Acne Treatment: Past to Present

The first acne treatments developed by dermatologists, back in the 19th century, differ little from some over-the-counter medications you can buy today at almost any pharmacy. Sulfur, along with other irritants, was used to dry out the skin, causing the blemish to peel and loosen the clog in clogged pores.

In the 1940s and 1950s, drying lotions included antibacterial ingredients along with sulfur. The main problem with sulfur was that, although it worked, it usually tended to lose its effectiveness with prolonged use. It has been shown that the skin quickly adapts to the active ingredients.

It wasn’t until the use of the first antibiotic, penicillin, in acne medications that more effective antibacterial treatments came into use. However, penicillin turned out to have very little effect on acne, although it would circulate in the bloodstream, it would not penetrate the skin. Fortunately, other antibiotics (namely tetracycline) were discovered that did penetrate the skin. This drug, along with clindamycin and erythromycin, became the treatment of choice for acne for several decades.

Benzoyl peroxide has been used to treat acne since the 1920s, when Jack Breitbart of Revlon Laboratories discovered the treatment’s efficacy. It was available as an over-the-counter treatment and by prescription (in higher concentrations). Its long-lasting popularity is attributed to its antibacterial properties and its effects as an exfoliating agent. Benzoyl peroxide also limited the secretion of certain fatty acid-containing oils known to contribute to acne breakouts.

Vitamin A acid (Retin-A) was developed in the late 1960s and became another important acne treatment when it hit the market in the early 1970s. Vitamin A helps acne by normalizing exfoliation within of the follicle, which helps reduce the formation of blackheads, whiteheads and other acne lesions. However, many patients have experienced significant swelling and redness in the first few weeks of use, causing some patients to discontinue use.

This has been a problem with many traditional acne treatments, they can cause extreme irritation and are pro-inflammatory. It seems contradictory that the cure is similar to the problem: both were inflammatory.

Building on the discovery of vitamin A, isotretinoin, a derivative of retinoic acid, was launched in 1982. Known by the trade name Accutane, it has proven effective in treating an extreme form of acne known as cystic or nodular acne. . It is normally taken over a 20 week course and for those affected by severe cases it has proven to be nothing short of a miracle. However, it has a number of potentially serious side effects, including: a sudden inability to see at night (so driving at night can be dangerous), intracranial pressure, liver inflammation, and serious birth defects.

Oral contraceptives have also been shown to be effective for women with acne. They work by normalizing the surges in hormones that can cause acne.

Alpha hydroxy acids, such as glycolic acid and citric acid, are other over-the-counter acne treatments. They have been shown to be effective in increasing the shedding of skin cells, which helps to remove blocked follicles. They are also popular for their antibacterial and anti-inflammatory properties.

In addition to these, acne patients have been subjected to other unusual treatments in search of a cure. More than 50 years ago, German doctors used X-rays to treat their acne patients. It was considered extremely effective in drying out the sebaceous glands, it was even used to remove facial hair. Fast forward to today and this therapy, used on many thousands of patients, is known to have caused multiple skin cancers and thyroid cancer in these patients due to radiation.