What are the goals of treatment for acne vulgaris?

Updated: Jan 30, 2020
  • Author: Ginard I Henry, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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The treatment objectives are decreasing the count of P acnes, decreasing the hyperkeratosis, and decreasing the sebum production. Topical antibiotic preparations and those with systemic effect have been used, as have sebum antagonists. Benzoyl peroxide is a common bactericidal with a free oxygen radical moiety as its active mechanism. It simultaneously decreases the organism concentration and the amount of free fatty acids available on the surface. Because it is a keratolytic, enhanced global skin blood flow is recognized. Transretinoic acid (tretinoin) is a topical preparation with established efficacy. [41] The primary mechanism is to decrease retention hyperkeratosis by limiting cohesiveness of the keratinized layer. This regimen results in the thinning of the stratum corneum to approximately one half of its usual thickness.

Topical tetracycline, erythromycin, and clindamycin also have been used. [40] The pustular and papular forms respond better to these antibiotics than the cystic or comedonal forms. An oral tetracycline is also very efficacious.

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