Acne Vulgaris, is the dermatological term for pimples i.e. zits . Vulgaris means common, & I don’t need to elaborate how common it is. 15 % of all adolescents have severe acne which merits treatment. Nowadays we see an increased trend towards Adult or late onset Acne, the causes are varied & multifaceted involving our changing diet, environmental conditions, stress, hormones etc etc.

Today, we also see a rise in availibility of cosmetics which claim to treat Acne. All claims may not be sufficiently substatiated but definitely there do exist a number of excellent cosmetic products which can be used by Dermatologists as part of their treatment armamentarium .

Cosmetic preparations do have a number of advantages viz:
– Medications used can be reduced.
– In case of default follow up by the patient we are not worried as to any major side effects by continuous use of the products.
– Cosmetic, the term itself assures a fantastic patient compliance as regards the products physical appearance on use i.e the patients don’t feel greasy, sweaty, too dry , too opaque etc etc.
– Cosmetic products such as gentle cleansers, moisturisers can be used as therapy adjuvants, so that the medications used do not alter the skin’s appearance in terms of flaking, drying up, greasiness etc.
– Reputed cosmetic firms are very particular about the bases used in their products so we are fairly reassured of non acnegenecity, non allergenic conditions.

Luckily this trend is now catching up with pharmaceuticals also . More care is now taken as to in which vehicle the drug is delivered. Previously all that was seen was that the base had to be one which allows for optimum drug to be absorbed by the skin. Nowadays a lot of emphasis is also laid upon patient acceptance of the base in terms of comfort & wearability ! Non fragrant products are more popular by & large. This is a far cry from previous trends which advertised different fragrance ranges in their skin products.

It is very important for a Dermatologist to have an extensive knowledge of various cosmetics & their contents so as to ensure their proper usage. In my practice I do have a particular bias towards certain cosmetic preparations based on my experience with patients. I still tend to keep an open mind, but unfortunately the trend for advertising of cosmetics does not involve visits by their Reps to Dermatologists. Quite a few companies advertise & sell their products via pharmacies. I believe that it is a part of my continuing education to take some time off now & then & visit cosmetic counters in malls etc so that I know what’s new in the market & how it works.

The leading companies for cosmetic products which are used as Anti Acne or Adjuvants are LUTSINE, GLYDERM, NEUTROGENA, ROC, CLINIQUE & LANCASTER. Again , I repeat this statement is based on my experience and is not to be taken as a slight to any one Company. The LUTSINE & NEUTROGENA range is a lot. It includes anti acne face washes which are medicated, non medicated gentle , antiseptic etc. They also have a good range of lotions to be used after wash on the face. These also come in pledgets for patient conveniences. The masks which are to be used once or twice a week are medicated with known antibacterial formulary which controls new lesions & also helps minimise intake of antibiotics.

ROC , CLINIQUE & LANCASTER products are good because:
1. Being reputed companies the Quality of products is excellent so as to not aggravate Acne.
2. They contain, albeit in small quantities, well known medical formularies like Retinol, Alpha Hydroxy Acids, Beta Hydroxy Acids, Benzoyl Peroxide etc. Now these preparations are very dilute as compared to pharmaceuticals but then they can be used very wisely by a Dermatologist to support his or her treatment.
3. Patient acceptibility is very high.
4. Most of their day wear products contain sun protection factor alongside , being very easy to ‘wear’ day long.
5. Make up products also vary according to skin types, are non occlusive, sun protective, non acnegenic thus fulfilling most needs of today’s Woman.
6. Sun protection is necessary in acne cases to prevent exacerbation of lesions, generalised skin appearance and an even tone in skin colour. Roc has a combination cream, named Alpha + Matt, which on use shows a very good range of action . It is hydrating at the same time gives a ‘No Shine ‘ look, is sun protective & helps both in reducing acne and lightening skin colour.

Similarly the Retinol preparations from Lancaster can be used as night time treatment of acne.

CLINIQUE scores in their Alpha and Beta hydroxy ranges where acne treatment is concerned, but on the whole most of their products are conducive to acne prone skins & those undergoing Dermatological treatment.

GLYDERM, an American based company, similarly has a wide range of Hydroxy acid preparations which are indispensible to a dermatologist in Acne Therapy. Except for Clinique & Lancaster , the other companies distribute through pharmacies, proving their products to be ‘ Cosmetic Treatments”.

But every coin has two sides. Cosmetics also have a number of disadvantages, especially in the way their advertising & marketing is concerned. The sellers at times, make claims which are not adequately substantiated. The name of the game is to sell. Marketing techniques at times are standard & do not take into consideration the geographical area one lives in. It is very important to remember that a single individual may show different skin appearances based on the climatic conditions & environment. The other thing I have noticed as that most cosmetic preparations are sold as a set of different things eg wash, cleanser, toner, day cream, night cream, mask etc. Now its worth thinking that we have only about 12 to 16 waking hours. Where on earth is the time to apply so many things daily. If you do so then there is no time for anything else isnt it ? Also most patients are confused by all the products. It has happened so often in my practice, that a patient comes to me carrying all she has bought in a bag & asks me, how to use the products !

Products are sold saying, ‘cures acne’. I wish Acne cure was so simple. Each Acne case is different. Textbook treatments cannot be used routinely then how can they claim so confidently. What helps one patient may be detrimental to another. 80 % of Acne cases need a Dermatologist to treat them & they should not be waylaid otherwise. A single company may not have all products that are a cure for all problems. It is a dermatologist who is best qualified to sift through all available products .

I repeat that what I have written is my experiece. I do not say this is good or this one is bad nor that my views should be yours too. All I have tried is to present both sides of the coin, same as cosmetics & Dermatology are also inextricably intertwined.

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