Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be controlled.
People who have mild acne have a few blemishes. Many people can treat mild acne with products that you can buy without a prescription. A product containing benzoyl peroxide or salicylic acid can clear mild acne.
Despite the claims you may see, no acne treatment clears the skin overnight. At-home treatment requires 4-8 weeks to see improvement. Once acne clears, you must continue to treat the skin to prevent breakouts.
When To See a Dermatologist
If you have a lot of acne, painful acne lesions including cysts or nodules, scaring acne, or have acne that is not clearing with non-prescription options, you should see a dermatologist. Dermatologists offer the following types of treatment:
Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil or helping the dead skin cell shed out of the pores. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.
Acne treatment that works throughout the body: Medicine that works throughout the body may be necessary when you have red, swollen, or painful types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these:
- Antibiotics- helps to kill bacteria and/or reduce inflammation.
- Birth control pills- helps to regulate hormone levels
- Spironolactone- helps to decrease hormone signaling on oil glands for women.
- Isotretinoin aka “Accutane”- the only treatment that works on all causes and all types of acne
Procedures that treat acne: Your dermatologist may treat your acne with a procedure that can be performed during an office visit. These treatments include:
- Lasers and other light therapies: These devices reduce the p. acnes bacteria. They can also reduce the redness of fading acne lesions. Your dermatologist can determine whether this type of treatment can be helpful for you.
- Chemical peels: Usually of different ingredients or strengths than can be purchased at the beauty store or medi-spa. Dermatologists use chemical peels to treat non-inflammatory up to moderately inflammatory acne. Chemical peels can also help with some types of pigmentation old acne lesions leave behind.
- Acne removal: Your dermatologist may perform a procedure called ‘drainage’ or ‘extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.
Waiting for acne to clear on its own can be frustrating. Without treatment, acne can cause permanent scars, low self-esteem, depression, and anxiety.
To avoid these possible outcomes, dermatologists recommend that people treat acne. When the skin clears, treatment should continue. Treatment prevents new breakouts. Your dermatologist can tell you when you no longer need to treat acne to prevent breakouts.
Brand names: Absorica®, Accutane®, Amnesteem®, Claravis®, Myorisan®, Sotret®, and Zenatane™
Isotretinoin is a prescription pill for severe acne. This type of acne causes deep, painful cysts and nodules. As this acne clears, scars often appear. Isotretinoin may also be recommended if your acne is resistant to all other treatment options, even if nodules and cysts are not present. Treatment with isotretinoin often results in prolonged clearance of acne. Skin can remain clear for years after taking your last pill or even permanently for some patients. For this reason, it is considered the only potential acne ‘cure.’
Isotretinoin Has Several Known Side Effects That Will Be Reviewed by Your Doctor
Isotretinoin is not safe for everyone. Your doctor will review the side effects and take a detailed history to make sure this medication is suitable for you.
One course of treatment takes around 5 to 7 months. Sometimes, one course of treatment takes less time or a bit more time. Dermatologists tailor the treatment to each patient.
Due to possible side effects, your dermatologist can only prescribe this medicine if you:
- Enroll in iPLEDGE™, a program from the U.S. Food and Drug Administration (FDA).
- See your dermatologist for follow-up visits.
- Sign forms that state you know the risks of taking isotretinoin.
Patients Who Can Become Pregnant Must Take a Few Extra Precautions:
- Take required pregnancy tests before and while taking isotretinoin.
- Avoid getting pregnant.
- Declare your method of birth control to the doctor and iPLEDGE.
Patient safety is a dermatologist’s first concern. If this medicine is an option for you, your dermatologist will talk with you about how to take this medicine safely and what you can expect. You and your dermatologist should jointly decide whether this medicine is right for you.
If isotretinoin is an appropriate treatment for you, you will be under close medical supervision while you take this medicine.