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