Introduction
Acne is a protracted inflammatory skin infection and is the most common skin ailment. It is normal for teenagers to contract acne, which is caused by hormones that cause pores to become clogged and infected with some bacteria (Chen et al., 2018). Therefore, the condition is peculiar in the case of Jess, who is suffering from severe acne. The treatment plan below indicates the appropriate therapy for her condition.
Treatment Plan
The treatment is intended to target key factors blameable for the formation of lesions: higher production of sebum, hyperkeratinization, colonization by propionibacterium spots, and the subsequent inflammatory reaction. The aim of the treatment therapy is to prevent the formation of scars, to reduce psychological indisposition, and perseverance of lesions (Rabey, 2020). There are three main different treatment options that Jess can use to counter further development of the lesions.
Jess can use topical retinoids that are active in treating both inflammatory and non-inflammatory abrasions. They help to prevent comedones, reduce surviving comedones, and level inflammation. Topical retinoids inhibit the power of follicular keratinocytes by preventing extreme cornification and follicular jam. They also mitigate the production of pro-inflammatory cytokines, hence reducing the number of comedones and inflammatory lesions by 40 percent to 70 percent (Dubey & Amane, 2019, p. 2317). Topical retinoids can be used as a monotherapy to treat non-inflammatory skin conditions or combined with antibiotics to heal inflammatory spots. They can also be used after treatment involving the use of systemic drugs is discontinued for maintenance. Topical retinoids have side effects, such as irascibility with erythema and scaling (Brian & Jones, 2016). If Jess uses the medication, it is appropriate that she applies very small amounts at the beginning. The drugs become fully active after twelve weeks, after which continuous maintenance therapy can be applied to prevent flashes. Adapalene (Differin) is considered the most effective topical retinoid. Tazarotene (Tazorac) is also quite effective. Tretinoin (Retin-A) and adapalene are the least effective.
Topical and oral antibiotics can be used as a monotherapy mainly to treat mild to moderate inflammatory or mixed skin condition. However, they play a better role when used together with topical retinoids. Topical antibiotics are likely to cause bacterial resistance, hence, it is appropriate that they be used alongside benzoyl peroxide (McLaughlin et al., 2019). The most preferred antibiotics include clindamycin and erythromycin. Antibiotics begin to show results after six weeks of use and can be continued for several months, after which they may be discontinued bit by bit. Topical retinoids are then used for maintenance after signs of healing. The therapy has shown effectiveness in decreasing the number of inflammatory abrasions by 52 percent to 67 percent, although there is no strong empirical support (Tan et al., 2018, p. 60). It is advisable to use stronger doses to achieve better control of the skin condition.
Benzoyl peroxide is a bactericidal agent available over-the-counter. It is packaged in many different concentrations and formulations that vary in strength from 2.5 percent to 10.0 percent (Gholami et al., 2017, p. 199). Even though Jess can start using any formulation at the beginning, it is better she starts with a lower concentration; a stronger formulation is likely to cause irritation and would not be more effective. Benzoyl peroxide acts by killing propionibacterium acnes through the release of oxygen in the follicle. The drug starts to show effectiveness rather quickly within a span of five days (Vikrant et al., 2019). However, it can cause bleaching, hence Jess ought to know that textiles that come in contact with benzoyl peroxide, including bed sheets and towels, may be decolorized.
Benzoyl peroxide is preferred because it does not cause bacterial resistance. It is applied in treating mild to moderate mixed acne. It is more effective when used together with topical retinoids. It helps to reduce the risk of bacterial resistance when used alongside topical and oral antibiotics (Christensen et al., 2016; Gholami et al., 2017). Some variations of benzoyl peroxide contain salicylic acid, which is a cleansing product. The products come with anticomedonal properties and are less effective than topical retinoids. Benzoyl peroxide is commonly mixed with erythromycin, clindamycin, or adapalene. Other possibly efficient over‐the‐counter prescription drugs for acne treatment include alpha‐hydroxy acids, azelaic acid, sulphur, resorcinol, and zinc. However, their efficiency has no empirical support from randomised controlled clinical trials (Yang et al., 2020). Additionally, there are no research studies comparing their effectiveness when combined with other topical treatments.
Conclusion
Acne is a common illness that affects most teenagers in the United States. The infection can be controlled through the use of three main kinds of therapy, including topical retinoids, topical and oral antibiotics, and over-the-counter prescription mainly involving benzoyl peroxide. The therapies can act independently across mild to severe inflammatory and non-inflammatory acne. However, all therapies work best when combined with each other since they help to serve distinctive functions. Benzoyl peroxide is preferred because it does not cause bacterial resistance while topical retinoids can be used for maintenance after treatment goals are realized. The drugs come with different limitations; topical retinoids cause irascibility with erythema and scaling, while benzoyl peroxide can cause bleaching. It is also advisable that the medication be used in small quantities initially.
References
Brian, B., & Jones, Y. (2016). Efficacy, safety, and patient satisfaction with a combined acne treatment regimen for the treatment of acne vulgaris in adolescent student athletes. Journal of General Practice, 04(01), 1-7. Web.
Chen, X., Wang, S., Yang, M., & Li, L. (2018). Chemical peels for acne vulgaris: A systematic review of randomised controlled trials. BMJ Open, 8(4), e019607. Web.
Christensen, G. J. M., Scholz, C. F. P., Enghild, J., Rohde, H., Kilian, M., Thürmer, A., Brzuszkiewicz, E., Lomholt, H. B., & Brüggemann, H. (2016). Antagonism between Staphylococcus epidermidis and Propionibacterium acnes and its genomic basis. BMC Genomics, 17(1), 1-14. Web.
Dubey, A., & Amane, H. (2019). Comparative clinical study of efficacy and safety of adapalene 0.1% gel versus benzoyl peroxide 2.5% gel for the treatment of acne vulgaris. International Journal of Basic & Clinical Pharmacology, 8(10), 2317. Web.
Gholami, M., Mokhtari, F., Siadat, A., Jafari-Koshki, T., Faghihi, G., Nilforoushzadeh, M., Hosseini, S., & Abtahi-Naeini, B. (2017). Efficacy of intense-pulsed light therapy with topical benzoyl peroxide 5% versus benzoyl peroxide 5% alone in mild-to-moderate acne vulgaris: A randomized controlled trial. Journal of Research in Pharmacy Practice, 6(4), 199. Web.
McLaughlin, J., Watterson, S., Layton, A. M., Bjourson, A. J., Barnard, E., & McDowell, A. (2019). Propionibacterium acnes and acne vulgaris: New insights from the integration of population genetic, multi-omic, biochemical and host-microbe studies. Microorganisms, 7(5), 128. Web.
Rabey, N. G. (2020). How does topical benzoyl peroxide compare with adapalene for people with acne? Cochrane Clinical Answers, 5(34), 34–65. Web.
Tan, A., Schlosser, B., & Paller, A. (2018). A review of diagnosis and treatment of acne in adult female patients. International Journal of Women’s Dermatology, 4(2), 56–71. Web.
Vikrant, J., Karan, S., & Anil, G. (2019). A comparative study between topical adapalene (0.1%) versus a combination of topical adapalene (0.1%) and intense pulsed light therapy in the treatment of inflammatory and noninflammatory facial acne vulgaris: A split-face randomized controlled trial. Indian Journal of Drugs in Dermatology, 5(1), 19. Web.
Yang, Z., Zhang, Y., Lazic Mosler, E., Hu, J., Li, H., Zhang, Y., Liu, J., & Zhang, Q. (2020). Topical benzoyl peroxide for acne. The Cochrane database of systematic reviews, 3(3), CD011154. Web.