Is there anything in our own homes that can clear acne fast? I have terrible acne and I have tried everything but it won’t go away.
Acne occurs when hormones, keratin (the hard dry material on skin), sebum, (the oily material we all have on our skin) and bacteria interact. It usually develops during adolescence, when the production begins, in both sexes, of male sex hormones (called androgens). The androgens cause the sebum-producing glands to enlarge and produce more. Often the ducts to the skin’s surface become blocked, leading to the small bumps we call blackheads or whiteheads. The medical terms are open or closed comedones. The blackness of a blackhead has nothing to do with dirt, and washing will not prevent or treat blackheads. The dark color is produced by the oxidation of hardened sebum exposed to the air.
Bacteria in the glands break down the sebum, creating mild acids which are irritating to the walls of the gland, leading to inflammation. This produces the pimple: a red, raised bump which may or may not have obvious pus in it.
In many people, the comedones and pimples occur only in the top part of the skin, and will heal without scarring. Some people though get much deeper pimples, which may develop into cysts or actual abscesses. This deeper form of acne is very likely to cause permanent scarring, and obviously requires much more vigorous treatment.
There are now many ways to treat acne, but no single treatment is best for everyone; and a doctor must evaluate the location and severity of the acne in order to plan appropriate therapy. For example, acne in areas other than the face, like the back or chest, usually does not respond well to topical treatments such as creams or gels, and will require an oral antibiotic or other pill treatment. Mild superficial acne, which appears on the face only, will often do very well with some of the topical treatments that are available over the counter without a doctor’s prescription.
In response to the second question, I know of no home remedies that will help acne. Frequent face washing, the use of antibacterial soaps or abrasive soaps will not have any effect. There are no consistent dietary changes that will help. The old myth about chocolate causing outbreaks is probably just that — a myth — but if someone notices that their acne goes up and down depending on what they eat, then they should obviously avoid the foods that worsen the condition.
The over-the-counter treatments are creams and gels containing benzoyl peroxide. They are applied once or twice a day, and are allowed to dry on the skin. They may be irritating, in which case they should be applied in a lower concentration, or less frequently.
Treatments that must be prescribed include Retin A, which comes in various strengths and as a cream or a gel. It is applied at night, and washed off in the morning. It can be irritating, but a person’s skin adapts to it, and the concentration of the cream or gel can usually be increased with time. It can be alternated with benzoyl peroxide. Retin A often causes the acne to get worse for the first four to six weeks; but this does not mean that it won’t work eventually.
Other topical medicines include antibiotics in liquid or gel form, sometimes combined with benzoyl peroxide, as in Benzamycin. Cleocin T is another commonly used topical antibiotic. Azelex is a recently approved antibacterial cream which is not an antibiotic.
For oral treatment, one of the tetracyclines or erythromycin is often used. Dermatologists like the tetracycline called Minocin, which causes less stomach upset and fewer reactions to sunlight; but it is expensive and probably doesn’t work any better than plain generic tetracycline.
For severe acne with deep cystic lesions, an oral vitamin A derivative called isotretinoin (Accutane) can be used. It must be taken for several months. It can cause birth defects, and women taking it must be on an effective contraceptive to prevent pregnancy. It often produces side effects of dry eyes and dry mucus membranes such as the mouth or vagina. One course is usually all that is needed. This drug has really revolutionized the care for severe acne.
As you can see from what I have written, there is no fast cure for acne, especially if it is severe. Different creams may have to be tried. Some people may react better to one oral antibiotic than to another. Often it takes several months to see if a treatment is working. However, most cases of acne can be greatly helped if you hang in there, stay with a doctor experienced in the different treatments or a dermatologist, apply the topical medicines conscientiously, and remember that this is a long process — cures don’t occur overnight.