果酸(Alpha hydroxy acid)

果酸是水果中提取出的各种有机酸,甘醇酸和乳酸是护肤配方中最常出现的两种,商品中果酸的浓度一般不高于10%。

作用机制

果酸可以加速表皮细胞脱落和更新,并促进皮肤组织修复,从而帮助痤疮治愈,并防止毛孔进一步堵塞。[1-4]

用药注意:

可能会出现红斑、肿胀、刺痛、烧灼感等; 用药期间,皮肤易受阳光影响,要注意防晒。

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过氧化苯甲酰(Benzoyl peroxide)


过氧化苯甲酰是一种抗菌剂,既可以作为处方药,又可以用于非处方药,可以配制成乳剂、凝胶、洗剂等。[6-9]

(了解更多:美国国家医学图书馆 )

作用机制:

过氧化苯甲酰有杀灭痤疮丙酸杆菌、溶解粉刺和收敛的作用[10],也有助于减少炎症反应[11-13]。可以配制成2.5%、5%、10%不同浓度的乳霜、凝胶或洗剂等,2.5%的浓度和更高浓度的疗效类似,但副作用相对少些[10,14]

用药注意:

刚开始使用时,少数敏感肌肤会出现红斑、瘙痒、干燥等刺激反应。[10] 约1-3%的患者会出现过敏反应,伴随有炎症或结硬皮。[15]

间苯二酚(Resorcinol)

也称为雷琐酚或雷锁辛,可用于治疗痤疮、湿疹、银屑病等。很少单独用于治疗痤疮,常和其它抗痤疮药物联合使用,比如硫磺。[16]

(了解更多:维基百科)

作用机制

有灭菌和溶解角质的作用,有助于清除粉刺。

用药注意:

可引起皮肤刺激,有时会出现红斑或脱皮。最好避免与其它刺激性药物、化妆品以及清洁用品同时使用。

水杨酸(Salicylic acid)

很多治疗痤疮的非处方药中,都含有水杨酸。[18]低浓度的水杨酸通常用作粉刺清洁剂,高浓度的水杨酸(20%-30%)则用于化学剥脱术,去除皮肤可再生的角质层。[24]

(了解更多:美国国家医学图书馆)

作用机制

水杨酸有调节角化速度、溶解角质层和防止毛孔堵塞的作用,也有助于溶解粉刺。[20-21]

用药注意:

可能会引起轻微的刺激。

避免与其它外用痤疮药物联合使用。

疗效不显著,治疗效果中等。

硫磺(Sulfur)

硫磺是治疗痤疮的传统外用药,通常用在皮肤清洁用品中。

(了解更多:维基百科)

作用机制

硫磺有去除皮肤油脂和溶解角质的作用,有助于清除粉刺,不过也可能导致新粉刺的形成[22-23]

用药注意:

副作用包括脱皮、红斑等。

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  2. Aztori L, at. al. "Glycolic acid peels in the treatment of acne." Journal of the European Academy of Dermatology and Venereology. 1999; 12(2): 119-122.
  3. Kessler E, et. al. "Comparison of α- and β-hydroxy acid chemical peels in the treatment of mild to moderately severe facial acne vulgaris." Dermatologic Surgery. 2008; 34(1): 45-50.
  4. Ilknur T, et. al. "Glycolic acid peels versus amino fruit acid peels for acne." Journal of Cosmetic and Laser Therapy. 2010; 12(5): 242-245.
  5. Kurtzweil, Paula. "Alpha hydroxy acids for skin care."FDA Consumer. 1998.
  6. "Benzoyl Peroxide". MedlinePlus. 2010. American Society of Health-System Pharmacists, Inc. 2011.
  7. Berger, et. al. Andrew's Diseases of the Skin. Philadelphia: W.B. Saunders Company, 2000.
  8. Ives T. "Benzoyl Peroxide." American Pharmacy. 1992; 32(8): 33-8.
  9. Weinberg J. "The Utility of Benzoyl Peroxide in Hydrophase Base (Brevoxyl) in the Treatment of Acne Vulgaris." Journal of Drugs in Dermatology. 2006; 5(4): 344-9.
  10. Sagransky M, Yentzer B, Feldman S. "Benzoyl peroxide: A review of its current use in the treatment of acne vulgaris." Expert Opinion on Pharmacotherapy. 2009; 10(15): 2555-2562.
  11. Dutil M. "Benzoyl peroxide: Enhancing antibiotic efficacy in acne management." Skin Therapy Letter. 15(10): 5-7.
  12. Harper J. "Benzoyl peroxide development, pharmacology, formulation and clinical uses in topical fixed combinations." Journal of Drugs in Dermatology. 2010; 8(9): 482-487.
  13. Tanghetti E, Popp K. "A current review of topical benzoyl peroxide: New prospectives on formulation and utilization." Dermatologic Clinics. 2009; 27(1): 17-24.
  14. Fakhouri T, Yentzer B, Feldman S. "Advancement in benzoyl peroxide-based acne treatment: Methods to increase both efficacy and tolerability." Journal of Drugs in Dermatology. 2009; 8(7): 657-661.
  15. Drobil M, Lindemayr H. "Contact Sensitization to Benzoyl Peroxide." Contact Dermatitis. 1981; 7(3): 137-40.
  16. Bowe W, Shalita A. "Effective over-the-counter acne treatments." Seminars in Cutaneous and Surgery. 2008; 27(3): 170-176.
  17. "Resorcinol Topical." Drugs.com. 2010. Cerner Multum, Inc. 1996-2006.
  18. "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2010. National Institutes of Health. 2011.
  19. Shalita A. "Comparison of a Salicylic Acid Cleanser and a Benzoyl Peroxide Wash in Treatment of Acne Vulgaris." Clinical Therapeutics. 1989; 11(2): 264-7.
  20. "Salicylic Acid Topical." MedlinePlus. 2010. American Society of Health System Pharmacists, Inc. 2011.
  21. Lionel F. The Encyclopedia of Visual Medicine Series: An Atlas of Dermatology. New York: The Parthenon Publishing Group, 1997. Pg.148-150.
  22. "Sulfur Topical." Drugs.com. 2010. Cerner Multum, Inc. 1996-2000.
  23. "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases Jan. 2006. National Institutes of Health. 2001.
  24. 安琪、李斌、鲁玉俢等. 痤疮的临床治疗进展. Journal of Clinical and Experimental Medicine. 2013. 12(9):720-722

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