Medicines can help manage the severity and frequency of acneoutbreaks. A number of medicines are available. Your treatment will depend on the type of acneyou have (pimples, whiteheads, blackheads, or cystic lesions). These medicines improve acne by:

• Unplugging skin pores and stopping them from getting plugged with oil (tretinoin, which is sold as Retin-A).
• Killing bacteria (antibiotics).
• Reducing the amount of skin oil (isotretinoin).
• Reducing the effects of hormones in producing acne (certain oral contraceptive pills for women).

The best medical treatment for acne often is a combination of medicines. These could include medicine that you put on your skin (topical) and medicine that you take by mouth (oral). Or you may take medicines such as clindamycin/benzoyl peroxide, a gel that contains two topical medicines.

Medication choices

Treatment of acne depends on whether inflammation or bacteria are present. Some acne consists only of red bumps on the skin with no open sores (comedonal acne). Topical creams and lotions work best for this type of acne. But if bacteria or inflammation is present with open sores, oral antibiotics or isotretinoin may work better.

There are different types of acne. The most common acne is the type that develops during the teen years. Puberty causes hormone levels to rise, especially testosterone. These changing hormones cause skin glands to start making more oil (sebum). Oil releases from the pores to protect the skin and keep it moist. Acne begins when oil mixes with dead cells  and clogs the skin's pores. Bacteria can grow in this mixture. And if this mixture leaks into nearby tissues, it causes swelling, redness, and pus. A common name for these raised bumps is pimples.

Certain medicines, such as corticosteroids or lithium, can cause acne to develop. Talk to your doctor about any medicines you are taking.

Acne treatment depends on whether you have a mild, moderate, or severe type of acne. Sometimes your doctor will combine treatments to get the best results and to avoid developing drug-resistant bacteria. Treatment could include lotions or gels you put on blemishes or sometimes entire areas of skin, such as the chest or back (topical medicines). You might also take medicines by mouth (oral medicines).

Mild acne

Treatment for mild acne(whiteheads, blackheads, or pimples) may include:

• Gentle cleansing with warm water and a mild soap, such as Dove or Cetaphil.
• Applying benzoyl peroxide(such as Brevoxyl or Triaz).
• Applying salicylic acid (such as Propa pH or Stridex).

If these treatments do not work, you may want to see your doctor. Your doctor can give you a prescription for stronger lotions or creams. You may try an antibioticlotion. Or you may try a lotion with medicine that helps to unplug your pores.

Moderate to severe acne

Sometimes acne needs treatment with stronger medicines or a combination of therapies. Deeper blemishes, such as nodules and cysts, are more likely to leave scars. As a result, your doctor may give you oral antibiotics sooner to start the healing process. This kind of acne may need a combination of several therapies. Treatment for moderate to severe acne may include:

Description:

By:  Graham Douglas, Fiona Nicol, Colin Robertson The 12th Edition of this famous medical textbook, which was 'Highly Commended' in the 2006 British Medical Association Medical Book Competition, builds on the extensively rewritten previous edition. Over 500 clinical photographs and diagrams now illustrate the text, whilst new topics have been added to make the book even more comprehensive. A complementary DVD now accompanies the book, with specially-recorded videos demonstrating many of the clinical examination routines as they are described in the main text. The book is written by a team of editors and contributors who are all active clinicians and experts in their specialist fields, including in general practice where much of clinical teaching is now based. It describes the practical skills which every clinician must acquire and develop in order to evolve diagnostic procedures and management strategies and plans.

• This text provides a clear description of the fundamental skills of patient evaluation and examination, answering the cunning questions which arise from this.
• Starts with a general overview section on history taking and the general examination that provide the framework on which to hang the detail.
• The systematic examination section documents clearly the relevant history, examination and special investigations as well as giving advice on their significance.
• The final section covers specialised areas and emphasises an integrated and structured approach to these patients.
• Closely linked to its sister publication, Davidson's Principles & Practice of Medicine, which complements the information in this text.
• Available with full online access on Student Consult and with a DVD of specially-recorded videos demonstrating key clinical examination routines following the format laid out in the book.

• The complementary DVD contains over two hours of specially-recorded videos demonstrating many clinical examination routines following the outline described in the main text.
• A new introductory chapter emphasises the important principles in beginning a patient examination.
• Two new chapters focus more precisely on the Skin and the Endocrine System, areas previously covered in the more general examination sections of the book.
• A new chapter on the Examination of the Eye, previously incorporated into the examination of the neurological system.
• Two new chapters focus on specific situations:.

• Pre-operative Assessment looks at the examination required of a patient prior to sedation and anaesthesia.
• Examination to confirm death.

The book now includes over 50 clinical examples in OSCE format, as used in final MB and MRCP (UK) PACES examinations, to help with revision.


Macleod's Clinical Examination, 12th Edition