Two million women, young and old, suffer from unsightly pimples on their skin. Fortunately, the range of weapons to combat these unsightly pimples is constantly expanding. The point with Pr Brigitte Dréno, head of the dermato-oncology department at the University Hospital of Nantes (44).
Lack of sleep, unhealthy lifestyle, stress, unbalanced diet, excessive consumption of fast sugars-all of these modify the ecosystem of the skin and promote the appearance of acne pimples. This is often compounded by a series of mistakes, starting with skin irritation and bad cosmetic habits.
The first tip to rebalance the skin is to “use a cleansing gel that respects the pH of the epidermis,” explains Professor Brigitte Dréno, head of the dermatology-cancerology department at Nantes University Hospital (44). For example, those created by spas (Uriage, Avène, La Roche-Posay, etc.) or other dermocosmetic ranges suitable for fragile and reactive skin. “We avoid fruit- and plant-based products on oily skin,” says the specialist, who advises against homemade masks based on avocado, lemon or any other plant extract. Essential oils should not be used to dry and disinfect the skin. Do not use scrubs, anti-imperfection masks or other cleansers…. Cleansing the skin twice a day with a mild product is more than enough!
3 types of treatment
When acne is mild, dermatologists have 3 types of treatment available: benzoyl peroxide, topical retinoids, and topical antibiotics.
- Benzoyl peroxide is effective against the proliferation of acne bacteria, but has the disadvantage of being photosensitizing.
- Topical retinoids (vitamin A analogs) act by combating inflammation and overactivity of the pilosebaceous follicle. The latest, adapalene, is less irritating and just as effective as tretinoin. Tripharotene is not yet licensed in France, but should soon receive marketing authorization for back injuries. Azelaic acid, which has little antimicrobial activity, and zinc gluconate can be added.
- Local antibiotics are usually macrolides (erythromycin, clindamycin). Fixed combinations combining different classes of drugs in a single cream have been available for some years: retinoids and benzoyl peroxide or antibiotics and retinoids.
Antibiotics: never more than 4 months of treatment
“For minimal and moderate acne, I have abandoned local antibiotics because of the development of bacteria resistant to these drugs,” explains Prof. Dréno. In most cases, the same result is achieved with peroxide without inducing resistance. Only in cases of more severe acne (affecting the trunk or back), the dermatologist may have to suggest oral antibiotics. But never for a long period. “We see patients in consultation who have been taking cyclins for a year. That’s too long.”
In practice, one should never exceed 4 months of treatment. If antibiotics fail to control acne, a change of strategy is needed: isotretinoin (Roaccutane) is a very effective solution, although the drug has many side effects.
A new anti-acne pill
Some pills make acne worse, others improve it. The main problem lies in the progestin used. Older generation pills tend to turn into androgens. And this does not like the skin at all! In contrast, pills such as Jasmine, Jasminelle, Belara or Triafemi have a positive impact on the skin. Triafemi was the only drug with both a contraceptive and anti-acne indication.
A new estrogen-progestin, Œdien, also got both indications. “It is a fairly well-tolerated pill,” says Professor Dréno. Because every woman has a different hormonal profile, it is often difficult to find a pill that is well tolerated and matches her lifestyle. The arrival of a contraceptive that also has anti-acne properties is good news. Ideally, the pill should be combined with a local treatment. Caution: discontinuation of the contraceptive may be followed by a relapse.
An app to manage acne
Effaclar Spotscan is a free app suitable for all cell phones. It allows you to accurately assess the severity of skin lesions and benefit from personalized follow-up. It integrates a simulator that provides an overview of the appearance of the skin after the recommended treatment. It is aimed at all people suffering fromacne. Using an algorithm designed with dermatologists which incorporates nearly 6000 faces of men and women aged 10 to 58 years with all types of blemishesThis app provides tips and best practices for correcting lesions and preventing them from worsening. To analyze your acne-prone skin, clean it and take three self-portraits. The app lists the blemishes and determines a severity score from 0 to 4+. If the score is 2 or higher, users are encouraged to consult a dermatologist.
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