Treating Mild Acne
Mild acne consists of small lesions, such as blackheads, whiteheads or pustules, which appear at or near the surface of the skin. As such, mild cases of acne can sometimes be controlled at home by:
- Gently washing the affected area(s) with warm water and a mild soap twice a day to remove dead skin cells and excess oil
- Using a topical (applied to the skin) over-the-counter acne treatment containing benzoyl peroxide or salicylic acid
Even mild cases of acne may require the help of a dermatologist. If the acne does not respond to at-home treatment, a dermatologist can assess the situation and determine an appropriate therapy. In these cases, combination therapy (two or more treatments) may be used. Combination therapy may include use of a prescription topical antimicrobial or topical retinoid. These prescription topicals can be very effective in clearing mild acne.
Following the 12 Ways to Get Better Results from Acne Treatment
Treating Moderate to Moderately Severe Acne
In moderate to moderately severe acne, numerous whiteheads, blackheads, papules and pustules appear that cover from ¼ to ¾ of the face and/or other affected area(s). Moderate to moderately severe acne usually requires the help of a dermatologist and combination therapy (using two or more treatment options). Treatments used to treat moderate to moderately severe acne are:
Physical methods, such as comedo extraction or light therapy
Prescription Medications
Prescription Medications
- Topical (applied to the skin) antimicrobials
- Topical retinoids
- Oral antibiotics
- Oral contraceptives
Over-the-counter topical acne medications
Dermatologists recommend early treatment for moderate to moderately severe acne because when moderate to severe acne is not treated early, scars can develop. Acne scars take two forms—as raised thickened tissue or as a depression, such as pits or pock marks. The only reliable method of preventing or limiting the extent of these scars is to treat acne early in its course, and for as long as necessary. Additionally, anyone with acne who has a known tendency to scar should be under the care of a dermatologist.Treating Severe Acne
Severe acne is characterized by deep cysts, inflammation, extensive damage to the skin and scarring. It requires an aggressive treatment regimen and should be treated by a dermatologist. Severe, disfiguring forms of acne can require years of treatment and may experience one or more treatment failures. However, almost every case of acne can be successfully treated.
Physical methods and prescription medications that dermatologists use to treat severe acne include:
More About Treating Acne
Acne Medications Not for Use During Pregnancy
Some potent acne medications must not be used by women who are pregnant or who may become pregnant because of the potential harm to a fetus. These medications include:
- Hormonal therapy – estrogen, flutamide, spironolactone
Women in their child-bearing years need to avoid pregnancy while using these medications.
Acne Therapies
Over-the-Counter Products
Used to treat mild, moderate and severe acne, the effectiveness of over-the-counter medications lies in the product’s active ingredient(s). Not all active ingredients work the same way. The active ingredient benzoyl peroxide reduces P. acnes; whereas, salicylic acid helps correct abnormal skin shedding. For lesions to clear, the product(s) must be effective against the factor(s) causing the acne. The following describes common active ingredients used in over-the-counter acne medications sold in the United States. Check with your dermatologist or pharmacist before combining acne products.
Alcohol and acetone
Found together in some over-the-counter medications used to treat acne, acetone works as a degreasing agent and alcohol has mild antimicrobial properties. When used alone, acetone tends to have no effect.
Benzoyl peroxide
The mainstay of over-the-counter acne treatment, benzoyl peroxide works to clear up acne by reducing P. acnes and removing dead cells from the skin to prevent comedones. It was one of the first agents found to be effective in treating mild acne and has been used in acne treatment for decades. The principal side effect is excessive dryness of the skin, so be sure to follow directions and not use more than stated unless otherwise instructed by a physician. Care should also be taken when applying it to avoid the bleaching effect. Benzoyl peroxide has been known to bleach hair, sheets, towels and clothing. For this reason, an old shirt should be worn after applying benzoyl peroxide to acne on the back or chest. Benzoyl peroxide is available over-the-counter as a lotion or gel. Use of benzoyl peroxide should be continued after acne clears to prevent new lesions from forming.
“Herbal,” “organic” and "natural" products
Over-the-counter products labeled “herbal,” "organic" or "natural" are marketed as acne treatments but their effectiveness has rarely been tested in clinical trials. The value of such treatments is generally unknown.
Resorcinol
A popular ingredient in over-the-counter acne medications, resorcinol controls small acne lesions and is frequently combined with sulfur in over-the-counter products.
Salicylic acid
Effective in treating non-inflammatory acne lesions, salicylic acid helps correct the abnormal shedding of skin cells and unclog pores to resolve and prevent lesions. Salicylic acid does not have any effect on sebum production or P. acnes. Like benzoyl peroxide, salicylic acid must be used continuously. Once stopped, pores clog and acne returns. Salicylic acid is found in many over-the-counter acne products, including lotions, creams and pads. It may be irritating to the skin.
Sulfur
Sulfur has been used for more than 50 years in combination with other agents, such as alcohol, salicylic acid and resorcinol and is found in many over-the-counter acne medications. While long used to treat acne, it is not known how sulfur works to clear acne. Due to its unpleasant odor, sulfur is not frequently used alone as an acne treatment.
