Effective ways to treat facial acne
treatment
If you try over-the-counter acne products for several weeks and they don't help, ask your doctor about more effective prescription medications. A dermatologist can help you with the following:
Control acne
Preventing skin scarring or other damage
Hide scars as much as possible
Acne medications work by reducing oil production and swelling or by treating bacterial infections. Most prescription acne medications don't show results until you've used them for four to eight weeks. Acne treatment may extend for months or years until it disappears completely.
Your doctor determines your treatment regimen based on your age, the type and severity of your acne, and your willingness to stick to the regimen. For example, you may have to wash the affected skin and apply medications twice a day for several weeks. Topical medications will often be used in conjunction with medications taken by mouth (oral medications). It is worth noting that treatment options for pregnant women are limited due to the risk of side effects.
Talk to your doctor about the risks and benefits of the medications and other treatments you're considering. Make follow-up appointments with him every three to six months until your skin improves.
Topical medications
The most popular prescription topical medications for acne include:
Retinoids and retinoid-like medications. Medications containing retinoic acids or tretinoin are often helpful in treating moderately severe cases of acne. These medications come in the form of creams, gels, and liquid preparations. Examples include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage, others). You can use this medicine in the evening, and the dose starts from three times a week, then you can use it daily when your skin gets used to it. It prevents hair follicles from becoming clogged. Do not use tretinoin at the same time as benzoyl peroxide.
Topical retinoids increase your skin's sensitivity to the sun. It can also cause dry skin and redness, especially in people with brown or black skin. Your skin may tolerate adapalene cream better.
Antibiotics. These medications work by killing excess skin bacteria and reducing redness and inflammation. You can use both a retinoid and an antibiotic for the first few months of starting treatment, with the antibiotic in the morning and the retinoid in the evening. Antibiotics are often used with benzoyl peroxide to reduce the possibility of bacteria becoming resistant to antibiotics. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, others) and erythromycin with benzoyl peroxide (Benzamycin). It is not recommended to use topical antibiotics alone.
Azelaic acid and salicylic acid. Azelaic acid is a natural acid produced by yeast. It has antibacterial properties. Azelaic acid 20% cream or gel appears to be as effective as many conventional acne treatments when used twice a day. Prescription azelaic acid (Azelex, Finacea) is an appropriate option during pregnancy and breastfeeding. It can also be used to treat skin discoloration that occurs with some types of acne. Side effects may include skin redness and minor skin irritation.
Salicylic acid may help prevent clogged hair follicles and is available in wash-off products and leave-on products. But studies proving its effectiveness are limited. Side effects may include skin discoloration and minor irritation.
Dapsone. Dapsone (Aczone) 5% gel is recommended twice daily for the treatment of inflammatory acne, especially for women with acne. Side effects include redness and dryness.
There is no strong evidence to show the effectiveness of using zinc, sulfur, nicotinamide, resorcinol, sodium sulfacetamide, or aluminum chloride in topical acne treatments.
Oral medications
Antibiotics. For moderate to severe cases of acne, you may need to take oral antibiotics to reduce bacteria. The first choice for treating acne is usually a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin). Macrolide may be an option for people who cannot take tetracycline, including pregnant women and children under 8 years of age.
Oral antibiotics should be used for the shortest possible time to prevent antibiotic resistance. It should also be combined with other medications, such as benzoyl peroxide, to reduce the risk of antibiotic resistance.
Severe side effects from using antibiotics to treat acne are rare. But these medications increase your skin's sensitivity to the sun.
Combined oral contraceptives.
The U.S. Food and Drug Administration has approved four combined oral contraceptives to treat acne in women who also want to use them to prevent pregnancy. These are products that combine progestin and estrogen (Ortho Tri-Cyclen 21, Yaz, others). The benefits of this treatment may not start to appear for a few months, so using other acne medications along with it for the first few weeks may help.
Common side effects of combined oral contraceptives include weight gain, breast tenderness, and nausea. These medications are also associated with an increased risk of cardiovascular disease, breast cancer, and cervical cancer.
Antiandrogens. Spironolactone (Aldactone) may be considered for women and adolescent girls if oral antibiotics do not help their condition. It works by blocking the effect of androgen hormones on oil-producing glands. Its possible side effects include breast tenderness and duraPainful menstruation.
Isotretinoin. Isotretinoin (Amnesteem, Claravis, others), a substance derived from vitamin A, may be prescribed for moderate to severe cases of acne that does not respond to other treatments.
Possible side effects of oral isotretinoin include inflammatory bowel disease, depression, and severe birth defects. But all people receiving isotretinoin must participate in an FDA-approved risk management program. They will need to visit their doctors regularly to monitor side effects.
Treatments
For some people, the following treatments may be helpful, either alone or in combination with medications.
Phototherapy. A variety of light-based treatments have been tried, with some success. Most of them require multiple visits to your doctor. But more study is needed to determine the ideal method, light source, and dose.
Chemical peeling. This procedure uses repeated applications of a chemical solution, such as salicylic acid, glycolic acid, or retinoic acid. It is a suitable treatment for mild acne. It may improve the appearance of the skin, but its effect does not last long, and treatment usually needs to be repeated.
Drainage and extraction. Your doctor may use special tools to gently remove whiteheads and blackheads (comedoes), or remove cysts that topical medications haven't cleared. This technique temporarily improves the appearance of your skin, but it may also cause scarring.
Steroid injections. Nodular and cystic lesions can be treated by injecting them with steroid medication. This treatment showed rapid improvement, along with pain relief. Side effects may include skin thinning and discoloration in the treated area.
Treatment of children
Most studies of acne medications have been done in people 12 years or older. Increasingly, it seems that young children also develop acne. The US Food and Drug Administration (FDA) has increased the number of topical products approved for use in children. Guidelines from the American Academy of Dermatology indicate that topical benzoyl peroxide, adapalene, and tretinoin in preteen children was effective and did not increase the risk of side effects.
If your child has acne, consider consulting a pediatric dermatologist. Ask about medications that should be avoided with children, appropriate doses, drug interactions, side effects, and the extent to which treatment affects the growth and development of the child’s body.
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Alternative medicine
Some alternative and complementary medicine approaches may be helpful in reducing acne:
Tea tree oil. Gels containing at least 5% tea tree oil may be effective, as can lotions containing 5% benzoyl peroxide, but tea tree oil products are slower to work. Possible side effects include minor itching, burning, redness, and dryness, making it an unsuitable option for people with rosacea.
Brewer's yeast. The Hansen CBS strain of brewer's yeast fungus has been shown to reduce acne when taken orally. But it may cause gas (flatulence).
More research is needed to determine the potential effectiveness and long-term safety of these and other integrative approaches, such as biofeedback and Ayurvedic compounds. Consult your doctor about the advantages and disadvantages of these treatments before trying them.
Lifestyle and home remedies
You can prevent or control mild to moderate acne by using over-the-counter products, as well as following basic good skin care and other self-care techniques, as follows:
Wash the affected areas with a mild cleanser. Use your hands to wash your face with a mild soap or cleanser (Cetaphil, Vanicream, others) and warm water twice daily. Be careful when shaving the affected area of your skin.
Avoid using certain products such as facial scrubs, astringents, and face masks. They usually irritate the skin and can make the condition worse. Excessive washing and exfoliation of the skin also irritates the skin.
Try over-the-counter acne products to dry up excess oil and increase exfoliation. Look for products that contain benzoyl peroxide and adapalene as active ingredients. You can also use products that contain salicylic acid, glycolic acid, or alpha hydroxy acids. You may not see any improvement until a few weeks after using the product.
Creams cause less acne irritation than gels or ointments. Over-the-counter acne medications may cause initial side effects such as redness, dryness, and flaking, but they often improve after one month of use.
Avoid irritants. Greasy or oily cosmetics, sunblocks, hair styling products, or acne concealers may aggravate the condition. Instead, use products labeled as water-based or non-comedogenic (don't clog pores), as they don't often cause acne.
Protect your skin from the sun's rays. The sun increases skin discoloration, which sometimes persists after acne has cleared in some people. Some acne medications also make you more susceptible to sunburn. Consult your doctor to find out whether the medication you are taking falls into this class of medications. If it is one of them, avoid exposure to sunlight as much as possible. Use a non-oily (non-comedogenic) moisturizer that contains sunscreen regularly.
Avoid scratching or putting pressure on your skin. Protect your acne-prone skin from contact with objects such as phones, helmets, collars, tight belts, and backpacks.
Avoid touching or exfoliating acne-prone areas. This may trigger more acne, infection, or scarring.
Take a shower after strenuous activities. The presence of oils and sweat on your skin can lead to breakouts.
Coping and support
Acne and acne scars can cause anxiety and may affect social relationships and self-image. Sometimes talking to your family, a support group, or a counselor can help.
Stress can make acne worse.
Try to manage stress by getting enough sleep and practicing relaxation techniques.
Prepare for your appointment
If you have acne that doesn't respond to self-care and over-the-counter treatments, make an appointment with your doctor. Early and effective treatment for acne reduces the risk of scarring and permanent damage to your self-confidence. After an initial examination, your doctor may refer you to a specialist in diagnosing and treating skin conditions (dermatologist).
Here is some information to help you get ready for your appointment.
What you can do
Make a list of your key medical information, such as other conditions you have and any prescription or over-the-counter products you use, including vitamins and nutritional supplements.
Key personal information, including any major stresses or recent changes in your life.
Create a list of questions to ask your doctor. Preparing a list of questions in advance can help you make the most of your time with your doctor.
Here are some basic questions to ask your doctor about acne. If you have additional questions during your visit, don't hesitate to ask.
What treatment approach do you recommend for me?
If initial treatment isn't effective, what will you recommend next?
What are the possible side effects of the medications you prescribe?
How long can I safely take the prescribed medication?
How soon will my symptoms start improving after starting treatment?
When will the next visit be to evaluate the feasibility of treatment?
Is it safe to stop treatment if it doesn't seem to be working?
What health care steps might improve my symptoms?
Do you recommend making any changes to my diet?
Do you recommend changing the over-the-counter products I use for my skin, including soaps, lotions, sunscreens, and cosmetics?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being prepared to answer them may provide some time to discuss any points you may want to talk about at length. Your doctor may ask you the following questions:
When did you first notice this problem?
Have you noticed anything in particular that causes your acne to flare up, such as stress or the approaching period of your period (for girls and women)?
What medications do you take, including prescription and over-the-counter medications, vitamins and supplements?
For girls and women: Do you use birth control pills?
For girls and women: Is the menstrual cycle regular?
For girls and women: Are you pregnant or planning to become pregnant soon?
What types of soaps, lotions, sunscreen, hair care products and cosmetics do you use?
How does having acne affect your self-esteem and confidence in social situations?
Does your family have a history of acne?
What treatments and skin self-care routines have you followed up to this point? Have any of these treatments or procedures proven effective?
Has anyone in your family used isotretinoin or hormone therapy to treat acne? Have any of these treatments proven effective?