Using Creams for Acne Treatment

Acne Creams

Acne creams are a mainstay treatment for acne in teenagers.

From Azelex to Ziana, topical acne creams are typically the first-line treatment for all types of acne.

But some teens dislike using them -- they don't give quick results, they often have to be used every day for long periods of time, and they have some side effects. By finding the right acne cream for your teen might improve compliance and your child's complexion.

OTC Acne Creams

Most acne creams are only available with a prescription, but a few non-prescription, over-the-counter acne creams can be used, especially for mild acne, including:

• benzoyl peroxide - available in a number of forms and brands, such as Persa-Gel, Clearasil, Neutrogena, and OXY, etc.
• salicylic acid - usually used for mild comedonal acne (blackheads and whiteheads), especially if a teen can't tolerate other medications, and can include Neutrogena Oil-Free Acne Wash Cream Cleanser and ZAPZYT Pore Treatment Gel

Prescription Acne Creams

Although OTC acne creams can help many teens with mild acne, those with more moderate to severe acne will likely need a prescription acne cream, either by itself or with an oral antibiotic or other acne treatment.

Commonly used prescription acne creams include:

• Retin-A (tretinoin)
• Retin-A Micro (tretinoin)
• Differin (adapalene)
• Tazorac (tazarotene)
• Azelex (azelaic acid)

• Epiduo (adapalene-benzoyl peroxide)
• Benzaclin (clindamycin-benzoyl peroxide)
• Duac (clindamycin-benzoyl peroxide)
• Acanya (clindamycin-benzoyl peroxide)
• Benzamycin (erythromycin-benzoyl peroxide)
• Ziana (tretinoin-benzoyl peroxide)
• Sulfur-sulfacetamide sodium
• Dapsone

With so many acne creams, how do you know which to choose for your teen's acne?

Although your pediatrician may simply choose the latest and greatest acne cream, especially if she has samples on hand, that doesn't necessarily mean it is any better than some of the other acne creams, all of which work pretty well.

Cost can be a big factor, especially as some of the newer acne creams are expensive and not always well covered by insurance. That might lead you to a prescription for the older versions of Retin-A and Benzamycin, both of which are now generic.

Side effects are the other big factor, as some acne creams cause more skin irritation than others.

In general, a retinoid acne cream, such as Retin-A, Retin-A Micro, Differin, or Tazorac, are considered the first-line prescription acne creams for most teens with mild acne.

Next, if that doesn't work in a few months, or initially if the child has more moderate acne, a combination acne cream, which combines two ingredients, will likely be tried. An oral antibiotic might also be added to a teen's acne cream regimen if he has moderate acne.

Acne Creams - What You Need to Know

• The best acne creams are often the ones that work well and cause the least amount of skin irritation. Unfortunately, there is typically some trial and error involved in finding the best acne cream, so don't be surprised if your pediatrician starts with one medication and then has to change it to a milder, or stronger medicine, depending on your child's reaction.

• Other acne treatment options include oral isotretinoin (Accutane) for severe acne and hormonal therapy with oral contraceptives for girls with moderate acne.
• For teens with sensitive skin, starting their acne creams every other day or every other night may reduce the initial burning and irritation that many teens have. It may even be helpful to wash the acne creams off after a certain amount of time (15 to 30 minutes) until your teen starts to get used to them.
• Your teen shouldn't usually use other medications that may irritate his skin when starting a new acne cream, such as an astringent or scrub for acne.

• Using too much acne cream -- more than a pea-sized amount for your teen's whole face -- can also cause more irritation, and won't make the medicine work any better.
• Acne creams are usually less irritating than acne gels.

_Sources:

_{Habif: Clinical Dermatology, 5th ed.}

_{Shamban AT. Multimodal treatment of acne, acne scars and pigmentation. Dermatol Clin. 01-OCT-2009; 27(4): 459-71}

_{Zaenglein, Andrea L. Expert Committee Recommendations for Acne Management. Pediatrics, Sep 2006; 118: 1188 - 1199.}