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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.
acne patient

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Salicylic acid. Salicylic acid is an organic beta hydroxy acid that is a natural plant-derived ingredient. It causes cells of the stratum corneum to shed more rapidly to prevent pores from clogging and allow space for new cell growth, helping reduce and prevent blackheads. Salicylic acid is found in acne cleansers and topical acne treatments, and is designed to cleanse, exfoliate and prepare the skin to make other anti-acne ingredients more effective. Although it reduces bacteria and excess oil from the skin, its main role is correcting abnormal keratinization.

Benzoyl peroxide. The benefit of benzoyl peroxide in the treatment of acne is its ability to kill the bacteria that cause acne and oxidize the oils on the surface of the skin produced by the sebaceous glands. Benzoyl peroxide increases the pH of the skin, causing some clients to develop redness, itching, stinging and sometimes swelling of the skin. Its strong oxidative properties can bleach hair and clothing, as well as create sun sensitivity in some clients.

Glycolic acid and alpha lipoic acid. Combining these two ingredients can help correct the abnormal keratinization and the abnormal sebum secretion in acne-prone individuals. The major corrective effects are a reduction in abnormal sebum secretion and the elimination of abnormal keratinization.

Azelaic acid. This is a natural plant-derived dicarboxylic acid, and is a prescription product used in the treatment of acne. In lower concentrations, it can be obtained without a prescription, and when combined with other anti-acne products, it can help eliminate acne and hyperpigmentation. It has antibacterial and keratolytic effects on the stratum corneum. The keratolytic effect reduces the formation of blackheads and increases the penetration of the azelaic acid into the pilosebaceous gland. This enhances the antibacterial effect of the azelaic acid and decreases the P. acnes that cause inflammatory acne lesions.

Vitamin A. Retinoic acid, retinol and other retinoids are vitamin A-derived ingredients that have significant keratolytic effects on the stratum corneum. Retinoic acid, adapalene and other retinoids are only available with a prescription; however, retinol is available without a prescription.