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Acne Treatments: Old vs. New

Experts compare the latest acne treatments to time-tested remedies.

'Gold Standard' vs. New Treatments continued...

"If a patient has mild to moderate acne, this is still frequently my first recommended treatment. It's the easiest and the most economical, and it works very well for many people," says Jamal.

But while it works well, it can dry and irritate skin. And it was this very complaint that became the impetus for developing one of the first "boutique" acne treatments -- an over-the-counter product known as ProActiv Solution.

Blanketing the nation with celebrity-packed infomercials, product inserts, and direct mail ads, it fast became one of the most popular private-label acne treatments around. But what's in it -- and does it really work?

"It contains a much lower percentage of benzoyl peroxide, in a vehicle that isn't as drying as most prescription medications. And that frequently makes compliance better; so in that respect, yes, it can work better for some people," says Jamal.

Patients' Views

That said, Jamal tells WebMD that pretty much every patient she sees has either used ProActiv, or is currently using it, and is dissatisfied with results.

"I think the problem is that it works initially, but then stops working. At least that's what most of my patients report," says Jamal.

Goldberg agrees. He reports that most of his patients have also tried and failed on ProActiv.

"I think there's a point where it stops working. But to be fair, I think there are probably millions of people for whom the level of effectiveness it achieves is more than enough, just as there are some for whom it's not enough and professional treatment is needed," he says.

The High Price of Treatment

The cost of ProActiv is about $40 for the three-piece starter supply -- about 30 to 60 days worth of treatments, depending on the condition of your skin.

If you aren't overly sensitive to benzyl peroxide, other over-the-counter preparations like Oxy Balance (a 5% solution) and Oxy Maximum (a stronger 10% solution) sell for about $5 for a 30- to 60-day supply. Alternately, Neutrogena's On The Spot Acne Treatment contains the milder 2.5% benzoyl peroxide solution in a preparation closer to ProActiv, and it sells for about $6 for a 30- to 60-day supply.

More recently, another over-the-counter treatment emerged known as Nicomide-T. A topical preparation in cream or gel form, it is derived from vitamin B. In clinical trials of 1,000 patients conducted by the manufacturer it was shown to reduce redness and inflammation not only associated with acne, but also many acne treatments -- like Retin A. In other studies conducted by the manufacturer it was found to be more effective than the topical antibiotic treatment clindamycin. Independent studies found it to be equally as effective as clindamycin "without concerns over bacterial resistance," according to research published in the Journal of Dermatological Treatment.

Still, some doctors say it works best only on mild acne.

"I've used the oral form of this treatment and not had great results. It seems limited to treating mild acne," says Jamal.

Nicomide-T sells for about $40 for a 30-gram tube -- a 30- to 60-day supply.

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