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A Multifaceted Approach to Acne

By: Lawrence Samuels, MD
Posted: January 30, 2012, from the February 2012 issue of Skin Inc. magazine.
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Acne is recognized as a multifactorial disease requiring a multifaceted approach to therapy. Establishing an accurate assessment is essential for developing a treatment strategy for acne and evaluating treatment success. Treatment of acne is directed at reversing the pathologic process. The mechanism of action of each treatment, and its ability to address one or more of the causes of acne needs to be evaluated when creating an acne treatment program.

Therefore, treatment must contain products that:

  • Prevent abnormal epidermal cell growth;
  • Normalize and enhance skin exfoliation at the opening of the pore;
  • Kill the bacteria in the pore;
  • Reduce the exaggerated inflammatory response; and
  • Control abnormal and excessive sebum production.

Treatment is designed to heal active lesions and prevent their formation. True scarring must be distinguished from erythematous or hyperpigmented spots that can result from inflammatory acne. The latter generally resolve throughout a few months without visible marks. Acne should be treated aggressively to prevent permanent scarring.

Most acne treatment programs contain a single active ingredient, such as benzoyl peroxide. Results of clinical trials indicate treatment programs that contain multiple active ingredients working together may produce better results.2 It is important to remember that many acne clients have additional skin problems, especially women 30–50 years old. Rough skin texture, brown skin discoloration, skin dryness and fine lines can complicate the treatment of acne. A customized, multifaceted treatment regimen is needed to treat individual clients. Initially, determine the client’s skin type—sensitive vs. normal or dry-normal vs. normal-oily. This will guide the selection of a cleanser; acne solution gel, cream or lotion topical treatment; and spot treatment.

Following are some common acne-fighting ingredients.