I'm doctor Mike Evans my question is work is the best way to treat
acne acting vulgarities a skirt a clue
your auger send bad but in fact it's an old word that means common
which acne certainly is acne is fascinating in the pantheon of diseases
many ways trivialize it is simply part of teenage life that faith and and
really doesn't have any health consequences
but what if I framed in a different way acne is a disease that makes people feel
bad
often very bad about themselves just when it was critical that they feel good
about themselves
it's a disease that can scar for life but that could have been prevented
a disease that research shows this is damaging the quality of life
is chronic distressing condition such as as per epilepsy or diabetes
and the timing is so unfortunate just as we start to be more where her parents
oil geyser center located near upper chest back neck and face
all highly visible areas begin pumping out skin Greece
adults can get acne about 10 percent still have a 25
but almost all teenagers do get acne which 15 having a more severe case
it tends to come on earlier in women but do to get a little bit works
unlike most likely resources on the internet I'm not gonna offer you 100
percent here
there really is no cure for acne most to the therapies and gonna discuss have
about a 40 to 70 percent success rate
getting to a higher success rate really depends on you finding your own special
recipe that often requires
you combine different agents what we call step up their
p okay the first piece advice is to talk to a doctor about it
repeat after me my doctor has see more embarrassing things and whatever I show
him or her
so bring acne up and go back if your team isn't working
now
I bet I can guess the current approach them if you're taking who are suffering
from acne
perhaps you wash your skin vigorously to keep like it
to a minimum maybe put people claim or whenever you have an outbreak
any made even avoid certain foods you think worsen your
me well actually the black and black kids
is really just melanin in oxidized lipids not there
so cleaning vigorously or picking can actually inflamed pimples
washing once daily with the mild soap for so close Kinder's fine
pretty people came under existing actually doesn't actually make much a
difference
a key key learning is that when you treating acne you're actually not doing
much for the current pimple
you're preventing the next round so if you are playing the cream
NEC going where you get pimples for most people this is in what we call the
T-cell
it takes 60 weeks and sometimes longer to see if acne treatment is working
diet and acne is interesting
most research shows no connection but the trial quality is generally poor
for example studies trying to provoke acne with large amounts of chocolate
show expect but the trials for to shorten too small to be definitive
a small trial using a low-glycemic diet showed some improvement but
I I'd say there's not enough evidence at this kinda recommend one way being over
another
the answer is likely just eating healthfully and if a patient find a big
difference with a food
I say if I so that food that understand the best treatment for acne we need to
start with the biology lesson
than a mere test then step up their p I think if you comprehend the biology
Lackie it makes treatment a lot easier to understand
when you hit puberty many things happen but
two things in particular at your skin first we get more plugging
this is because the hormonal changes appear ready cause more
oil production what we call see them and the surface of the skin becomes a bit
more crusty
what we call karen is a sin the second thing that happens as we get more
information
this is mostly because the bacteria to colonize is our skin called P acnes
the P acnes mixes with this evil man oil and causes an inflammatory reaction
which gives redness and swelling
now acne confuses as I think because there are so many treatments
1 review indicated a hundred and forty different treatments in into engine 50
combos
so kicker for the mall but we can ask what the clinical research says is the
most effective all these treatments
and I think it follows our biology lesson it's developing a strategy to
a reduce plugging Mb minimize information
we just have acne treatment is to start with one therapy
if it works great if if it only works personally or not at all then you need
to step up to the next level by changing or adding a therapy
okay let's take a bit of a detour into a topical 101
total cals are r medicine see you apply your skin like a cream or gel or lotion
jails had to be stronger and more drying cream so if you have oily skin
and a gel might be a good idea if you have less oily skin
the cream would be better and we all react differently to different topic or
so it's a good idea to experiment with a topical in one area before you apply
everywhere
mister with a lower strength and then ramp it up if you need more
effectiveness
now let see look in the mirror and now by the way is a good time to take a
picture of yourself
pre-treatment leader for comparison let's see you see mostly red and
inflamed pimples
then you need to do something about the information which means you need to try
to reduce the bacteria P acnes
benzoyl peroxide or BP is first line here and it's available over the counter
at any pharmacy
it's good to go graduate bps as he didn't seem to be much difference with
the different strengths I tell people to start with los drinks like
2.5 percent and and start putting on for two hours for four nights in for four
hours for four nights and then the whole night
and then wash it off in the morning if you tolerate that well but you want more
fact than you can try switching to a stronger version
remember you have to give it a few months to see if it works
alright back to the mir look in your face if you see plugin on your skin
which would be small bumps blackheads or whiteheads then you need to focus on
unplugging the classic can plug in agent in acting cares called the retinoid
retinoids work by making your skin less Christina and you need a prescription to
get this treatment
sometimes you can make your skin a bit red and dry so again experiment
dryness can be helped with a moisturizer so if you look in the mirror and see
both red spots
and black or white heads on your skin they need to both
unplugged and reduce information by using a combination of both retinoid NPP
but I suggest you start with one to see how your skin reacts
there's some debate about which one should be first but usually
most people start with BP as its over the counter
okay if these first-line agents have worked it's time to look at the NEX
options for step up therapy
if your women you can consider using a birth control pill as it reduces the
hormones that cause plugging in the first place
this is an especially effective approach if you can have flare-ups have acne
around your period
you can also consider a topical antibiotic to reduce P acnes and
information
these can be prescribed to pre mixed with BP or retinoid
if you already know you tolerate these next we often step up to antibiotics
take by mouth
now we do you worry a bit about over using antibiotics
so it's good to take a break every few months to see if you still need it
if your step up their peers not worked after all these treatments your doctor
has
other options that you can discuss finally if you've exhausted
all your options there is a very strong right now I taken by mouth called
isotretinoin
it is the supreme employer and and it's incredibly effective for severe acne
been a mixed message here though isotretinoin has some potential side
effects and and a powerful drying effects are you really need to pack your
lip balm and moisturizer and so on
and including the fact it absolutely can not be taken by women that is pregnant
so you need to be monitored closely when you're on this medication
having said that I have seen isotretinoin change the lives of more
severe acne sufferers
in and if you think scarring is likely then this may be a reason to consider it
a try no
in some sense acne treatment a simple reduce plugging
information but it's all so complicated as there are many many agents that do
these two things
treating acne is a bit like basketball have to experiment with various players
in combinations
the score can fluctuate initially and it takes a little while to figure out who
will win
but you can win if you stick with
I made a card to help you sort out all the different treatments it's free at my
favorite medicine DICOM
I really hope this helps take care
just