Natural Treatment For Acne

Best Acne Treatment. Possible Contributing Factors for Acne:


• Hormonal
o Signs of androgen excess would include precocious puberty
and hirsutism
o Possible causes of androgen excess would include polycystic
ovary disease, adrenal tumor, ovarian tumor and pituitary
tumor
• Mechanical
o Physical pressure from headbands, violins, chin straps, sports
helmets, guitar straps and orthopedic braces have induced
localized acne; wool and other rough textured fabrics and
occlusive clothing may also be irritants
• Contact
o Oil-based cosmetics, oil-based scalp lubricants, topical tar
products, and hairspray
o Occupational materials such as coal tar, pitch, mineral oil and
petroleum oil
o Ingestion, inhalation or transcutaneous penetration of
halogenated aromatic hydrocarbons, including components in
paint, varnishes, lacquers, fungicides, insecticides, herbicides,
wood preservatives and oils
• Environmental
o Heat and humidity may induce comedones
o Pressure, friction, and excessive scrubbing or washing can
exacerbate existing acne by causing microcomedones to
rupture
o Hair styles low on the forehead/neck may cause excess
sweating, occlusion and make acne worse
• Emotions
o Intense anger or stress can exacerbate acne, causing flares or
increasing mechanical manipulation.
• Drugs (see also Acne Comparison Chart)
o Hormones: androgenic hormones in women, corticosteroids,
corticotrophin (ACTH), oral contraceptives high in progestin
o Topical steroid induced perioral acne
o Bromides, chlorides, halothane, iodides (e.g., Kelp)
o Antiepileptic drugs: gabapentin, phenytoin, phenobarbital & trimethadione  
o Tuberculostatic drugs: ethambutol, isoniazid & thionamide  
o Miscellaneous: cyclosporine, cyanocobalamin, dantrolene, gold
salts, lithium salts, maprotiline, psoralens, quinidine, quinine &
topical coal tar
o Select cancer drugs: cetuximab, erlotinib & gefitinib
• Family history (genetics) often provides prognostic clues














Best Acne Treatment. Diet


• There is anecdotal evidence that certain foods exacerbate acne
• Chocolate – the evidence that chocolate is acnegeic had several
methodological flaws: small sample size; treatment duration and follow-up not long enough to detect changes; and high fat content of control bar may have been acnegenic
• Advice regarding diet should be individualized.

Best Acne Treatment. Isotretinoin (Accutane, Clarus) Highlights


• Official indications: severe nodular and/or inflammatory acne,
acne conglobata & recalcitrant acne.
• Other considerations:
♦ extensive acne involving face and trunk, associated with scarring;
failure to respond to or inability to tolerate systemic antibiotics
and/or hormonal therapy; family history
♦ Significant psychological distress because of acne
• Due to common side effects, avoid concurrent acne topicals, vitamin
A supplements, and follow-up topical retinoids for about 4 months

Best Acne Treatment. Can Diane 35 be used as contraceptive?


• Berlex Canada does not recommend that Diane 35 be prescribed
as contraception alone.  They recommend the use of alternative
contraception while on Diane 35.  However, Diane 35 is indicated
for contraceptive monotherapy in other countries (e.g. Australia).

Best Acne Treatment. What COCs have the official indication for acne tx?


• In Canada, Alesse, Tri-cyclen & Diane 35 have official indications
for acne in the product monograph.
• Yasmin is as efficacious as Tri-cyclen & Diane 35
 for mildmoderate acne, but not officially indicated.
{Yaz in the USA recently got  acne FDA indication}
• All COCs are generally beneficial, likely due to estrogens effect
on sex hormone binding globulin (SHBG) resulting in an
antiandrogenic effect.
  Limited and conflicting evidence does
not support the superiority of one progestin over another.

Best Acne Treatment. COCs: Role in women with acne


• Acne accompanied by mild or moderate hirsutism
• Inadequate response to other acne treatments
• Acne that began or worsened in adulthood
• Premenstrual flares of acne
• Excessive facial oiliness
• Inflammatory acne limited to the “beard area”

Best Acne Treatment. Antibiotics (ABX): Considerations


• Using BP with topical ABX is strongly recommended to reduce
the risk of bacterial resistance!
• Oral ABX are useful for more extensive/severe inflammatory
acne; however, due to bacterial resistance concerns, shorter
“pulse” courses may be preferred over longer-term maintenance
therapy.
• Topical antibiotics are useful as follow-up to an oral ABX course.