Common Acne Treatments, Explained

If you thought breakouts were a thing of the past, think again. Thanks to hormones, acne can plague men and women of all ages — plus, it can be notoriously stubborn to get rid of.

The first step is to understand the definition of acne, which is the clogging of a pore with dead skin, oil, and bacteria, says Jessie Cheung, MD, a dermatologist based in Chicago. But because there’s no way to know for sure what’s behind a breakout, you’ll want to see a dermatologist about what treatments you should try. Here are popular medication options that can help clear up your skin once and for all.

1. Benzoyl Peroxide

This go-to ingredient is an effective pimple-erasing medication because it helps unclog pores and targets Cutibacterium acnes (C. acnes), the bacteria that causes breakouts. But it doesn’t work overnight. You might notice some improvements after about three weeks, though it can take four to eight weeks for blemishes to fade away, according to the American Academy of Dermatology (AAD). The downside? It can be drying and cause redness and peeling, especially if you have sensitive skin. In general, benzoyl peroxide is a good option for people with mild or moderate acne — for example, those who have some pimples and breakouts but don’t have nodular acne. Extra downside? It can stain towels and clothing. Be sure to let the product absorb fully.

Where to Get It Find it in over-the-counter preparations, such as gels, face washes, or spot cream.

2. Glycolic Acid

This alpha hydroxy acid exfoliates the top layer of skin, helping to keep your pores clear. Plus, the treatment also bolsters collagen production, smoothing out lines and wrinkles and lightening dark spots, Dr. Cheung says. Production of collagen slows as we age. In fact, according to Scientific American, after age 20, that production will begin declining by an estimated 1 percent annually.

Where to Get It Beauty stores and drugstores carry over-the-counter versions of cleansers, serums, peels, and moisturizers. If you need something stronger, see your dermatologist for an in-office peel.

3. Salicylic Acid

Where to Get It The drugstore shelves are packed with salicylic washes, creams, gels, and foams. Cheung also likes using salicylic acid for in-office peels.

4. Azelaic Acid

Where to Get It You’ll find it as a gel, foam, or cream in both over-the-counter and prescription products, according to MedlinePlus.

5. Niacinamide

Where to Get It You can find 2 to 4 percent gels over the counter. Your dermatologist can prescribe stronger formulations.

6. Sulfur

Typically found in volcanic areas, this chemical helps inhibit the growth of acne-causing bacteria. Many products also combine sulfur with another ingredient like sulfacetamide to reduce inflammation.

Where to Get It Sulfur can be found as a prescription from your dermatologist or in some over-the-counter products. Cheung recommends sticking to the face washes. It can be a bit smelly, but using a wash means the active ingredient can be delivered to your skin and rinsed off afterward.

7. Topical Retinoids

“These are the backbone to any good acne regimen,” Cheung says. Derived from vitamin A, retinoids slough off the top layer of skin to keep pores clear, and ultimately help prevent pimples from popping up. They’re especially good for women who’re grappling with acne along with fine lines and wrinkles. Because retinoids stimulate collagen production, they can smooth out the skin and help reverse signs of aging. The only downside is that they can be drying, so dermatologists recommend slowly easing into the regimen. For example, start by applying the product every two days, then every other day, and so on.

Where to Get It You can find adapalene, a retinoid gel designed to reduce acne, over the counter. Other skin formulas are available by prescription only or over the counter in doctor’s offices. There are also creams that contain a weaker version of retinoids, called retinol, available over the counter.

8. Combination Hormonal Birth Control Pills

Per MedlinePlus, hormonal birth control pills contain a combination of a type of estrogen and progestin. These oral contraceptives target inflammatory acne (larger bumps) as well as blackheads and whiteheads, according to Informed Health Online, a health information source in Germany. Birth control works by inhibiting the production of a type of hormone called androgen, which is linked to acne, so this can be a good choice for people with hormonally driven acne — for example, women who tend to break out around the time of their menstrual periods.

Where to Get It Either a dermatologist or gynecologist can issue you a prescription.

9. Spironolactone

This diuretic medication, traditionally prescribed for conditions like high blood pressure, also blocks testosterone, and so reduces oil production and lessens the likelihood of a breakout occurring, says Cheung.

Where to Get It Ask your dermatologist for a prescription.

10. Isotretinoin

This oral form of vitamin A is “the only acne treatment that treats the three causes of acne: superficial bacteria, inflammation, and clogged pores,” Cheung says. “It’s great for people suffering from severe acne who’ve tried everything, including topicals and in-office treatments.” You’ll take this for four to five months, but the effects can linger — oftentimes, people feel that their skin is drier or more sensitive, she says. But, she points out, for many people, it’s worth it to have clearer skin for the long term.

For pregnant women, isotretinoin may increase the risk for birth defects, so women going on it will need to follow the Food and Drug Administration’s iPLEDGE program. This entails taking two pregnancy tests before starting the medication, plus monthly pregnancy tests during the regimen, and committing to using two types of birth control one month before, during, and after stopping the drug.

11. Lasers

By heating up the skin, lasers can kill off acne-causing bacteria — plus, the heat to skin cells prompts them to respond by rebuilding collagen, Cheung says. Still, keep your expectations in check. The AAD notes that lasers are often not 100 percent effective, and you may need an additional medication to help clear your skin. The AAD further says you’ll likely need multiple treatments over several weeks to see results.

Where to Get It There are many options available, but you should talk to your dermatologist about which laser treatment is right for you.

Additional reporting by Melinda Carstensen

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