Acne Treatment: More About Control Than Cure
Acne is not just for teenagers. Adults can get acne, too. Although acne usually clears up on its own after several years, itâ€™s important to treat it to prevent scarring and to feel better about your appearance. There are many options for acne treatment, from over-the-counter preparations to prescription medications and medical procedures. Remember that acne treatment is an ongoing process that takes time. If one treatment isnâ€™t working, you may need to switch to another. There is no cure for acne, but it can be controlled in most cases. Work with your doctor to find the right product, treatment, or combination of both to suit the severity of your skin condition.
Acne Treatment No. 1: Topical Benzoyl Peroxide
Topical acne treatments are creams, gels, or lotions that you apply directly to your skin. Benzoyl peroxide is an inexpensive, over-the-counter product that you can use to treat milder forms of acne. It works by controlling some types of bacteria that can contribute to acne. Benzoyl peroxide comes in a liquid or bar that you use to cleanse your face. It is also available as a cream, lotion, or gel that you rub in gently to affected areas once or twice a day. Common side effects can include dryness, peeling, tingling, or stinging. It may take up to six weeks for benzoyl peroxide medications to work.
Acne Treatment No. 2: Topical Salicylic Acid
This is another over-the-counter preparation thatâ€™s you can use topically to treat mild acne. Salicylic acid is a type of beta hydroxy acid that lightly peels the skin, helping to unblock clogged pores. It canâ€™t stop oil production, however, and has to be used consistently to keep pores clear. Salicylic acid is found as an ingredient in many acne treatment creams and gels. The main side effect is dryness, and salicylic acid may also make your skin more sensitive to sun exposure.
Acne Treatment No. 3: Retinoids
Topical retinoids are generally used to treat more mild forms of acne. They work by preventing the obstruction of your pores that can lead to pimples and blackheads. Retinoids, which are derived from vitamin A, may also have a direct anti-inflammatory effect on your skin. A commonly used retinoid is Retin-A, Retin-A Micro, and Renova (tretinoin), which is available by prescription only. A small dab of Retin-A is applied once a day or as prescribed by your doctor. Side effects include dryness, scaling, burning, and increased sensitivity to sunlight.
Acne Treatment No. 4: Topical Azelaic Acid
Azelex (Azelaic acid) works by killing the bacteria that infect pores. It also breaks down keratin, which is a protein produced by your skin that can block your pores. This prescription medicated cream is applied twice daily; because it may take more than four weeks for this acne treatment to work, you should continue using it as directed even if you have not noticed immediate improvement. Side effects can include dryness, scaling, burning, irritation, and itching. In rare cases this medication can cause your skin to lose its pigment.
Acne Treatment No. 5: Topical Antibiotics
Antibiotics applied to the skin are commonly used to treat mild cases of acne. Antibiotics may be combined with retinoids or benzoyl peroxide to control bacteria that contribute to acne. The most commonly used antibiotics used for acne are clindamycin and erythromycin. They come in gels or lotions and are usually applied twice daily. The most common side effects are local irritation.
Acne Treatment No. 6: Topical Sulfa Antibiotics
Sulfa antibiotics are among the oldest types of antibiotics and they can effectively treat acne. Klaron (sulfacetamide) and Sulfacet-R (sulfacetamide with 5-percent sulfur) are available by prescription. These topical forms of sulfa can be applied twice daily as skin lotions. Sulfa drugs may cause an allergic reaction in some people so these drugs are not usually used as a first- line therapy for acne.
Acne Treatment No. 7: Oral Antibiotics
If your acne is not responding to topical treatments, your doctor may prescribe an oral antibiotic. Oral antibiotics are usually used for more serious acne. The bacteria that antibiotics control in acne is called Propionibacterium acnes. Common antibiotics used to treat acne include doxycycline, tetracycline, and minocycline. It may take up to eight weeks for oral antibiotics to be effective. Possible side effects include nausea, sensitivity to sunlight, dizziness, and headache.
Acne Treatment No. 8: Isotretinoin
Isotretinoin (Sotret, Claravis, Amnesteem, Accutane) is a derivative of vitamin A that can suppress acne over a long period of time and is extremely effective for severe acne. But because isotretinoin can cause severe birth defects and has dangerous side effects such as liver damage, only doctors who are registered in an FDA-mandated program can prescribe it, and women in particular will need to be monitored monthly. This drug works primarily by shrinking the glands that cause your skin to be oily. [Note: The brand-name isotretinoin product Accutane is no longer being manufactured.]
Acne Treatment No. 9: Birth Control Pills
If youâ€™re a young woman with acne, birth control pills may be an effective acne treatment for you. Birth control pills help regulate the hormones in your blood that cause your skin to be oily. The American Academy of Dermatology cautions against using birth control pills for acne if you have migraines or any blood- clotting disorders or if you are a smoker.
Acne Treatment No. 10: Lasers
Lasers are an emerging acne treatment that have shown promise. Different types of lasers treat acne in various ways. Blue and red light therapy uses a low- intensity, painless blue light that kills acne-causing bacteria on skin. A series of treatments is usually required. Pulsed light and heat energy therapy simultaneously attacks bacteria and shrinks sebaceous glands to reduce oil production. Thirdly, diode lasers can destroy sebaceous glands in the dermis, the thick middle layer of skin, without harming the outer layer of skin. Diode lasers may be painful and skin may be red or swollen immediately following the treatment.
Acne Treatment No. 11: Chemical Peels, Microdermabrasion, and Lasers
Severe cases of acne that cause pus-filled cysts or nodules may result in scarring. Treatments include light chemical peels or microdermabraision for milder cases. For more severe scarring, laser resurfacing can be effective. These procedures remove the outer, damaged layer of skin and expose new, smoother skin. Side effects include redness and swelling. Healing begins in a few days, but may take up to 10 days, and multiple procedures may be required in some cases. The best way to prevent acne scars is work closely with your doctor as early as possible to find the most effective treatment for your type of acne.
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