Acne Treatment Reviews

Acne is a common skin disease especially in adolescents. It usually disappears at or around the age of 25 but in some people, it can persist long into adulthood.

Acne can be “cured” by a combination of good skincare, natural remedies and drugs. The treatment may need to be kept up until the root causes are removed but even adult acne can be treated.

Given the sheer number of acne drugs out there, it can be difficult finding the right ones that are effective for you. While some treatment options are more effective than others, it should be noted that there is no acne treatment that works for everyone.

Discussed below are the most commonly used remedies in acne treatment. 

Vitamins

Vitamin A: Vitamin A is a fat-soluble vitamin and its biologically active form is retinal.

Retinal is the light molecule which is responsible for the ability of the eyes to see color and to see in low-light.

Retinoids which are commonly used in acne treatment are analogs of vitamin A. However, the simple vitamin is safer to use than these synthetic analogs and it also provides similar benefits.

Vitamin A can help rejuvenate the skin by exfoliation of dead skin cells and stimulation of new collagen production. It is also involved in the regulation of hormonal balance and immune function. Therefore, it can help prevent inflammatory acne lesions and reduce sebum production.

High doses of vitamin A should be avoided in acne treatment so as to prevent toxicity.

Vitamin B5: Vitamin B5 is useful in acne treatment for two reasons: to reduce the size of skin pores and to regulate the production of hormones and fatty acids through Coenzyme A.

By reducing the size of the skin pores, this vitamin prevents them from clogging up while driving the excess sebum collecting in them up to the skin surface where it can be removed.

When vitamin B5 stimulates Coenzyme A, it drives forward fat metabolism. When fat metabolism is reduced, the excess fat is pushed to the skin, where it gets stuck in the pores and clogs them. This leads to the formation of acne lesions.

Vitamin B5 also reduces the production of androgens through increased utilization of Coenzyme A. Androgens, such as testosterone, are responsible for the hormonal imbalance that trigger acne outbreaks.

To treat acne, high doses of vitamin B5 are required.

Vitamin D: Vitamin D is also called the sunshine vitamin. It is naturally synthesized in the skin from cholesterol on exposure to sunlight.

Vitamin D especially as one of its active forms, vitamin D3, is effective for treating a number of skin diseases including acne. In acne treatment, vitamin D helps break down acne comedones such as whiteheads and blackheads.

It reduces sebum production by inhibiting the enlargement of the sebaceous glands. It can provide a selective anti-inflammatory effect too; and also a protective effect through its antioxidant property.

Vitamin D can also provide a potent antimicrobial action to kill off acne-causing bacteria.

This antimicrobial effect is produced by regulating the immune response to bacterial attack. Vitamin D contributes to the release of a class of natural antibiotics by leukocytes in epithelial cells.

Vitamin E: Vitamin E is a very strong antioxidant. It is capable of neutralizing reactive oxygen species including the destructive peroxyl radicals.

Because it can remove harmful free radicals and mop up toxins on the skin, vitamin E protects the skin from the kinds of damage that can cause acne.

The antioxidant benefit of vitamin E is skin-deep.

It can help stabilize and protect the sebaceous glands too. These glands are the primary site of attack by the hormones and bacteria that trigger acne breakouts.

The vitamin also prevents the oily sebum secreted from this gland from going rancid. When sebum deteriorates, as it does when there is no antioxidant to prolong its usefulness, it hardens. The solidified sebum can no longer flow in and out of the skin pores. Therefore, it clogs the pores and cause acne lesions.

Vitamin E also protects the skin from the harmful ultraviolet rays of sunlight. It promotes wound repair and the replacement of damaged skin cells.

Vitamin E is best taken as an oral supplement for treating acne. It should also be combined with other antioxidants such as vitamin A and selenium to get the best benefits from it.

Minerals

Zinc: Zinc is an essential mineral needed in trace amounts in the body. It is the most important mineral in the body after iron and it is the only mineral found in all classes of human enzymes.

The serum level of zinc is directly linked to the severity of acne. Zinc deficiency also causes a number of skin diseases including acneiform dermatitis.

Zinc inhibits the conversion of testosterone to dihydrotestosterone (DHT). By reducing the levels of DHT, zinc protects the sebaceous gland from undue stimulation from male sex hormones.

Zinc ions have antimicrobial effects. Therefore, they can kill off acne-causing bacteria.

Zinc also has anti-inflammatory properties through its regulation of granulocytes which are immune cells involved in inflammation.

Zinc is also needed for the optimal absorption of vitamins A and E in the body. Therefore, a multivitamin preparation of these vitamins should include zinc if it must be used to treat acne.

Selenium: Selenium is trace micronutrient which is essential for different biological processes. Selenium is useful in acne treatment as an antioxidant.

First, it is an antioxidant on its own. Secondly, it increases the antioxidant effects of vitamin E.

Selenium exerts its antioxidant effects through a class of enzymes known as glutathione reductase. These enzymes scavenge peroxides and protect the skin from oxidative damage.

Other means by which selenium is beneficial in acne treatment include its anti-inflammatory properties and its contributions to the normal functioning of the immune system.

Selenium also contributes directly to skin health by improving the elasticity of the skin.

Botanicals and Home Remedies

Aloe: Aloe vera or Aloe barbadensis is a universal herb used for treating skin diseases. It is extensively used in the cosmetic industry to provide soothing, moisturizing and nourishing effects on the skin.

However, aloe provides even more benefits for treating acne. It has an antimicrobial property that makes it effective for killing off acne-causing bacteria. It can also reduce the swelling of acne nodules and other inflammatory lesions.

Aloe is known to heal wounds. It can penetrate deep into the skin to speed up healing; it can also help rejuvenate the skin and fade off acne scars.

Honey: Honey is a natural acne remedy.

It is a supersaturated solution of simple sugars. This means that it is made up of mostly glucose and fructose dissolved in too little water. Therefore, honey draws moisture onto itself, and can dehydrate microbial cells in this way.

However, the antimicrobial property of honey is even more extensive. It can kill off acne-causing bacteria by other means. These include removing iron needed for microbial metabolism, restoring the acidic pH of the skin and slowly releasing hydrogen peroxide which breaks down microbial cells.

The most medicinal of all honeys is the Manuka honey, and its chief antimicrobial effect is not even one of the 4 listed above.

Manuka honey has a high concentration of MGO (methylglyoxal). A second equally potent but unknown antimicrobial compound is also suspected.

Honey is a common ingredient of acne masks. It is a very effective home remedy for acne.

Hydrogen Peroxide: Hydrogen peroxide is one of the 2 peroxides used to treat acne. The other one, benzoyl peroxide, is only available in topical acne medications. Hydrogen peroxide solutions can be bought at the store, and it is commonly used as a disinfectant at home.

Hydrogen peroxide is an oxidizer. This property allows it to break down microbial cells and kill off acne-causing bacteria. This effect on bacteria cells is only minimal on skin cells since hydrogen peroxide breaks down to water and oxygen on contact with the skin.

This peroxide is also a good exfoliant. It can peel off the top layer of the skin, and remove acne-causing bacteria, dead skin cells and the film of dirt formed on the skin.

In this way, hydrogen peroxide can also help unclog the pores. However, care should be taken when applying the peroxide because it can bleach hair and fabrics.

Hydrogen peroxide is not for acne sufferers with dry and sensitive skin types since it can irritate the skin and dry it too. It may also cause a burning or itching sensation.

Vinegar: The two vinegars commonly used in acne treatment are white vinegar and apple cider vinegar.

Vinegars are acidic solutions. They are applied on the area of the skin affected by acne, and they can help restore the pH of the skin. Vinegars are also useful for their antiseptic and antibacterial effects. They can kill off acne-causing bacteria by breaking down their cell membranes.

Vinegars can be ingested or applied topically in the treatment of acne. Since they are acidic solutions, vinegars should be sufficiently diluted with water before use.

Even dilute solutions of vinegars can be harsh on the skin and other mucosal surfaces. Therefore, they are not for everyone.

They also cause skin dryness, and may lead to new acne breakouts by triggering rebound production of excess sebum.

Topical Medications

Benzoyl Peroxide: Benzoyl peroxide is a powerful bleaching agent. It is used for whitening teeth and for bleaching hair and fabrics.

Like hydrogen peroxide, benzoyl peroxide is a strong oxidizer with an antiseptic property. It is available in 3 strengths (2.5%, 5% and 10%) in topical acne products.

Benzoyl peroxide acts exactly like hydrogen peroxide: it breaks down cell membranes to kill off acne-causing bacteria; it exfoliates the skin by removing the dead skin cells and excess sebum collected on it; and it is quickly converted to harmless benzoic acid and oxygen when it touches the skin.

However, benzoyl peroxide can irritate the skin and dry it. Therefore, it should be used carefully.

The lowest strength (2.5%) is effective in acne treatment and the highest concentration (10%) should be used only in people with severe acne who do not have sensitive skin types.

Salicylic Acid: Salicylic acid is a phenolic acid which is structurally related to aspirin.

It can be obtained from plants in which it serves as a hormone. It is sometimes called vitamin S by some researchers because of its importance in the body.

The most useful properties of salicylic acid in acne treatment are its anti-inflammatory and antibiotic properties. It is included in topical acne products in concentrations ranging from 0.5% to 2%.

Salicylic acid promotes the breakdown of acne comedones. It also removes dead skin cells and bacteria from the skin by exfoliation. This action increases the turnover of the skin. Salicylic acid can also prevent and relieve inflammatory acne lesions. It will also promote local blood microcirculation to improve skin health.

However, salicylic acid can cause skin dryness and irritation. These side effects are increased in acne formulations where it is combined with benzoyl peroxide or sulfur.

Alpha Hydroxyl Acids: The two alpha hydroxyl acids usually included in acne products are glycolic acid and lactic acid.

These hydroxyl acids help reduce skin inflammation, promote the growth of a new top layer of skin after exfoliating the old layer.

Resorcinol: Resorcinol is a phenol with a similar but milder activity to salicylic acid and benzoyl peroxide.

Sulfur: Sulfur is a strong exfoliant with an astringent property. It dries up acne comedones but can easily dry up the skin too. Sulfur has a strong, repulsive, chemical odor.

Adapalene: Adapalene is a third generation topical retinoid (vitamin A analogs) used to treat acne. It is formulated as gels and creams to treat mild to moderate acne.

Unlike older retinoids, adapalene can be used along with benzoyl peroxide. It also increases the absorption and effects of topical clindamycin in acne treatment.

Oral Medications

Tetracycline Antibiotics: Most antibiotics used in acne treatment are taken orally. Generally, there are 2 types of oral antibiotics used in treating acne. These are the tetracycline antibiotics and erythromycin.

The tetracycline antibiotics include tetracycline, doxycycline, minocycline, oxytetracycline and lymecycline.

They are generally broad-spectrum antibiotics that are capable of killing off acne-causing bacteria such as P. acnes. However, each of them is recommended to treat different types and stages of acne.

Doxycycline, for example, is prescribed when tetracycline and erythromycin fail while minocycline is used for treating pustular acne (where acne lesions such as pimples dominate).

All tetracycline antibiotics cause photosensitivity of the skin. They can cause hyperpigmentation and discoloration of the skin, teeth and gums. Vitamin C is often prescribed along with these antibiotics to reduce this side effect.

Isotretinoin: Isotretinoin is an oral first-generation retinoid commonly used to treat severe cystic acne especially when other treatment options fail.

Isotretinoin was commonly known as Accutane before 2009 when it was pulled off the market following wide claims about its side effects. It is currently sold under other brand names including Roaccutane.

Isotretinoin causes cell death in the sebaceous glands. In this way, it reduces the enlargement of the gland and the production of excess sebum. It is also known to kill off Propionibacterium acnes, the major bacteria responsible for acne development.

However, the side effects of isotretinoin are extensive. It is not recommended for pregnant women because it causes birth defects, and it should only be taken under strict medical supervision.