What are the medicines for treating skin problems?

First of all, it must be made clear that there is no "magic medicine" that can cure all skin problems. All medicines must first correspond to a clear diagnosis of skin problems. Currently, the conditioning medicines commonly used in clinical practice are divided into two main directions: topical and oral. The core premise is to first determine whether your problem is inflammation, barrier damage or pigment metabolism. Indiscriminate use of medicines will increase the burden on the skin, and even cause sensitive skin and hormonal face.

Last month, I met a young girl who had just graduated. She had recurring red pimples on her cheeks and her mouth was closed. She read the online guide and bought metronidazole and adapalene to apply all over her face. After half a month, the pimples were not much gone. Instead, her face was so thin that it became red and stinging when the cold wind blew. She couldn't even tolerate the mild facial cleanser that she uses every day. This is a typical pitfall of indiscriminate use of medicines without correcting the symptoms.

Let’s talk about the most common acne problems first, such as mild to moderate closed mouth and inflammatory papules. Adapalene gel is currently recognized as the first choice drug. However, please note that it can only be applied to the skin lesions. Tolerance must be slowly established. People who are preparing for pregnancy or pregnant must not touch it.； If you have red, swollen, pus-filled acne, benzoyl peroxide gel or clindamycin gel is more targeted. However, clindamycin is an antibiotic and cannot be used alone for a long time. It is easy to develop drug resistance and will have no effect if used again later. If you have severe acne with nodules and cysts all over your face, you have to take isotretinoin orally. This drug is indeed very effective, but its side effects are also clear. It will cause dry mouth and skin, and it has clear teratogenicity. You must strictly follow the doctor's instructions and follow the course of treatment. The risk of taking it by yourself online is really high.

Many people think that only skin care products for sensitive skin and damaged barrier are enough. In fact, in the acute stage, when skin becomes red, hot, and itchy, skin care products alone cannot suppress the inflammation. Instead, over time, it will leave discoloration and aggravate the barrier problem. At this time, it is perfectly fine to use weakly effective hormone ointments such as desonide cream for three to five days in the short term. I have met many patients who waved away and dared not use it as soon as they heard the word "hormone". They endured the recurrence of inflammation, which made it more difficult to repair. Of course, hormonal ointments must not be used for a long time. If you use them continuously for more than a week, there are risks. If you have repeated sensitivity and require long-term maintenance, it is much safer to switch to non-hormonal tacrolimus ointment or pimecrolimus cream. However, there may be an adaptation period of burning and itching in the first few days of use. Don't stop using it as soon as you feel uncomfortable. Most people can get used to it after three to five days.

If it is a problem with abnormal pigment metabolism such as post-inflammatory hyperpigmentation or chloasma, the commonly used topical conditioning drugs are hydroquinone cream and azelaic acid cream. Hydroquinone is currently the most effective ingredient for lightening the spots. The regular medicinal concentration is 2%. Don’t blindly buy high-concentration hydroquinone from unknown brands, which can easily burn the face and turn it black. Taken orally, tranexamic acid tablets are well recognized for their improvement in chloasma. However, this medicine is originally used to stop bleeding. People with a history of thrombosis, menstruation, and those who are planning to become pregnant cannot take it. They must be evaluated by a doctor before they can be prescribed.

Nowadays, many people on the Internet recommend taking vitamin C and vitamin E to regulate the skin. This actually depends on the situation. If the daily intake of fruits, vegetables and nuts is sufficient, eating extra is basically useless. If the dietary intake is indeed insufficient or you are in the recovery period of post-inflammatory hyperpigmentation, taking some according to the doctor's advice can play a supporting role, but don't have the mentality that you can whiten and change your skin after taking them for a few months. It is simply unrealistic. As for the popular health products such as collagen peptides and grape seed extract, there is currently no clear clinical evidence-based evidence to prove that they have a conditioning effect on skin problems. There is a high probability that they will pay an IQ tax.

I usually tell the patients who come for consultation that using medicines for skin conditioning is like treating potted plants at home. You have to first figure out whether the roots are rotten, infested with insects, or damaged by the sun. Only by applying the correct amount of medicine can the disease be cured. Indiscriminate application of fertilizers and sprays will only kill the flowers. If you really can’t figure out what skin problem you have, it’s much more reliable to go directly to the dermatology department of a regular hospital for a consultation than to buy random medicines based on the Three Days and Three Nights guide.