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How To Treat Moderate Acne Vulgaris

This week I'll be continuing my series on the types of acne and treatment options for each. If you haven't already taken my acne quiz, get to it so you can figure out which type you have. We already went over the treatment options for mild acne vulgaris, so now it's time to move on to moderate acne vulgaris.

Quick refresher before we get started: moderate acne vulgaris consists of papules and pustules. Papules are slightly elevated, solid lesions that have a "sandpaper" feel when you rub your hand over the area. A pustule is the more inflamed version of a papule. They are dome-shaped, fragile lesions containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. Lovely! Now that we know what we're dealing with, see what you can do about it when you


  • High Concentration Benzoyl Peroxide: You can get up to a 10% concentration of benzoyl peroxide without a prescription, but if your acne still won't budge, it might be time to step it up with a prescription. Yep, time to see the doc. She will be able to prescribe you a higher concentration, and more importantly, evaluate your acne one-on-one and determine the right course of treatment for you. If you do get a prescription for a higher dose of benzoyl peroxide, use it sparingly and only every other day at the most, as it can be very, very drying. Be sure and moisturize and use a high SPF every day, as it will also increase your sensitivity to the sun.
  • Topical Prescription Antibiotics: Topical antibiotics wipe out acne-causing bacteria on your skin, and can be effective for those of you afflicted with non-inflamed papules. The most commonly prescribed are Clindamycin and Erythromycin, which come in either a gel or a cream form, and are applied twice daily. The good thing about topical antibiotics is that the side effects are minimal, they don't cause much drying or irritation, and can potentially clear up moderate cases of acne in about 8-12 weeks.
  • Oral Prescription Antibiotics: Oral antibiotics kill acne-causing bacteria deeper within your pores than topical ones. So if your acne hasn't responded to topical treatments, you might need to try an oral one. The most commonly prescribed are Tetracycline and Doxycycline. There are generally more side effects for anything you take orally, so be sure and discuss what they are with your doctor, since they vary between each prescription. You can bet on at least increased sensitivity to the sun, and maybe some nausea and headaches.

As with any prescriptions, make sure you discuss any potential side effects with your dermatologist before starting a treatment plan. Don't be scared to ask questions — you are paying for your doctor's time so you should make sure you get the most out of it. And trust me, physicians have heard everything under the sun, so don't hold back! Also make absolutely sure you tell your dermatologist what other drugs you're taking — legal, illegal, over the counter, prescription, whatever. Nobody's going to arrest you, and your doctor needs to know so you don't have a potentially dangerous drug interaction. Let me know if any of you have tried any of these treatments, and what you thought!


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