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Getting rid of acne for good

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Q: I’m almost 40, and I still have acne. I thought this was a teenage problem, but it’s just stuck around. Is there anything I can do?

Dr. Wright: Acne is an embarrassing problem that, for many people, persists long after adolescence. The good news is that a form of vitamin B3 called niacinamide and a naturally occurring substance called azaleic acid are both effective against the most common form of acne, called acne vulgaris.

In 1987, the British Journal of Dermatology reported two double-blind, placebo-controlled studies on using azaleic acid creme to treat acne. One of the studies, which involved 40 patients, showed that azaleic acid was significantly more effective than the placebo in reducing the degree of acne and the number of inflamed lesions after one, two, and three months of observation. Side effects were reported to be minimal.

And in an eight-month study involving 859 individuals, researchers found that topical azeleic acid was as effective as commonly used topical benzoyl peroxide and retinoic acid (a form of vitamin A). As an added benefit, it caused significantly fewer side effects than those agents. Topical azaleic acid was also found to be as effective as orally administered tetracycline.

In 1995, the International Journal of Dermatology reported on a study comparing the topical use of a 4 percent niacinamide gel with a 1 percent clindamycin gel (a commonly used antibiotic) in 76 individuals with acne. After eight weeks, 82 percent of those using niacinamide showed improvement, as compared with 69 percent of those using clindamycin.

At present, topical niacinamide gel and azaleic acid are readily available through any compounding pharmacy.