Acne Treatments

Acne - Treatment Overview

Acne treatment depends on whether you have a mild, moderate, or severe form. Sometimes your doctor will combine treatments to get the best results and to avoid developing drug-resistant bacteria. Treatment could include lotions or gels you put on blemishes or sometimes entire areas of skin, such as the chest or back (topical medicines). You might also take medicines by mouth (oral medicines).

Mild acne

Treatment for mild acne ( whiteheads, blackheads, or pimples) may include:

* Gentle cleansing with a mild soap (such as Dove or Neutrogena).
* Applying benzoyl peroxide (such as Brevoxyl or Benzac).
* Applying salicylic acid (such as Propa pH or Stridex).

If these treatments do not work, you may want to see your doctor. Your doctor can give you a prescription for stronger lotions or creams. You may try an antibiotic lotion. Or you may try a lotion with medicine that helps to unplug your pores.

Moderate to severe acne

Sometimes acne needs treatment with stronger medicines or a combination of therapies. Deeper blemishes, such as nodules and cysts, are more likely to leave scars. As a result, your doctor may give you oral antibiotics sooner to start the healing process. Inflammatory acne may need a combination of several therapies. Treatment for moderate to severe acne may include:

* Applying benzoyl peroxide.
* Draining of large pimples and cysts by a doctor.
* Applying prescription antibiotic gels, creams, or lotions.
* Applying prescription retinoids.
* Applying azelaic acid.
* Taking prescription oral antibiotics.
* Taking prescription oral retinoids (such as Accutane).

Treatment for acne scars

Treatment may improve and even remove acne scars. Sometimes a combination of treatments works best. These treatments include:

* Collagen injections, which smooth the skin by plumping the skin under the scar.
* Dermabrasion, which uses a whirling wire brush to skim off scar tissue.
* Laser resurfacing, which uses a carefully controlled laser to burn away scar tissue.
* Chemabrasion, which uses chemicals to peel away top layers of skin.

What To Think About

* Most treatments for acne take time. It often takes 6 to 8 weeks for acne to improve after you start treatment. 1 Some treatments may cause acne to get worse before it gets better.
* If your acne still hasn't improved after several tries with other treatment, your doctor may recommend that you take an oral retinoid, such as isotretinoin (Accutane). Doctors prescribe this medicine as a last resort, because it has some rare but serious side effects and is expensive.
* Certain low-dose birth control pills may help control acne in women who tend to have flare-ups before menstruation.

Acne Treatments

Treatments for acne come in two forms; topical treatments (applied to the skin) and oral medicines (taken by mouth). While mild acne usually responds to self-care measures and topical treatments, moderate to severe cases may require prescription medicines.

It’s a good idea to try to get an understanding of your acne and how severe it is. This will help you to select the most appropriate treatment.


Minimal: Acne cleansers and OTC treatments

Mild: Acne cleansers, OTC treatments, Topical benzoyl peroxide, Topical antibiotics

Moderate: Topical retinoids, Topical benzoyl peroxide, Topical antibiotics, Oral antibiotics, Hormone pills

Severe: Oral retinoids ((Isotretinion or Accutane)

Home and OTC Treatments

OTC means Over-The-Counter and you can get these products from your pharmacist, you don't need a prescription. The following are all appropriate for milder cases of acne.


Self Care: Keep acne prone areas clean but avoid aggressive cleansing with strong soaps. Do not pick pimples or spots as this can aggravate your acne and result in scarring.

Skin cleansers: are available over the counter and are usually useful in the treatment of mild acne (e.g. Oxy and Clearasil Max). More on skin cleansers.

Benzoyl peroxide: (Benoxyl, Benzac) helps shed excess skin, unblock the hair follicles and decrease skin oiliness. It’s antibacterial properties help to reduce the amount of bacteria on the skin. Benzoyl peroxide is a bleaching agent and can stain clothes and towels. Wash your hands after applying. More on benzoyl peroxide.

Natural Treatments: there are a number of natural treatments that can help manage acne. More on natural products.

If these do not work you may want to see your doctor who can give you a prescription for a stronger medicine.

Topical Prescription Treatments

Most suitable for moderate to severe acne. Topical treatments are applied to the skins surface. All of the following are prescription medicines available only from your doctor or skin specialist. Your doctor will be able to help decide if they are the right medicines for you.


Topical Retinoids: Chemically related to vitamin A, retinoids ‘unplug’ follicles and help unclump cells. These are also available only on prescription and must not be used during pregnancy.

Topical Antibiotics (Clindamycin and erythromycin): antibiotic liquids for pus-filled spots, not blackheads or whiteheads. They are applied to the skin to decrease bacteria and sebum.

Oral Prescription Medicines

Suitable for moderate to severe acne. These are prescription medicines. Your doctor will be able to help decide if they are the right medicines for you.


Oral Antibiotics: Oral antibiotics are prescribed for moderate to severe acne. Treatment with these usually continues for months, often in combination with products meant for topical application.

Isotretinoin: This drug is prescribed for the most severe forms of acne and is effective where most other treatments fail. Like topical retinoids, isotretinoin is a chemical relative of Vitamin A and reduces the formation of sebum. That means fewer skin bacteria and less inflammation of the skin follicles. Isotretinoin generally is not used at the same time as topical anti acne preparations.

Hormone contraceptive pills: in females these help regulate hormones that are responsible for acne and greasy skin.

Nutritional Treatments


Wholefood diet: A diet high in refined sugars and starches tends to increase quantities of insulin in your body. This may in turn increase the levels of male hormones that cause acne. Cutting back on refined carbohydrates may help although there is little evidence to support a consistent link between diet and acne.

Antioxidants: Antioxidants neutralise damaging free radicals that are believed to play a role in acne and inflammation. Fresh fruit and vegetables are naturally rich in antioxidants. You could also try a drink like carrot juice which contains beta-carotene - a powerful antioxidant and precursor to Vitamin A. Alternatively there are many good antioxidant supplements available.

Zinc: 60 to 90 mg a day of this mineral improves some people’s acne. Several double-blind trials indicate that zinc supplements can reduce the severity of acne.

Herbal Treatments


Tea Tree Oil: Applied to the skin Tea Tree Oil has been growing in popularity as an alternative to over the counter and prescription acne treatments. Tea Tree Oil has powerful anti-fungal and anti-bacterial qualities. Many people with acne find that their skin is very sensitive to Tea Tree Oil, so start with a mild dose and test it on a small area of skin. For topical treatment of acne, the oil is used at a dilution of 5–15%

Olive Leave Extract: Olive Leaf Extract is believed to have powerful antibacterial properties.

Licorice Root Extract: Licorice root extract possesses natural anti-inflammatory agents that may soothe skin affected by acne.

Green Tea and Green Tea Extract: Green tea is rich in bioflavanoids and antioxidants (particularly EGCG) which are useful in fighting free radicals.

Burdock: Burdock has been used historically to treat a range of skin problems. It is believed to have a cleansing action although there is little scientific evidence to support this. Burdock root tincture may be taken in the amount of 2 to 4 ml per day and can also be found in herbal teas.

Alternative Treatments


Acupuncture: Acupuncture may be helpful in the treatment of acne. Several studies have reported that acupuncture can help with acne treatments however the general consensus is that more study is required.

Hypnosis: Anecdotal evidence suggests that hypnotherapy may help in preventing scarring from acne.

Acne Treatment Time Scale

Many acne treatments may take a while to work (anywhere from 2-6 months). Don’t stop using the treatment within this time period. If your acne does not improve talk to your doctor or pharmacist. Your should also talk to them about any side effects from, or irritations to, your acne treatment. Some acne treatments tend to dry out the skin during the initial stages but the skin usually adjusts.