The reasons why medicines are not effective in acne at times are many. The cause of treatment failure in acne may be with the patient, the disease, the medications and even the doctor!
Causes of Treatment Failure in Acne: The Patient
Some patients with acne fail to follow instructions properly regarding the proper dosage of the medication, its strength and the optimum duration of treatment. Dosages are changed without consulting the doctor and treatment stopped before the pimples are brought under control. Some patients fail to understand how to use the acne medications properly, either because of carelessness or because the communication from their doctor or pharmacist were inadequate.
The acts of omission or commission on the part of the patient can be avoided by giving proper instructions with specific benefits of observing compliance regarding the acne medications. Clearly written, legible instructions with correct dosage, strength and duration of treatment should accompany each and every acne prescription.
Causes of Treatment Failure in Acne: The Disease
Response to treatment in acne depends upon the severity, extend and duration of the blemishes. Acne, with its relationship to hereditary, hormonal and lifestyle changes, can be unpredictable in its response to various therapeutic interventions. Unless the acne triggers are taken care of well, acne medications usually fail to give the deserved results.
Causes of Treatment Failure in Acne: The Medications
If the medications chosen to treat acne are not suitable for the particular type of acne, obviously it is not going to help. For example, topical acne preparations alone will not control severe and very severe types of acne, unless they are combined with oral acne medications. Likewise, topical antibiotics are comparatively ineffective in comedonal acne.
At times, Propionibacterium acnes can become resistant to topical and systemic antibiotics. Using lower strengths of the medications and for short durations is another important cause for treatment failure in acne.
Patients may discontinue the treatment if the medications irritate the skin or cause new flare ups.
Causes of Treatment Failure in Acne: The Physician
If the treating physician is not well-versed in the different types of acne and its pathogenesis, wrong combinations of medications or ineffective medicines may be used with poor results in many cases. The best doctors to treat acne are the dermatologists, who are well trained and aware of the advances in the treatment of acne in its varied presentations.
How to Prevent and Avoid Treatment Failure in Acne
If the patient compliance is found to be the cause of poor response to treatment, the following steps will ensure better compliance:
- Reduce the strength of the topical medication, for example, use 2.5% benzoyl peroxide in place of 5% or shift to 0.025% tretinoin in place of 0.05%.
- Use different formulation of the same medication; for example, cream instead of gel, which is more drying.
- Change to an alternative, less irritant topical medication in consultation with the physician.
If the treatment response is not up to the expected levels despite the patient following the instructions to the letter, consider the following:
- Increase the strength of preparation.
- Increase the duration and frequency of application.
- Antibiotics are combined with benzoyl peroxide or topical retinoids to reduce the chances of developing drug resistance.
- Explore the possibility of using oral isotretinoin in eligible patients.
How to Prevent and Avoid Treatment Failure in Acne: Related Articles
- Principles of Treatment of Acne: Guidelines on How to Get Rid of Your Pimples. These important principles of acne treatment will help the acne sufferers effectively keep their pimple problem under control.
- Acne Treatment Precautions: Home Remedies, OTC Products, Food and Pimples.There are certain precautions that the acne sufferers have to take to reduce the chances of acne scars and limit the side effects of acne medications.
Sources:
- Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009;60:S1-50.
- Simpson NB & Cunliffe WJ. Disorders of the Sebaceous Glands in Rook’s Textbook of Dermatology. 2004; 7: 43.1-43.75.
Disclaimer
The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purposes only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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