Who treats acne?

A general healthcare provider or a dermatologist can diagnose and treat acne. If you have stubborn acne that doesn't improve with treatment, a dermatologist can help.

 

How severe can acne get?

Acne is ranked by severity:

Grade 1 (mild): Mostly whiteheads and blackheads, with a few papules and pustules.

Grade 2 (moderate or pustular acne): Multiple papules and pustules, mostly on your face.

Grade 3 (moderately severe or nodulocystic acne): Numerous papules and pustules, along with occasionally inflamed nodules. Your back and chest may also be affected.

Grade 4 (severe nodulocystic acne): Numerous large, painful and inflamed pustules and nodules.

How is acne treated?

There are several ways to treat acne. Each type of treatment varies based on your age, the type of acne you have and the severity. A healthcare provider might recommend taking oral medications, using topical medications or using medicated therapies to treat your skin. The goal of acne treatment is to stop new pimples from forming and to heal the existing blemishes on your skin.

Topical acne medications

Your healthcare provider may recommend using a topical acne medication to treat your skin. You can rub these medications directly onto your skin as you would a lotion or a moisturizer. These could include products that contain one of the following ingredients:

Benzoyl peroxide: This is available as an over-the-counter product (such as Clearasil, Stridex and PanOxyl) as a leave-on gel or wash. It targets surface bacteria, which often aggravates acne. Lower concentrations and wash formulations are less irritating to your skin.

Salicylic acid: This is available over the counter for acne as a cleanser or lotion. It helps remove the top layer of damaged skin. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging.

Azelaic acid: This is a natural acid found in various grains such as barley, wheat and rye. It kills microorganisms on the skin and reduces swelling.

Retinoids (vitamin A derivatives): Retinol, such as Retin-A, Tazorac and Differin, which is available without a prescription, breaks up blackheads and whiteheads and helps prevent clogged pores, the first signs of acne. Most people are candidates for retinoid therapy. These medications aren't spot treatments and must be used on the entire area of skin affected by acne to prevent the formation of new pimples. You often need to use these for several months before noticing positive results.

Antibiotics: Topical antibiotics like clindamycin and erythromycin control surface bacteria that aggravate and cause acne. Antibiotics are more effective when combined with benzoyl peroxide.

Dapsone: Dapsone (Aczone) is a topical gel, which also has antibacterial properties. It treats inflamed acne.

Oral acne medications

Oral acne medications are pills that you take by mouth to clear your acne. Types of oral acne medications could include:

 

Antibiotics: Antibiotics treat acne caused by bacteria. Common antibiotics for acne include tetracycline, minocycline and doxycycline. These are best for moderate to severe acne.

Isotretinoin (Amnesteem, Claravis and Sotret): Isotretinoin is an oral retinoid. Isotretinoin shrinks the size of oil glands, which contributes to acne formation.

Contraceptives: The use of certain contraceptives can sometimes help women and people AFAB who have acne. The U.S. Food and Drug Administration (FDA) approved several types of birth control pills for treating acne. Some brand names include Estrostep, Beyaz, Ortho Tri-Cyclen and Yaz. These pills contain a combination of estrogen (the primary AFAB sex hormone) and progesterone (a natural form of steroid that helps regulate menstruation).

Hormone therapy: Hormone therapy is helpful for some people with acne, especially if you experience acne flare-ups during menstruation or irregular periods caused by excess androgen (a hormone). Hormone therapy consists of low-dose estrogen and progesterone (birth control pills) or a medication called spironolactone that blocks the effect of certain hormones at the level of your hair follicles and oil glands.

Additional acne therapies

If topical or oral medications don't work well for your acne or if you have scars from your acne, a healthcare provider may recommend different types of acne therapies to clear your skin, including:

Steroids: Steroids can treat severe acne with injections into large nodules to reduce inflammation.

Lasers: Lasers and light therapy treat acne scars. A laser delivers heat to the scarred collagen under your skin. This relies on your body's wound-healing response to create new, healthy collagen, which encourages growth of new skin to replace it.

Chemical peels: This treatment uses special chemicals to remove the top layer of old skin. After removal of the top layer of skin, new skin grows in smoother and can lessen acne scars.

HIFU- High intensity focussed ultrasound delivers elivers heat to the scarred collagen under your skin. This relies on your body's wound-healing response to create new, healthy collagen, which encourages growth of new skin to replace it.

How do antibiotics treat acne?

Antibiotics are medications that target bacteria. Some used to treat acne also can decrease inflammation. Bacteria can clog your pores and cause acne. Antibiotics are responsible for:

Blocking bacteria from entering your body.

Destroying bacteria.

Preventing bacteria from multiplying.

A healthcare provider will recommend antibiotics if you have acne caused by bacteria or if you have an infection. Antibiotics get rid of an infection if bacteria gets into a popped pimple, which can swell and become painful. This medication isn't a cure for acne and you shouldn't take it long-term to treat acne.

 

How can I make my acne go away at home?

If you have acne, you can start an at-home skin care routine to help your acne go away by:

Washing your skin at least once daily with warm (not hot) water and a gentle cleanser. Cleansers are over-the-counter skin care products that help clean your skin.

Washing your skin after you exercise or sweat.

Avoid using skin care products with alcohol, astringents, toners and exfoliants, which can irritate your skin.

Removing your makeup at the end of the day or before you go to bed.

Choosing an oil-free moisturizer to apply on your skin after cleansing.

Avoid popping, picking or squeezing your acne. Let your skin heal naturally to prevent scars from forming on your skin.

If your at-home skin care routine isn't effective at treating acne, visit a healthcare provider.

 

Is acne treatment safe for people who are pregnant?

Many topical and oral acne treatments aren't safe to take during pregnancy. If you're pregnant or planning on becoming pregnant, it's important to discuss acne treatments with your healthcare provider and notify them if you become pregnant.

 

How long does it take for acne to go away?

On average, it can take between one to two weeks for acne pimples to clear up on their own. With medicated treatment and a good skin care routine, you can speed up your body's healing time to make acne go away faster. For severe acne, it can take several weeks for your acne to go away, even with treatment.

How can I prevent acne?

You can't completely prevent acne, especially during hormone changes, but you can reduce your risk of developing acne by:

 

Washing your face daily with warm water and a facial cleanser.

Using an oil-free moisturizer.

Wearing "noncomedogenic" makeup products and removing makeup at the end of each day.

Keeping your hands away from your face.

What can I expect if I have acne?

Acne often goes away in early adulthood, though some people will continue to experience acne throughout adulthood. Your healthcare provider or a board-certified dermatologist can help you manage this condition. Various medications and therapies are effective forms of treatment. They target the underlying factors that contribute to acne. It may take several different types of treatment before you and your healthcare provider find one that works best for your skin. The skin care products that work for you might not work for someone else with similar symptoms.

Can acne cause scars?

Yes, sometimes acne can cause scarring. This happens when the acne penetrates the top layer of your skin and damages deeper skin layers. Inflammation makes your acne pores swell and the pore walls start to breakdown, which causes skin damage. Scarring can be a source of anxiety, which is normal. Before treatment, your healthcare provider will determine what type of acne caused your scars. There are several treatment options available for acne scars.