Acne Treatment Options When Medication Does Not Work Try This Live Session

Acne is a concern for many. Especially when it doesn't improve with medication or keeps recurring, it can be daunting to know how to approach it. Today, we'll address various questions about acne treatment and explore effective management methods.

Non-professional acne extraction can actually worsen the condition. Antiseptics only work on the skin surface, and acne bacteria are deep inside the pores, making them difficult to remove with antiseptics. Antiseptics without antibiotic components cannot kill acne bacteria.

• Avoid forceful extractions: It's okay for acne that extracts easily, but forcefully squeezing is not advisable.
• Be especially careful with red acne: Inflamed red acne has thin walls and can rupture easily. If bleeding occurs after extraction, it means it was squeezed incorrectly, so caution is needed.

Blue light is known to be effective for red inflammatory acne. However, its effectiveness may be somewhat lower for comedonal acne. While home-use blue light devices exist, clinic-grade devices use stronger power. Blue light treatment has the following characteristics:

• Caution with frequent use: Using it too often can dry out the skin and slightly accelerate skin aging. It's important to adhere to the recommended usage.
• Harmfulness: Blue light has a different wavelength than UV light, making it much less harmful. However, all treatments have both effects and side effects, so appropriate use is necessary.

Taking antibiotics for inflammatory acne can be helpful, but periodic antibiotic use can lead to a side effect called antibiotic resistance. If resistance develops, the medication's effectiveness decreases, making it difficult to see treatment results later on.

• Take only when necessary: It's best to take antibiotics short-term for treatment purposes only when acne is severe.
• Acne-specific antibiotics: Some general skin antibiotics are not effective for acne. Antibiotics effective for acne are mainly of the TC class, which are often not used for other conditions.

Isotretinoin (generic name, domestic product names include Accunetan) is a highly effective medication for severe acne. It is essential for severe acne that cannot be controlled by other treatments. The acne-suppressing effect varies with the dosage, and low-dose regimens are often used in Korea to control sebum and suppress acne.

• Key precautions:
  • Pregnancy: Strict contraception must be maintained during treatment and for at least one month (recommended three months) after stopping. It can severely affect the fetus.
  • Dryness: Sebum control can lead to dryness of the lips, nose, and eye mucous membranes. Using lip balm, petroleum jelly, and artificial tears can help.

Gold PTT has the significant advantage of being able to treat acne without medication. It is characterized by the absence of stress from taking daily medication. Laser treatment may be more effective than low-dose isotretinoin, and Gold PTT is reported to help reduce recurrence rates. There are cases in studies where the effect lasted up to two years, so it is considered a fairly long-lasting treatment method.

Which treatment is more effective depends on each patient's acne condition, severity, and lifestyle, so it is important to consult with medical staff to make a decision.

Diet and acne

There are various opinions on the effect of food on acne, but nothing has been 100% clearly established yet. However, three things known to potentially have a negative impact on acne are:

1. Foods that rapidly raise blood sugar: Very sweet foods raise blood sugar, which is not only bad for acne but also for overall health, so it's advisable to reduce them.
2. Dairy products: Some reports suggest that dairy products can negatively affect acne. However, not everyone reacts, and milk intake is important for growing adolescents, so there's no need to worry too much.
3. Individual trigger foods: If you notice acne appearing after eating certain foods, it's best to avoid them. This varies greatly from person to person, so you should observe and judge for yourself.

The effect of alcohol and smoking on acne

• Smoking: It is harmful in every way. Like UV rays, it promotes skin aging and increases inflammatory reactions, having a very negative impact on acne. It's best to avoid smoking.
• Alcohol: Small amounts of alcohol can cause temporary blood vessel dilation, making acne appear redder. Excessive alcohol consumption can stress the body and promote the secretion of stress hormones, which can worsen acne.

Some people worry that dermatological procedures might negatively affect acne. Most laser procedures are chosen appropriately by a dermatologist for the patient, so there's no need to worry too much. However, after some laser procedures, as skin elasticity improves, pores may temporarily become blocked, leading to a slight breakout of acne within a week after the procedure. In such cases, mild treatment can improve the condition.

• Thermage FLX: This is a high-frequency procedure that can actually help with acne. It is effective in improving both acne and reduced skin elasticity simultaneously.
• Recurrent acne: If acne repeatedly and severely recurs, sebum-suppressing treatments can be considered. Treatments such as isotretinoin medication or procedures that destroy sebaceous glands, like PDT or Gold PTT, can help reduce recurrence rates. These treatments can contribute to keeping acne from occurring for 6 months to 1 year, or even up to 2 years.
• Repeated acne in specific areas: For acne that keeps appearing in one spot, procedures like Agnes can selectively destroy those sebaceous glands. However, for acne across the entire face, PDT or Gold PTT may be more effective.

Acne typically begins with hormonal changes during puberty, starting on the nose and forehead (T-zone) and then spreading to the cheeks, chin, and around the mouth. In the past, acne tended to decrease in the late 20s or 30s, but recently, there has been an increase in adult acne patients suffering from acne even after their 30s and 40s. Adult acne tends to concentrate along the jawline or around the mouth, and stress or dieting can be aggravating factors.

• Importance of early treatment:
  • Faster results: Treatment is more effective when started early.
  • Scar prevention: Approximately one-third of acne patients can develop scars. Scars on thin skin, in particular, can be unsightly.
  • Prevention of pore enlargement: Neglecting acne can lead to enlarged pores and poor skin texture.
  • Psychological impact: Adolescent acne can cause psychological stress during a critical period of self-formation, so active treatment is necessary.

In the past, acne treatment options were limited, but recently, many effective treatments with reduced side effects have been developed, including antibiotics, low-dose isotretinoin therapy, and various laser and skin care procedures (e.g., Gold PTT) for those who cannot take medication. Consistent treatment tailored to individual conditions is important for maintaining healthy skin.