AcneNet This Month
October 2000

Tip of the Month

If you are using medications prescribed by a physician for the treatment of acne, you should tell your physician about any over-the-counter (non-prescription) medications you may also be using. Although over-the-counter medications are generally less potent than prescribed acne medications, they do have side effects and they may interact with prescribed medications to (1) cause more severe side effects, or (2) interfere with the potency of the prescribed medication.

Be sure to tell your physician about any herbal medications you may be taking in pill or liquid form, or applying topically to your skin. While herbal medications are often marketed as "natural", the "natural" label does not mean they are without side effects. Some herbal medications—especially those taken internally—can cause changes in blood pressure, heart rate and other bodily functions, and can have cross-reactions with prescribed medications.

Over-the-counter lotions and cremes can sometimes cause local irritation, redness of the skin, and skin scaling—especially if used excessively. Because these are side effects that may limit your ability to use prescribed medication at the prescribed dose, you should discuss your use of over-the-counter medications with your physician before any medications are prescribed.

You have heard people with acne say they would "use anything to get rid of my acne". In fact, most people with acne have used a great number of lotions, cremes, household chemicals, and other topically-applied substances in their search for a self-help acne treatment, and have found many of them to be ineffective and even harmful. Over a period of years, physicians and acne investigators have tested drugs that seemed to offer promise as acne treatments, and found many of them to be ineffective.

A British investigator compiled a list of more than 70 potentially promising therapies that were eventually shown to be of no benefit in the topical treatment of acne. Some are easily obtainable household chemicals. Some are medications usually prescribed for other conditions which, for one reason or another, seemed to offer promise in treating acne.

Among the therapies shown to be of no benefit in the topical treatment of acne:

• Household disinfectants (diluted to prevent serious chemical burns when applied to the skin)
    
• Household cleaning powders—e.g., Ajax, Comet
    
• Concentrated dish-washing detergents (while gentle washing with mild soap is recommended to cleanse the skin of excess oil, concentrated detergents have no added benefit and may cause the skin to become excessively dry and scaly)
    
• Industrial de-greasing chemicals such as acetone (any industrial chemical is potentially harmful and not meant for use on the human body)
    
• Anti-tuberculosis drugs isoniazid and rifampin (acne seemed to improve in some TB patients taking these drugs, but further investigation showed no benefit)
    
• Anti-depression medication (although these drugs may be useful in the treatment of depression associated with acne, they do not treat the acne)
    
• Sauna and massage
    
• Cellophane tape, duct tape, etc., applied overnight to the skin and stripped off in the morning (the tape will remove dead cells and excess oil on the surface of the skin, but no effect is seen on comedones, and overnight taping may cause hypersensitivity reactions in some people)

The best approach to Acne treatments is to follow current recommendations found on this website.

Question of the Month

Each month we pose a question that is answered the following month. This month’s question:

What is a good nutritional treatment for acne?

We’ll have the answer, and a discussion of the answer, on AcneNet next month.

Answer to last month’s Question of the Month

Last month’s question was:

Squeezing of acne comedones and pustules in front of a bathroom mirror is probably done hundreds or thousands of times every day. The fact that it is done so often is not a recommendation to do it. The procedure carries risks of further damaging an inflamed sebaceous follicle, or more seriously, of causing a secondary infection at the site of squeezing and increasing the risk of scarring.

Pustules can be superficial or deep. A superficial pustule might be "popped" by gently squeezing with minimal risk, but a deep pustule is not easily "popped". Because a deep pustule does not open when gently squeezed, squeezing may become more forceful with increased risk of tissue damage and infection. In fact, squeezing may leave the deep pustule in visibly worse condition than it was prior to squeezing.

Comedo extraction may be carried out by a physician or nurse in a physician’s office, when the procedure is deemed medically advisable. Comedo extraction at home, using extractors sold in magazine ads or over the Internet, is not advisable.