Editing Acne (section)

====Other medications====
Topical and oral preparations of [[nicotinamide]] (the [[amide]] form of [[Niacin (nutrient)|vitamin B<sub>3</sub>]]) are alternative medical treatments.<ref name=Rolfe2014>{{cite journal | vauthors = Rolfe HM | title = A review of nicotinamide: treatment of skin diseases and potential side effects | journal = Journal of Cosmetic Dermatology | volume = 13 | issue = 4 | pages = 324–8 | date = December 2014 | pmid = 25399625 | doi = 10.1111/jocd.12119 | s2cid = 28160151 | type = Review }}</ref> Nicotinamide reportedly improves acne due to its anti-inflammatory properties<ref name=Rolfe2014/> (influencing neutrophil [[chemotaxis]], inhibiting the release of histamine, suppressing the lymphocyte transformation test, and reducing nitric oxide synthase production induced by cytokines),<ref name="pmid38725769"/> its ability to suppress sebum production, and its wound healing properties.<ref name=Rolfe2014/> Topical and oral preparations of zinc are suggested treatments for acne; evidence to support their use for this purpose is limited.<ref name=Brandt2013>{{cite journal | vauthors = Brandt S | title = The clinical effects of zinc as a topical or oral agent on the clinical response and pathophysiologic mechanisms of acne: a systematic review of the literature | journal = Journal of Drugs in Dermatology | volume = 12 | issue = 5 | pages = 542–5 | date = May 2013 | pmid = 23652948 | type = Review }}</ref> Zinc's capacities to reduce inflammation and sebum production as well as inhibit ''C. acnes'' growth are its proposed mechanisms for improving acne.<ref name=Brandt2013/> [[Antihistamines]] may improve symptoms among those already taking isotretinoin due to their anti-inflammatory properties and their ability to suppress sebum production.<ref name=DC2016>{{cite journal | vauthors = Layton AM | title = Top Ten List of Clinical Pearls in the Treatment of Acne Vulgaris | journal = Dermatologic Clinics | volume = 34 | issue = 2 | pages = 147–57 | date = April 2016 | pmid = 27015774 | doi = 10.1016/j.det.2015.11.008 | type = Review }}</ref>

[[Hydroquinone]] lightens the skin when applied topically by inhibiting [[tyrosinase]], the enzyme responsible for converting the amino acid [[tyrosine]] to the skin pigment [[melanin]], and is used to treat acne-associated post-inflammatory hyperpigmentation.<ref name="Chandra2012"/> By interfering with the production of melanin in the [[epidermis]], hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time.<ref name="Chandra2012"/> Improvement in skin [[hyperpigmentation]] is typically seen within six months when used twice daily. Hydroquinone is ineffective for hyperpigmentation affecting deeper layers of skin such as the [[dermis]].<ref name="Chandra2012"/> The use of a [[sunscreen]] with [[Sun protection factor|SPF]]&nbsp;15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone.<ref name="Chandra2012"/> Its application only to affected areas lowers the risk of lightening the color of normal skin but can lead to a temporary ring of lightened skin around the hyperpigmented area.<ref name="Chandra2012"/> Hydroquinone is generally well-tolerated; side effects are typically mild (e.g., skin irritation) and occur with the use of a higher than the recommended 4% concentration.<ref name="Chandra2012"/> Most preparations contain the preservative [[sodium metabisulfite]], which has been linked to rare cases of [[allergic reaction]]s, including [[anaphylaxis]] and severe [[asthma]] exacerbations in susceptible people.<ref name="Chandra2012"/> In extremely rare cases, the frequent and improper application of high-dose hydroquinone has been associated with a systemic condition known as [[exogenous ochronosis]] (skin discoloration and [[connective tissue]] damage from the accumulation of [[homogentisic acid]]).<ref name="Chandra2012"/>